Define EBM.

EBM is the process of systematically finding, appraising, and integrating the best research evidence with clinical expertise and patient values as the basis for clincial decision making.

EBM is about asking questions, finding and appraising the relevantdata, and harnessing that information for everyday clinical practice.

What is the 4 step process involved in EBM?

(Hint: 4 A's)

(1) Ask a clinically relevant question

(2) Acquire the best available evidence

(3) Appraise (critically) the evidence

(4) Apply the evidence to patient care

What are the PICO Foreground (Clinically-relevant) Questions?

Patient and/or Problem

Intervention

Comparison (if relevant)

Outcome

What is the difference between background and foreground questions when asking clinically relevant questions?

Background Questions:

W/W/W/W/W/H

Foreground Questions:

Given patient, given intervention, how effective, (when compared against alternative or someone who doesn't take/do intervention).

Describe the 4S Hierarchy in obtaining the best evidence.

Most authoratative

Systems

Synopses

Summaries

Studies

Least authoratative

Introduce guidelines for critically appraising the medical literature.

Two rules of thumb:

(1) Just because it's in print doesn't mean it's true.

(2) The medical literature will support any side of any argument just about any time.

Are the results of the study valid? Bias?

What were the results? (size/precision of effect)

Will the results help me in caring for my patients?