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On the 90’ a shift is observed in some diseases patron: new diseases appear
(AIDS, Ebola virus), those related with ageing increase and others emerge (TB,
pneumonia, syphilis, etc) while consumers’ expectations and demands become
more intensive. The increasing costs and the need to control them force the
health care managers to create special agencies to evaluate health technologies.
In 1992, the Department of Biostatistics and Epidemiology of McMaster’s
University creates the Evidence Based Medicine Working Group. Since 1996, Oxford
lodges the Centre for EB Medicine and the Centre for EB Nursing.
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