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EBM

Is the ability to access, assess and apply the best evidence from systematic research information to daily clinical problems after integrating them with the physician's experience and patient's value.

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EBM

  1. 1. EVIDENCE BASED MEDICINE Dr. Dalia El-Shafei Assistant professor, Community Medicine Department, Zagazig University
  2. 2. LEARNING OBJECTIVES: 1. Define Evidence Based Medicine (EBM). 2. Demonstrate the steps of EBM. 3. List its importance and limitations.
  3. 3. IMPORTANT QUESTIONS What is the purpose of medicine? How do I decide what to do? You have to know where you’re going before deciding how to get there.
  4. 4. WHAT IS THE PURPOSE OF MEDICINE? Improving the quality of patients’ lives Research Public health Patient care
  5. 5. EVIDENCE BASED MEDICINE (EBM) Is the ability to access, assess and apply the best evidence from systematic research information to daily clinical problems after integrating them with the physician's experience and patient's value.
  6. 6. It is a process of lifelong, self- directed, problem- based learning (PBL). It is the conscientious, explicit & judicious use of current best evidence in making decision about the care of individual patients. May be extended to benefit not only individual patients or even health care services in the community.
  7. 7. WHAT IS EVIDENCE-BASED MEDICINE? EBM is the conscientious (meticulous), explicit (Clear) and judicious (Careful & wise) use of current best evidence in making decisions about the care of individual patients.
  8. 8. EBP is not about conducting research it is about USING RESEARCH
  9. 9. WHY EVIDENCE-BASED PRACTICE? Information overload and time constraints Need high quality, filtered information to make informed decisions Value of scientific knowledge for decision making Decisions should not be based only on intuition, opinion or unreliable information
  10. 10. Application of EBM into clinical decisions enhances the opportunity for optimal clinical outcomes & quality of life.
  11. 11. THE BEST AVAILABLE CLINICAL EVIDENCE Usually found in a clinically relevant epidemiological research that has been conducted using sound methodology. The evidence in literatures, by itself does not make a decision for the clinicians, but it can help support the patient care process.
  12. 12. PHYSICIAN'S CLINICAL EXPERTISE Refers to the clinician’s cumulated experience, education and clinical skills. Education Skills Experience Clinical expertise
  13. 13. EBM PROCESS “THE 6 AS” Assess patient Ask clinical question Acquire the evidence(s) Appraise the evidence(s) Apply the best evidence Assess your performanc e
  14. 14. • Start with the patient -- a clinical problem or question arises from the care of the patient ASSESS the patient • Construct a well-built clinical question derived from the case ASK the question • Select the appropriate resource(s) & conduct a search ACQUIRE the evidence • Appraise that evidence for its validity (closeness to the truth) & applicability (usefulness in clinical practice) APPRAISE the evidence • Return to the patient -- integrate that evidence with clinical expertise, patient preferences & apply it to practice APPLY: talk with the patient • Evaluate your performance with this patient ASSESS "Self- evaluation”
  15. 15. BARRIERS TO EBP Access & availability to information Limited time Lack of EBP skills Confidence in the value of the evidence Support from management Conflict with client centered philosophy of OT
  16. 16. EBM Definition Importance The “3” Pillars Process “the 6 As” Barriers

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