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Reviews: From Systematic to Narrative: Evidence Based Medicine/Practice

Definitions

Evidence-Based Practice is a way of providing health care that is guided by a thoughtful integration of the best available scientific knowledge with clinical expertise.  This approach allows the practitioner to critically assess research data, clinical guidelines, and other information resources in order to correctly identify the clinical problem, apply the most high-quality intervention, and re-evaluate the outcome for future improvement (Mesh, National Library of Medicine, 2009)

Evidence-Based Medicine is an approach of practicing medicine with the goal to improve and evaluate patient care. It requires the judicious integration of best research evidence with the patient's values to make decisions about medical care. This method is to help physicians make proper diagnosis, devise best testing plan, choose best treatment and methods of disease prevention, as well as develop guidelines for large groups of patients with the same disease. (from JAMA 296 (9), 2006)

Specific Pyramid for Evidence Based Medicine

 

The following pyramid is from an article by R. Brian Haynes published in Evidence Based Medicine 2001,  titled "Of studies, syntheses, synopses, and systems: the “4S” evolution of services for finding current best evidence."  

The figure provides a “4S” hierarchical structure, with original “studies” at the base, “syntheses” (systematic reviews) of evidence just above the base, “synopses” of studies and syntheses next up, and the most evolved evidence-based information “systems” at the top. Information seekers should begin looking at the highest level resource available for the problem that prompted their search.

Figure

 

 

Further Study

There are two excellent articles on this topic on the Wikipedia, the Free Encyclopedia site.  They are detailed and referenced.  Go to Evidence based practice or Evidence based medicine to read these entries.  The usual caveats apply.

EBP

This box has information about Evidence Based Practice (EBP) and how to locate evidence especially in the health disciplines. The links below take you to LHL Guides that the Reference Department created to help you.

The first stage of any evidence-based practice process is formulating an answerable question. This forms the foundation for your searching. A well-formulated question will facilitate the search for evidence and will assist you in determining whether the evidence is relevant to your question.

An answerable question has a format that follows the PICO concept. The acronym translates to:

  • P – populations/people/patient/problem
  • I – intervention(s)
  • C – comparison
  • O – outcome
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