Evidence-based medicine as Bayesian decision-making

We review two recent trends: the emergence of evidence‐based medicine and the growing use of Bayesian statistics in medical applications. Evidence‐based medicine requires an integrated assessment of the available evidence, and associated uncertainty, but there is also an emphasis on decision‐making, for individual patients, or at other points in the health‐care system. This demands consideration of the values and costs associated with potential outcomes. We argue that the natural statistical framework for evidence‐based medicine is a Bayesian approach to decision‐making that incorporates an integrated summary of the available evidence and associated uncertainty with assessment of utilities. We outline a practical agenda for further development. Copyright © 2000 John Wiley & Sons, Ltd.