Apologies for these musings. Others probably pointed out the problems long ago.
A problem seems to be that the term "evidence based medicine" is made to suffice for both "the whole" and "the part".
As described by Sackett in the paper referred to above "Evidence based medicine" is a system in which medical practice with varying degrees of supporting evidence is ranked according to the general quality of evidence of a particular type.
Usually when "evidence based medicine " is used in general parlance the term is used to describe evidence belonging to one of the particular types.
Thus, for example, practice supported by meta- analysis is one type of evidence based medicine; that supported by anecdotal expert opinion is a different type.
It might be helpful if Sackett's use were referred to as Evidence Based Medicine, and the other type had an adjective attached to describe it as "best", "good", "moderate" or "poor". So one might say "moderate-evidence based medicine".
There is then a problem in that that description would only refer to general evidence of that class. It would not refer to the quality of the particular evidence supporting the practice. Thus one might have a poor example from a moderate class, but to suggest that people use the term "poor moderate-evidence based medicine" might be a step too far.
A problem seems to be that the term "evidence based medicine" is made to suffice for both "the whole" and "the part".
As described by Sackett in the paper referred to above "Evidence based medicine" is a system in which medical practice with varying degrees of supporting evidence is ranked according to the general quality of evidence of a particular type.
Usually when "evidence based medicine " is used in general parlance the term is used to describe evidence belonging to one of the particular types.
Thus, for example, practice supported by meta- analysis is one type of evidence based medicine; that supported by anecdotal expert opinion is a different type.
It might be helpful if Sackett's use were referred to as Evidence Based Medicine, and the other type had an adjective attached to describe it as "best", "good", "moderate" or "poor". So one might say "moderate-evidence based medicine".
There is then a problem in that that description would only refer to general evidence of that class. It would not refer to the quality of the particular evidence supporting the practice. Thus one might have a poor example from a moderate class, but to suggest that people use the term "poor moderate-evidence based medicine" might be a step too far.