Is 'evidence-based medicine' a system in crisis?

I shall give them my "very hard stare" over the top of my glasses. The judges say they think it's intimidating

Go Galen
Hope the arm's better soon (medicinal of course)

Good idea, jane. I might just do that.

I heard an interview on the radio discussing how variably different individuals react to the same drugs for the same diagnosis and discussing how our genes as well as influencing the illnesses we are more likely than average to develop also influences how we respond to drugs.

Evidence based medicine is fine if you fall in the broad band of people who respond to any specific medication as expected, but there will always be a group of people who do not respond to any given medication as predicated but would respond to the medication that only helped a small group of people.

I say this with some feeling my reactions to medications can be very variable. I am allergic to penicillin. I over respond to some drugs, like steroids, and others have no effect on the condition they are supposed to remedy.

flickety good point. I reacted very badly to HRT - it caused such breast pain that I would walk to work in the mornings with tears streaming down my cheeks. Encouraged by the doctor (who was trying to be helpful of course because of my menopausal symptoms) I persevered (and changed brands, dosage etc etc) until I realised exactly what it was, stopped taking it and the breast pain disappeared. Years later, when I was desperate I tried it again and within a day or two the breast pain was back.

Yet thousands and thousands of women take those drugs and have little or side effects and all the positives.

EBM absolutely has to be nuanced for the individual.