Resumen

DELGADO-NOGUERA, Mario. The pulse of paradigms: A journey towards change in medical science. Rev. colomb. anestesiol. [online]. 2025, vol.53, n.2, 1139.  Epub 27-Mar-2025. ISSN 0120-3347.  https://doi.org/10.5554/22562087.e1139.

The history of medicine is a continuum of ideas and practices, characterised by progress, error rectification, and paradigm shifts. Drawing on Thomas Kuhn's concept of "paradigm shifts," this article examines the transition in medicine from a traditional paradigm, centred on clinical expertise and authority, to the Evidence-Based Medicine (EBM) and Clinical Epidemiology (CE) model.

Before the rise of EBM, medicine functioned as "normal science," relying on pathophysiological reasoning and academic authority. However, by the mid-20th century, anomalies such as diagnostic and treatment variability exposed the limitations of the traditional paradigm. EBM introduced an evidence-based approach, emphasising objectivity, reproducibility, and risk quantification in clinical decision-making.

Despite its advancements, this new paradigm faces significant criticisms. The proliferation of low-quality studies, scientific fraud, and a perceived detachment from the human aspects of medicine represent contemporary challenges. Nonetheless, EBM has redefined clinical practice, integrating rigorous scientific methodology with patient care. It has also transformed the doctor-patient relationship, enabling personalised treatment based on probabilistic risk assessments and patient preferences.

This article highlights the need to view clinical medicine as a journey marked by challenges in clinical practice, research, and scientific evidence in the ongoing pursuit of improving healthcare.

Palabras clave : Paradigm shifts; Evidence-based medicine; Clinical epidemiology; Science; Medicine.

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