BACKGROUND Expertise has been a contentious concept in Evidence-Based Medicine (EBM). Especially in the early days of the movement, expertise was taken to be exactly what EBM was rebelling against-the authoritarian pronouncements about "best" interventions dutifully learned in medical schools, sometimes with dire consequences. Since then, some proponents of EBM have tried various ways of reincorporating the idea of expertise into EBM, with mixed results. However, questions remain. Is expertise evidence? If not, what is it good for, if anything? METHODS In this article, I describe and analyze the three historical models of expertise integration in EBM and discuss the difficulties in putting each into practice. I also examine accounts of expertise from disciplines outside of medicine, including philosophy, sociology, psychology, and science and technology studies to see if these accounts can strengthen and clarify what EBM has to say about expertise. RESULTS Of the accounts of expertise discussed here, the Collins and Evans account can do most to clarify the concept of expertise in EBM. CONCLUSIONS With some additional clarification from EBM proper, theoretical resources from other disciplines might augment the current EBM account of expertise.

中文翻译：

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循证医学专业知识：三个模型的故事。

背景技术专业知识在循证医学（EBM）中一直是一个有争议的概念。尤其是在运动的早期，专业知识被认为正是循证医学所反对的——在医学院尽职尽责地学到的关于“最佳”干预措施的独裁声明，有时会带来可怕的后果。从那时起，EBM 的一些支持者尝试了各种方法将专业知识的理念重新融入到 EBM 中，但结果好坏参半。然而，问题仍然存在。专业知识是证据吗？如果没有的话，它有什么好处（如果有的话）？方法在本文中，我描述和分析了EBM中专业知识整合的三种历史模型，并讨论了将每种模型付诸实践的困难。我还研究了医学以外学科的专业知识，包括哲学、社会学、心理学和科学技术研究，看看这些描述是否可以加强和澄清 EBM 对专业知识的看法。结果 在此处讨论的专业知识描述中，柯林斯和埃文斯的描述最能阐明 EBM 中的专业知识概念。结论 通过 EBM 本身的一些额外澄清，来自其他学科的理论资源可能会增强当前 EBM 的专业知识。