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SJHC e-Library: Evidence-Based Medicine

INTRODUCTION

Evidence-Based Medicine (EBM) is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. [BMJ.1996;312(7023): 71-72]

evidence based medicine

Individual clinical expertise means the proficiency and judgment that individual clinicians acquire through clinical experience and practice. This requires using clinical skills and past experience to rapidly identify each patient's unique health state and diagnosis, their individual risks and benefits of potential interventions, and their personal values and expectations. 

External clinical evidence means clinically relevant research, often from the basic sciences of medicine, but especially from patient centred clinical research into the accuracy and precision of diagnostic tests (including the clinical examination), the power of prognostic markers, and the efficacy and safety of therapeutic, rehabilitative, and preventive regimens. External clinical evidence both invalidates previously accepted diagnostic tests and treatments and replaces them with new ones that are more powerful, more accurate, more efficacious, and safer. [BMJ.1996;312(7023): 71-72]

Patient values are the unique preferences, concerns and expectations each patient brings to a clinical encounter and which must be integrated into clinical decisions if they are to serve the patient. 

When these three elements are integrated, clinicians and patients form a diagnostic and therapeutic alliance which optimizes clinical outcomes and quality of life. [What is EBM, Center for Evidence-Based Medicine, Toronto]

USING EBM

1) Define the question (PICO)

2) Determine the most valuable article types

3) Search for evidence

Learn more from external tutorials and resources



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George Pennal Library, St. Joseph's Health Centre, Toronto, Ontario, Canada.