Evidence Based Medicine

Evidence-based medicine is nothing more than the integration of: the best, most up-to-date research evidence; excellent clinical expertise; and the patient’s own values or preferences. Some ask, "so what’s new about evidence-based medicine? Haven’t we been practicing evidence-based medicine all along?" In some respects this is true; however, we have not always carefully assessed the evidence upon which we base our clinical practice. We hear too often "that’s the way I do it because I’ve always done it that way" or "I do it this way because that’s the way I learned as an intern or resident" or "I do it this way because so and so told me."

The medical literature is changing rapidly. New therapies/medications are introduced rapidly. A question to ask yourself is how I as a clinician will continue to provide the most up-to-date care to my patients? Evidence-based medicine is a way to hone your self-learning skills. It will sharpen those skills that you will need to remain current.

There are four (4) steps to the practice of evidence-based medicine.

• Step 1 - Asking the well-built clinical question
• Step 2 - Search for the evidence
• Step 3 - Appraising the evidence
• Step 4 - Incorporating the evidence with clinical judgment and patient preferences