Evidence as Myth: Cognitive Traps of Evidence-Based Medicine in the Age of Scientific Absolutism. Reflections of a Clinician | Ukrainian Medical Journal

Stavytskyi V.V.

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Evidence as Myth: Cognitive Traps of Evidence-Based Medicine in the Age of Scientific Absolutism. Reflections of a Clinician

Evidence as Myth: Cognitive Traps of Evidence-Based Medicine in the Age of Scientific Absolutism. Reflections of a Clinician

March 4, 2026

170

Stavytskyi V.V.

УДК: 61:001

DOI: 10.32471/umj.1680-3051.273809

Keywords :

clinical expertise,

cognitive pitfalls,

epistemological boundaries,

evidence-based medicine,

mythologization of science,

randomized controlled trials

Resume

This article offers a critical analysis of evidence-based medicine’s (EBM) transformation from a methodological instrument into a dogmatic system acquiring the contours of a contemporary myth. It traces how the original visions of Archie Cochrane and David Sackett — initially aimed at integrating clinical expertise with scientific evidence — have been reduced to the absolutization of randomized controlled trials (RCT) and rigid hierarchies of evidence. This mythologization manifests in the substitution of historically contingent methodological constructs for universal truths, thereby obscuring EBM’s epistemological boundaries. The argument is illustrated through historical examples that reveal the inherently contextual and provisional nature of «evidence». The text further unpacks cognitive pitfalls endemic to the paradigm: the uncritical elevation of meta-analyses despite pervasive publication bias; the tension between population-level statistics and individualized patient care; and the ethical paradoxes embedded in RCT design. Special attention is devoted to the commercialization of «evidence» and the recent Cochrane Collaboration scandal. Evidence-based medicine must remain a supportive tool within the clinician’s repertoire — thoughtfully integrated with professional judgment and patient values — rather than ossifying into dogma that fosters the illusion of mastering nature’s irreducible unpredictability.

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