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Evidence based medicine

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Hesham Gaber

The document discusses evidence-based medicine and sources for clinicians to find high-quality evidence. It defines evidence-based medicine as integrating the best available research evidence, clinical expertise, and patient values. Randomized controlled trials are considered the gold standard for assessing new interventions. The document recommends searching multiple sources of varying methodological rigor, from the Cochrane Library which systematically reviews randomized trials, to UpToDate, Clinical Evidence, evidence-based guidelines, and PubMed. The key is finding the best evidence available to answer clinical questions and apply results to patients.

Health & MedicineEducation
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Drilling for the Best Evidence
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Evidence based medicine

Editor's Notes

  1. Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS: Evidence based medicine: what it is and what it isn’t. BMJ 1996;312:71-2. This definition of what EBM is and isn’t has gained wide acceptance and made it easier for us to get our points across.
  2. “ Explicit , judicious , and conscientious use of current best evidence from medical care research to make decisions about the medical care of individuals ” Clinical expertise IS important! Why? Experience with patients: improves efficiency of diagnosis and treatment Improves ability to determine applicability of research data to your patients Allows consideration of patient preferences EBM is the process of systematically finding the most recent applicable research, appraising its validity, and using it as the basis for clinical decisions. Clinical Expertise improves efficiency of Dx and Rx considers patient preferences Overestimates usefulness of therapy -placebo effect - loss to follow-up “ Have not all concerned physicians been doing this (EBM) for ages... ? The steps and recommendations of the EBM acolytes reek of obfuscations and platitudes.” WKC Morgan, London, Ontario Lancet , October 28, 1995
  3. Convert clinical information needs into answerable questions. Track down the best evidence to answer question. Critically appraise evidence for its validity and usefulness. Apply results to your clinical practice. Evaluate our performance.