''Evidence-based medicine doesn't rely on clinical insight, medical training or personal experience.''
Here you are comparing apples to oranges. First, the general body of science based information is gathered by a broad representation of professionals from the basic sciences (chemistry, biology, biochemistry, physiology…), research physicians, tenured faculty, practicing doctors to name some. It is from this body of evidence and understanding that medicine needs to rely.
''When evidence from a clinical trial suggests that one therapy is superior to another, it can be used to change prevailing medical practice. The effects of this information requires that some medical specialties and medical suppliers lose income while others gain income. And sometimes evidence may be preliminary rather than well established so that their long-term effects are not known.''
''The "establishment" itself (NCI) has stated on its official cancer information website on "state of the art" chemotherapy, it is unclear whether single-agent or combinations of drugs is preferable for first-line treatment. No data support the superiority of any particular regimen.''
Decision analysis is the application of explicit, quantitative methods to analyzing decisions under conditions of uncertainty. Decision analysis allows clinicians to compare the expected consequences of pursuing different strategies.”
“Similar results were report by Crowley et al in 2003. The CAR study showed that of 520 clinical questions for which answers were sought in the medical literature, in 53% of these cases the literature confirmed the management decision, but in 47% of these cases the literature changed the medication, diagnostic test, or prognostic information given to the patient. (
“The medical literature is immense, but only a small portion of it is immediately useful in answering clinical questions. The literature reports the whole spectrum of the scientific research process -- the long journey from in-vitro studies to double-blind randomized controlled trials. This has been called the "wedge of evidence" or the "pyramid of evidence."
“An understanding of how various levels of evidence are reported and how this literature is organized will help the searcher retrieve the highest levels of evidence for a particular clinical question. High levels of evidence may not exist for all clinical questions because of the nature of medical problems and research and ethical limitations.”