Evidence-Based Medicine in the Domain of Nuclear Medicine, the Fifty-Year View

The discipline of evidence-based medicine (EBM), though yet unnamed, was in its infancy when Seminars in Nuclear Medicine was inaugurated in 1971; commemorating the golden anniversary of this prestigious journal and the contemporaneous reign of its editors by publishing a 50-year historical consideration of EBM seems most apropos. EBM should be understood as a system of methods to eliminate partiality and improve the quality of evidence in the performance and review of data; much of EBM revolves around ensuring that conclusions are derived from rigorous research studies that protect against bias and are widely generalizable to other groups of patients. Subdomains within EBM that we will survey in this review include methods of performing and evaluating primary studies, standards of reporting of medical studies, methods of combining and aggregating data, and finally, methods of creating clinical practice guidelines. While many practitioners of nuclear medicine may not presently be familiar with the innovations of EBM, having been introduced after their formal education was completed, with the eventual arrival of more-recently trained staff, firm recommendations from our primary research journals, and with efforts to educate practicing physicians, this shortcoming is being addressed.