EBM (Evidence-Based Medicine) is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values. The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology. (Sackett D, 2002)
Evidence-Based Practice requires new skills of the clinician, including efficient literature searching, and the application of formal rules of evidence in evaluating the clinical literature.
ASSESS the patient: Start with the patient and consider the clinical issue/question arising during care
ASK the question: Construct a well built clinical question derived from the issue/question
ACQUIRE the evidence: Select the appropriate resource(s) & conduct a search
APPRAISE the evidence: Appraise the evidence for its validity (closeness to the truth) & applicability (usefulness in clinical practice)
APPLY talk with the patient: Integrate that evidence with your clinical expertise & patient preferences and apply it to practice
EVALUATION: Evaluate your performance with this patient
A well-built clinical question is directly relevant to patient care and helps guide searching for evidence-based answers. There are generally four components of a good clinical question and they are represented by the acronym PICO.
P - Patient, population or problem of interest
I - Intervention - therapy, prognostic factor, or exposure
C - Comparison intervention, if relevant
O - Outcome(s) of interest