[Evidence-based medicine: the emerging of a new model of clinical practice. Italian Group for Evidence-Based Medicine (GIMBE)].

The introduction of the Diagnosis-Related Groups System to finance Italian hospitals has troubled not only health policy makers but also single physicians, who find themselves in the position of "resource managers" lacking adequate competence to evaluate the effectiveness of medical interventions. Given the limited economic resources and the failure of exclusively managerial-organizational-based solutions, the use of work-related methodologies able to identify and enable diagnostic and therapeutic interventions of documented efficacy for all patients has become a necessity. Evidence-based medicine is an emerging paradigm of clinical practice: promoted by the formulation of specific problems, it is implemented by the collection, interpretation and integration of research-derived evidence. This new model, which facilitates the transfer of progress made in research to clinical practice thanks to the promotion of diagnostic and therapeutic interventions of documented efficacy, can improve the effectiveness and efficiency of health care. The authors review the cultural events that have encouraged the development of this new paradigm of clinical practice, describe its methods, advantages and limits and point out differences from traditional models.