How to Discuss Evidence-Based Medicine Honestly: Translating Research for Clients by Jayney Goddard, MSc, PG Dip Ed, FCMA, FRSM, Founder and President, The Complementary Medical Association. This article is valued at one hour of CMA CPD.

The CMA is known and respected the world over for our commitment to promoting the evidence base for complementary medicine. We firmly believe thatf few skills do more for a complementary practitioner’s credibility than the ability to talk about evidence well. Done badly, it pulls in one of two directions: over-claiming, where a modality is presented as proven beyond what the research supports, or dismissing, where evidence is waved away as irrelevant to “real-world” practice. Both erode trust – with clients, with conventional colleagues, and ultimately with the public whose confidence the whole sector depends on.

Done well, discussing evidence with clients becomes one of the most powerful demonstrations of professionalism you can offer. It signals that you take your work seriously, that you respect your client’s intelligence, and that you have nothing to hide. This article sets out why honest evidence conversations matter, the principles that underpin them, and a practical framework you can use in the treatment room. It closes with a short reflective practice exercise – valued at one hour of CMA CPD.

Why a discussion of evidence-based medicine matters for every part of our community

This is not a skill reserved for senior practitioners. It runs through every stage of a career and every part of the CMA community. Students need it instilled early, before less helpful habits form. Training schools that teach it well send graduates into practice who can hold their own in any professional conversation. Clinic owners benefit from a team whose evidence talk is consistent and defensible. And practitioners use it daily, often without realising how much a single well-judged sentence shapes a client’s confidence and outcome.

It also sits at the heart of what The CMA stands for. As an independent standards-setting body, our authority rests on the integrity of how our Members represent their work. Honest communication about evidence is not a constraint on good practice – it is good practice.

What “evidence-based medicine” actually means

A common misunderstanding, on both sides of the conventional/complementary divide, is that “evidence-based” means “proven by randomised controlled trials.” It never did. The phrase was popularised by David Sackett and colleagues, who in a now-famous 1996 editorial defined evidence-based medicine as the integration of three things: the best available external evidence, the clinician’s own expertise, and – crucially – the individual patient’s values and preferences.¹

That third pillar is often forgotten, yet it is where complementary and integrative practice frequently excels. Evidence does not make decisions; people do, in the light of evidence. When you explain to a client that a particular approach has promising but limited trial support, that your clinical experience suggests it helps people like them, and that the choice rests with them, you are not falling short of the evidence-based standard. You are meeting it precisely as its originators intended.

It also helps to understand that evidence exists on a spectrum of strength rather than as a simple yes/no. Systematic reviews and meta-analyses sit at the top, followed by randomised controlled trials, then observational studies, and finally case reports and expert opinion. No single hierarchy is universally agreed, but the broad principle is widely shared, and modern frameworks such as GRADE – now used by the World Health Organization and the National Institute for Health and Care Excellence (NICE) – grade the certainty of evidence in a structured, transparent way.² The practical point for practitioners is simple: some forms of evidence carry more weight than others, and being able to say where a given claim sits on that spectrum is a mark of competence, not weakness.

The two traps: over-claiming and dismissing

Over-claiming is the more obvious danger. It includes stating that a therapy “treats” or “cures” a named condition when the evidence does not support it, citing a single small study as though it were definitive, or borrowing the authority of science (“studies show…”) without being able to say which studies, how good they were, or what they actually found. Beyond the regulatory and ethical risks, over-claiming sets clients up for disappointment and damages the reputation of the whole field.

Dismissing is subtler and often well-intentioned. It shows up as “research can’t capture what we do,” or treating the absence of trial evidence as though it were positive proof of effect. Some of these points contain genuine truths – conventional trial design really does struggle with individualised, multi-component interventions – but used as a blanket shield against scrutiny, they read as evasive. The honest position acknowledges the limitations of the evidence base and takes it seriously.

A practical framework: the five-point evidence check

Before making any evidence-related statement to a client, run it through these five checks. With practice, it takes seconds and becomes second nature.

1. Source. Where does this claim actually come from? Can you name the study, review, or guideline – or are you repeating something you absorbed second-hand? If you cannot trace it, do not assert it.
2. Strength. Where does the evidence sit on the spectrum? A systematic review and a single anecdotal case are not the same currency. Be honest about what you are dealing with.
3. Scope. What does the evidence actually claim – and for whom? Evidence for one population, dose, or outcome does not automatically transfer to another. Watch for quietly widening the claim beyond what was studied.
4. Significance. Is the effect meaningful in real life, not just statistically detectable? And is it relevant to this client in front of you, with their particular circumstances and goals?
5. Speech. Can you phrase it honestly? Calibrated language – “there’s promising early evidence that…”, “some studies suggest…”, “we don’t yet have strong evidence, but in my experience…” – conveys far more authority than overstated certainty ever could.

The five checks work as much by what they prevent as by what they produce. If a statement fails on source or strength, that is your signal to soften the claim, not to drop the subject. Clients rarely expect certainty. What builds lasting trust is a practitioner who is visibly trustworthy about the limits of what they know.

Putting it into language

‘Honest’ does not mean ‘discouraging’. Compare “this will fix your insomnia” with “there’s reasonable evidence this approach helps a lot of people sleep better, though it doesn’t work for everyone – shall we try it and see how you respond?” The second is more truthful, more professional, and – because it sets realistic expectations – more likely to leave the client satisfied. Calibrated honesty and warm encouragement are not in tension. The most reassuring thing a practitioner can be is believable.

Reflective practice

Set aside ten minutes to reflect on your own evidence conversations. Recall a recent moment when you described what a treatment could do for a client. Which way did you lean – towards over-claiming or towards dismissing the evidence base – and what prompted it? Run that same statement through the five-point check now: how would you phrase it differently? Finally, identify one claim you make routinely in practice and commit to tracing its source this week. Note what you find, and whether it changes how you talk about it. Keeping a brief record of these reflections will build the habit far faster than intention alone, and provides valuable evidence of CPD.

Remember to log into your CMA membership portal in order to be able to keep a record of your CPD activities.

References

1. Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ. 1996;312(7023):71–72. Available at: https://www.bmj.com/content/312/7023/71 (full text: PMC2349778).
2. Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924–926. Available at: https://www.bmj.com/content/336/7650/924.

Further reading

You’ll find many more fascinating articles that the CMA has produced over the years, all of which are fully evidence-based, here on The CMA website. If you are particularly interested in looking into evidence for conditions, therapies, and more, please navigate to our Learn section from the top header.

The practical handbook

How to Read a Paper: The Basics of Evidence-Based Medicine and Healthcare (6th edition, 2019) by Trisha Greenhalgh. A clear, widely used introduction that walks readers through each step of appraising a research paper, from searching the literature to assessing methodological quality and statistics. The friendliest starting point, especially for students or anyone who finds research papers intimidating. British author (Oxford), so the framing fits a UK readership well. WileyAmazon

The clinician’s reference

Evidence-Based Medicine: How to Practice and Teach EBM (5th edition, 2018) by Straus, Glasziou, Richardson and Haynes. A short, practical classic for busy clinicians at any career stage, emphasising direct clinical application of EBM in real time. Two of its authors co-wrote the original 1996 definition of evidence-based medicine. More technical than Greenhalgh, so it suits established practitioners and training schools building a curriculum.

The accessible primer (free to read)

Testing Treatments: Better Research for Better Healthcare (2nd edition, 2011) by Evans, Thornton, Chalmers and Glasziou. Free to download as a PDF and also free to read on the NCBI Bookshelf. It tackles how we know whether a treatment really works, how reliable the evidence is, and how to make research serve patients’ needs, using vivid real-world examples aimed at both patients and professionals.

For the reflective reader: EBM’s own limitations

Greenhalgh T, Howick J, Maskrey N. “Evidence based medicine: a movement in crisis?” BMJ 2014;348:g3725. This influential paper argues, from within the EBM movement, that it has drifted in ways that can sideline individual patients and whole-person care — a critique that resonates strongly with complementary and integrative practice.