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Evidence Based Medicine

Evidence based medicine (EBM) is the conscientious, explicit, judicious and reasonable use of modern, best evidence in making decisions about the care of individual patients.

What is Evidence Based Medicine?

EBM circles

Evidence-based medicine requires the integration of the best research evidence with our clinical expertise and our patient’s unique values and circumstances.  (Straus SE, et al. Evidence-based medicine. 2005.)

Steps in EBM

Assess -- Clinical Evaluation.  The clinician must ASSESS the patient and the problem to determine the pertinent issues, which may include a differential diagnosis, treatment decisions, or prognosis.

Ask -- Clinical Question Development.  The clinician must draw from this evaluation and ASK a clear, answerable question to be pursued.

Acquire -- Searching for the Evidence.  The next step is to efficiently ACQUIRE the evidence from an appropriate source. Potential sources include original research studies, systematic reviews, evidence-based journal abstracts, textbooks and computerized decision support systems.

Appraise -- Critical Appraisal of the Evidence.  With a potential source in hand, the clinician must APPRAISE the evidence to further examine its worth and reliability.

Apply -- Applying Evidence to the Patient.  Finally, the process must conclude by returning to the individual patient, as the clinician has to decide whether it is appropriate to APPLY the evidence to the particular patient and their unique values and circumstances. Evidence alone is never sufficient to direct decision making. Rather, it must be put into context with a patient’s values.