Evidence-based medicine is the term used to describe the process of systematically reviewing, appraising and using the findings of clinical research to assist with the delivery of optimum clinical care to patients.
The most commonly quoted definition of evidence-based medicine is the one provided by Dr. David Sackett in his 1996 BMJ publication:
‘Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.’
The five steps of evidence-based medicine
Evidence-based medicine can be considered to be a 5-step process:
- Assess the patient
The process of assessing the patient results in the development of a clinical problem.
- Ask the question
Formulate a well-structured clinical question based upon the clinical problem that has arisen in this case.
- Acquire the evidence
Search the literature and resources for the best available evidence to answer the clinical question.
- Appraise the evidence
Review and critically appraise the evidence that you have found, assessing its validity, applicability and quality.
- Apply your findings
Now return to the patient and implement changes based on the evidence that you have discovered. Integrate the evidence with your own clinical expertise but also take into account the preferences of the patient. Monitor this process and self-evaluate your own performance.
The evidence-based medicine triad
It can, therefore, be seen that the practice of evidence-based medicine can be considered to consist of the following triad:
- Individual clinical expertise
- Best available external clinical evidence
- Patient expectations and values
Header image used on licence from Shutterstock
Medical Exam Prep would like to thank Dr. Marc Barton for permission to reproduce this extract from his book ‘Evidence-Based Medicine & Statistics for Medical Exams’.
About Dr. Marc Barton
Dr. Marc Barton qualified from Imperial College School of Medicine in 2001. Since that time, he has worked in a variety of different medical specialities. He worked as a GP partner from 2006 until 2008 and, more recently, as a higher specialist trainee in Emergency Medicine.
‘Evidence-Based Medicine & Statistics for Medical Exams’ is available for purchase here.