An integral methodological pluralism framework for evidence-based medicine

The practice of evidence-based medicine (EBM) is the process of systematically applying higher order critical thinking principles to diagnostic and therapeutic decision making. While the original principles of EBM emphasize the role of patient preferences, cultural values, and system issues in healthcare decisions, many critics of EBM suggest that this approach only recognizes research originating from an empirical perspective. Integral Methodological Pluralism (IMP) has the potential to improve EBM by expanding the breadth of medically usable knowledge without sacrificing depth or rigor of truth validation. The best evidence from all eight zones of IMP becomes relevant to medical practice and is balanced in the service of individual patient care and population outcomes. There is an opportunity to improve the practice of medicine through the integration of the insights of IMP into the principles of EBM. This article offers an exploratory framework of what that integration might look like.