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Sometime ago, I polled the list for translation of the word "evidence" in non-English languages. Here is again responses I received: [Evidence is that "which enables the mind to see truth" (Webster's Dictionary)] -Evidence as "ground for belief" ,that which justifies belief (English, Arabic) -proof (Dutch, German, Spanish, Portuguese, Finnish, Hungarian ,Italian) -fact (Slavic languages, French) -witness (Hindi) -knowledge (Norwegian) -scientific (Japanese) -information (Chinese) Interestingly, the usage in English also reflects the way how the word "evidence" is translated in different languages. No wonder why there is so much misunderstanding about EBM! Ben Djulbegovic From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Ash Paul Sent: Thursday, July 07, 2011 3:55 PM To: [log in to unmask] Subject: Re: EBM Anecdote: Today's NEJM Dear Hilda, There is a very good 2010 Swiss introductory article in the Journal of German Policy Studies which resonates a lot with what you have written: Evidenced-Based Policy: A Concept in Geographical and Substantive Expansion, by Frey and Lederman http://www.spaef.com/file.php?id=1225 Regards, Ash Dr Ash Paul Medical Director NHS Bedfordshire 21 Kimbolton Road Bedford MK40 2AW Tel no: 01234897224 Email: [log in to unmask]<mailto:[log in to unmask]> > -----Original Message----- > From: Evidence based health (EBH) [mailto:[log in to unmask]<mailto:[log in to unmask]>] On Behalf Of Bastian, Hilda (NIH/NLM/NCBI) [C] > Sent: 07 July 2011 16:26 > To: [log in to unmask]<mailto:[log in to unmask]> > Subject: Re: EBM Anecdote: Today's NEJM > > G'day! > > I think this is one of the problems with the word "evidence": so many people see any "fact" as "evidence", because that is, as you say, how the word is used elsewhere (as in "evidence of my own eyes"). However, an RCT, because it is a formal experiment, has probative value. That's a critical distinction that used to be made where I first learned about evidence - which was when I worked in courts. Just because information is organised and systematic, does not necessarily mean it has probative value. > > Yet, some of us see the word "evidence" as meaning "proof" (ie having probative value), but most people probably don't. It's often pointed out that evidence doesn't mean proof in languages other than English - but it doesn't really mean only specifically that in English either. > > In the world outside the EBM field, an eyewitness account and even circumstantial evidence are still evidence. It's a more complicated word in English than we think, and the community view of it must surely be more influenced by the legal use of the word (especially in a world where police and legal procedural TV shows are so widespread and popular), than by any re-purposing of the word health care tries to make. > > And that includes the different idea of the onus of proof. I had absorbed clearly when I worked in the courts, that proof means, more likely than not. It was called "the balance of probabilities" and it just had to tip 51%. When I entered the EBM world, I found out that "probable" in this world was set at 95% (or sometimes 90%). That's a gulf that is enormously wide. > > Suffice to say, I'm not sure evidence is a good term for what many of us mean, and I've started to avoid using it when I'm writing in English, too. > > Hilda > > > > From: "Bill Cayley, Jr"<[log in to unmask]<mailto:[log in to unmask]><mailto:[log in to unmask]<mailto:[log in to unmask]>>> > Reply-To: "Bill Cayley, Jr"<[log in to unmask]<mailto:[log in to unmask]><mailto:[log in to unmask]<mailto:[log in to unmask]>>> > Date: Thu, 7 Jul 2011 08:49:59 -0400 > To: "[log in to unmask]<mailto:[log in to unmask]><mailto:[log in to unmask]<mailto:[log in to unmask]>>"<[log in to unmask]<mailto:[log in to unmask]><mailto:[log in to unmask]<mailto:[log in to unmask]>>> > Subject: Re: EBM Anecdote: Today's NEJM > > I think the most pithy part of the article is the phrase: "Informed adverse anecdote transforms scattered data into sound clinical judgment" > > To my way of thinking (OK, so we're starting w/ anecdote already!) evidence is simply "any observation" - the difference between anecdote and RCT and meta-analysis is simply the degree to which the evidence is ORGANIZED and SYSTEMATIZED. Still, it takes real-life, clinical experience to know where to look and have the perception of nuance to know how to organize the evidence. > > Bill Cayley, Jr, MD MDiv > [log in to unmask]<mailto:[log in to unmask]><mailto:[log in to unmask]<mailto:[log in to unmask]>> > > Work: > Augusta Family Medicine > 207 W Lincoln, Augusta, WI 54722 > Tel: 715.286.2270 > Pager: 715.838.7940 > > Home: > 3604 Sharon Drive, Eau Claire, WI 54701 > Tel: 715.830.0932 > Mobile: 715.828.4636 > > A cheerful heart is good medicine... (Proverbs 17:22) > > From: Rakesh Biswas<[log in to unmask]<mailto:[log in to unmask]><mailto:[log in to unmask]<mailto:[log in to unmask]>>> > To: [log in to unmask]<mailto:[log in to unmask]><mailto:[log in to unmask]<mailto:[log in to unmask]>> > Sent: Wednesday, July 6, 2011 11:19 PM > Subject: EBM Anecdote: Today's NEJM > > To quote from: http://healthpolicyandreform.nejm.org/?p=14876&query=TOC > > "The key is to use these flashes of physician anguish to illuminate the Level I evidence and identify the real risk factors for a bad outcome. I suspect the amygdala did not evolve to store odds ratios and heterogeneity P scores, but when an adverse event has prompted me to review the literature, I come away with a clearer understanding. There's nothing like a baby free-floating in the abdomen to drive home the lessons from a prospective study of risk factors for uterine rupture. And that clarity of understanding will serve the next at-risk patient I encounter."