Evidence Based Medicine

What Is Evidence Based Medicine ?

“Evidence-based medicine (EBM) involves caring for patients by explicitly integrating clinical research evidence with pathophysiologic reasoning, caregiver experience, and patient preferences. EBM is a style of practice and teaching which may also help plan future research.”
David Cook

“Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. Evidence-based medicine is not “cook-book” medicine. External clinical evidence can inform, but can never replace, individual clinical expertise, and it is this expertise that decides whether the external evidence applies to the individual patient at all and, if so, how it should be integrated into a clinical decision.”
David Sackett

“Evidence based medicine requires you not only to read the right papers at the right time and then to alter your behaviour (and, what is often more difficult, the behaviour of other people) in the light of what you have found.”
Trisha Greenhalgh

“Evidence based clinical practice is an approach to decision making in which the clinician uses the best evidence available, in consultation with the patient, to decide upon the option which suits that patient best.”
Muir Gray

“The RCT is a very beautiful technique, of wide applicability, but as with everything else there are snags. When humans have to make observations there is always the possibility of bias.”
Archibald Cochrane

The practice of EBM requires utilization of the five A’s:

ASK: Develop a focused, pertinent clinical question
ACQUIRE: Use information technology to access accurate and reliable medical information
APPRAISE: Evaluate the evidence using the appropriate criteria
APPLY: Apply findings to the question asked/to the patient’s care
ACT: Communicate findings to the patient and/or team, reflecting on process and outcomes

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