Conclusions
To the extent that the central to the epistemology of EBM is that what
is justifiable or reasonable to believe depends on
CoE1, our findings indicate urgent need to refine
current EBM critical appraisal methods. If EBM is going to flourish, it
is crucial to develop methods with capacity to categorize CoE to
reliably differentiate between magnitude effects that are potentially
biased from those that are accurate and trustworthy. The major
opportunity, therein, lies in addressing the main limitations of this
study- carefully and painstakingly discerning various aspects of CoE
(from the components related to study limitations/risk of bias to
inconsistency, imprecision, or indirectness) to better characterize CoE
and its relationship to the magnitude of effects of health
interventions.