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              <p>Introduction. La médecine fondée sur les preuves (EBM) est la pierre angulaire de la décision médicale partagée. Le public mérite des informations claires, transparentes et dignes de confiance sur l’efficacité des médicaments. Pourtant, aujourd’hui, de nombreux médicaments sont prescrits et utilisés sans preuve solide de leur efficacité. Les essais cliniques randomisés (ECR) et leurs méta-analyses sont les meilleures études pour évaluer l’efficacité des médicaments et leurs effets indésirables, mais leurs résultats ne sont pas facilement interprétables en pratique et sont même parfois discutables par rapport aux données retenues. Dans une approche de décision médicale partagée, les médecins généralistes ont besoin que l’évaluation des médicaments soit fondée sur des résultats importants et pertinents pour le patient. L’objectif du projet Rebuild the Evidence Base (REB) est de combler le fossé entre les données nécessaires à la pratique clinique et les données disponibles de la recherche clinique.Méthodes et analyses. Les médicaments seront évalués selon des critères cliniques importants pour les patients et dans une population donnée. En utilisant les outils Cochrane, pour chaque population et critère d’évaluation choisis, seront réalisées : 1. une méta-analyse, fondée sur des essais contrôlés randomisés (ECR) avec un faible risque global de biais ; 2. l’évaluation des résultats issus des ECR de confirmation ; 3. l’évaluation de l’hétérogénéité statistique entre essais (I2), et 4. l’évaluation du risque de biais de publication. En fonction des résultats de ces analyses, les preuves seront évaluées selon quatre niveaux : preuve solide, résultat probant mais à confirmer, signal à confirmer, ou absence de preuve.Conclusion. Le projet REB propose une méthode de lecture et d’interprétation des essais cliniques randomisés et de leur méta-analyse afin de produire des données de qualité permettant aux médecins généralistes de se centrer sur l’évaluation du bénéfice-risque dans l’intérêt des patients. Si ces données n’existent pas, cela permettra à la recherche clinique de mieux définir ses objectifs.</p>
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