When To Use EBM
- Solve clinical problems.
- Develop focused clinical questions concerning the patient’s problem.
- Search primary and secondary literature for relevant articles.
- Integrate evidence from published research into patient care; judging relevance to the individual patient.
- Apply the results in clinical practice to each patient encountered.
- Process of life-long, problem-based learning.
Hierarchy of Evidence
The hierarchy of evidence pyramid provides a means to visualize the levels of evidence as well as the amount of evidence available. Systematic reviews and meta-analyses are the highest level of evidence therefore they are at the top of the pyramid but they are also the least common because they are based on the studies below them. Moving down the pyramid, the amount of studies increases but the level of evidence decreases.
EBM Cyle
1. Ask a question - a clinical problem/question arises out of the care of the patient. Construct a relevant, answerable question derived from the case (PICO).
3. Acquire Evidence - Select the appropriate POC tool(s) and conduct a search
4. Critical Appraisal - appraise the evidence for its validity (closeness to the truth), applicability (usefulness in clinical practice) and relevance (usefulness for that particular patient
5. Apply Evidence - Return to the patient - integrate that evidence with clinical expertise, patient preferences, and apply it to practice
6. Self-Assess- Evaluate your performance with this patient
Visualizing Evidence for EBM
Need Help?
What is EBM?
EBM Pyramid
The use of the hierarchy of evidence pyramid is not enough to determine the quality of research because study types can vary in quality whether it is a systematic review or a case study therefore critical appraisal skills are required to evaluate all types of evidence regardless of their level.