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6] EBM model 2: Finding the evidence.
The next step is to seek relevant evidence that will help you answer the question.
Sources are:
- Traditional methods (textbooks, journals).
- Ask an expert. (answer quality will vary)
- Summarised clinical evidence (BestBets).
- Electronic bibliographic databases(Cochrane Library databases, PUBMED, MEDLINE, EMBASE, and CINAHL).
To find relevant articles fast:
- Use Boolean operators "AND" and "OR"
- Example:
- Viral bronchiolitis
- Corticosteroids OR steroids OR glucocorticoids OR prednisolone OR dexamethasone
- Clinical score OR hospital stay
- (1) AND (2) AND (3).
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7] EBM model 3: Critical appraisal.
After obtaining relevant articles on a subject, the next step is to appraise the evidence for its validity and clinical usefulness.
Research evidence may be appraised with regard to three main areas:
- Validity
- Importance
- Applicability to the patient or patients of...
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1] Principles of evidence based medicine
Health care professionals are increasingly required to base clinical decisions on the best available evidence. Evidence-based medicine (EBM) is a systematic approach to clinical problem solving which allows the integration of the best available research evidence with clinical expertise and patien...
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2] What is evidence-based medicine?
The concept of evidence-based medicine (EBM), defined as the ‘‘integration of best research evidence with clinical expertise and patient values’’
The practice of it requires life long, self-directed learning where patient ca...
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5] PICO/PIO Example:
A 4 month old baby is admitted with viral bronchiolitis. The baby's symptoms worsen and you wonder if corticosteroids might help the child improve and reduce the length of hospital stay.
The key components of your clinical question would be:
Patient: 4 month old baby w...
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8] EBM model 4: Applying the evidence.
After critically appraising the evidence, we then decide whether that evidence can be applied to our individual patient or population, taking into account the patient’s own personal values and circumstances.
Both efficacy and risks should be fully discussed with the patient or parents, or b...
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9] EBM model 5: Evaluating the performance
As we incorporate EBM into routine clinical practice, we need to evaluate our approach at frequent intervals and to decide whether we need to improve on any of the four steps discussed above.
We need to ask whether we are formulating answerable questions, finding good evidence quickl...
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3] Why evidence-based medicine
To Improve quality care through the identification and promotion of practices that work, and the elimination of those that are ineffective or harmful.
EBM demands that the effectiveness of clinical interventions, the accuracy of diagnostic tests, and the power of prognostic...
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4] EMB model 1: Creating answerable clinical questions.
The practice of EBM should start with a well formulated clinical question.
A good question should be clear, directly focused on the problem and answerable by medical literature research.
A good clinical question has 3-4 components:
- Patient or problem
- Intervention, ...
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