What is evidence-based medicine?
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"The conscientious, explicit and judicious application of current best evidence to the care of individual patients." [Sackett DL, Rosenberg WMC, Gray MJA, et al. Evidence-based medicine: what it is and what it isn't. BMJ. 312:71-72 (1996)]
Guyatt GH, Haynes RB, Jaeschke RZ, et al. Users' Guides to the Medical Literature: XXV. Evidence-based medicine: principles for applying the Users' Guides to patient care. Evidence-Based Medicine Working Group. JAMA. 2000;284(10):1290-1296. |
Evidence-based medicine is used to
- Solve clinical problems.
- Integrate evidence from published research into patient care.
- Develop focused clinical questions concerning the patient’s problem.
- Search secondary databases and the primary literature for relevant articles.
- Judge the relevance to the individual patient.
- Apply the results in clinical practice to each patient encountered.
- Process of life-long, problem-based learning.
Steps in the EBM Process
| 1. The Patient | Start with the patient – a clinical problem/question arises out of the care of the patient (use Clinical Question Worksheet/ PICO model) |
| 2. The Question | Construct a relevant, answerable question derived from the case (use Clinical Question Worksheet/PICO model) |
| 3. The Resource | Select the appropriate resource(s) and conduct a search |
| 4. The Evaluation | Appraise the evidence for its validity (closeness to the truth) and applicability (usefulness in clinical practice)(use Critical Review Form For Therapy Study worksheet) |
| 5. The Patient | Return to the patient – integrate that evidence with clinical expertise, patient preferences, and apply it to practice |
| 6. The Self-Evaluation | Evaluate your performance with this patient |
EBM Cycle, The 5 A's
