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The world of science and medicine are constantly evolving with new discoveries and research. As a health care professional, it is important that we stay up to date with these innovations to provide the best possible care for our patients.
Evidence Based Medicine (EBM) comprises of the best research evidence, clinical expertise and patient values. In the middle of these three aspects, the sweat spot one might add, is EBM. EBM recognizes that times, as well as research literature, treatments and technologies, are changing and that we as doctors need to change with it. This task of staying up-to-date is made easy by EBM and the Five Step EBM Model. At the end of the day, it is us doctors working with the lives of others, so it is our duty to stay up to date.
EBM can be practiced in the following steps:
A problem cannot be solved without a solution - and a solution start with a question.
It is often difficult to translate a clinical problem into a answerable question. However, it is good practice to be able to convert our information needs into answerable questions. Use the following acronym to construct an answerable clinical question: PICO
Once the question is compiled, one must seek relevant evidence that will help answer this question.
Source of information include:
Remember to generate appropriate keywords for your searches and to use the Boolean operators "AND" and/or "OR" to combine or refine searches.
Relevant articles should always be appraised for its validity, clinical usefulness, importance and applicability to the patient/patients of interest.
This is often a skill and involves learning how to ask a few key questions regarding the validity of the evidence and it relevance. This will come with more experience as a doctor and by attending specific workshops.
After appraising for the validity and importance of our evidence, we need to decide whether the evidence can be applied to our patient or population.
A very important step in this process is keeping in mind the patient's individual personal values and circumstances when making the decision< the risks and efficacy of the evidence should be discussed with the patient and family at length to allow them to make an informed decision.
The costs and availability of resources in your local hospital or practice should be kept in mind if the evidence is applied.
Not only after, but during our incorporation of EBM into routine clinical practice we should constantly be evaluating our approach at frequent intervals. Areas of improvement at each step of the process should be noted as well
This is one of the most important steps to improved care and bettering of doctors in our country and around the world
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