Material possessions can be powerfully alluring – whether it’s buying new stuff we don’t need or can’t afford, or holding on to things for way too long. At the extremes, these inclinations can become highly problematic. Compulsive buying-shopping disorder is characterised by an insatiable desire to buy more things, and hoarding disorder, which involves a seemingly boundless desire to keep and accumulate possessions. Even if your own situation is not so extreme, you might be struggling to feel in control of your stuff.

Compulsive Shopping Of Stuff We Don't Need

Material possessions can be powerfully alluring - whether it's buying new stuff we don't need or can't afford, or holding on to things for way too long. At the extremes, these inclinations can become highly problematic.<ul><li>Our relationship to our things has deep psychological roots, which starts during early childhood and continually gets reinforced throughout the lifespan.</li><li>Children learn that a teddy bear or blanket provides them with comfort when they are separated from their parents</li><li>Teenagers learn what is cool from their peers and typically want what they have.</li></ul>

Wanting More Possessions

Triggers: Being in a shopping centre; being with friends in a shopping centre; seeing something that fits with my style and is on sale; wanting to look good for an upcoming special event; believing I’ve earned it because I’ve worked hard.Behaviour: Buying clothes that I think I need, but really just want.Consequences: Enjoyment while shopping; feeling happy when shopping with friends.

Buying Stuff: Triggers, Behaviour And Consequences

<ul><li>Make a concrete commitment to change your buying and storing habits.</li><li>Put your goals in writing - this will prevent you from forgetting or changing your goals along the way.</li><li>Identify what triggers and reinforces your buying & storing behavior.</li><li>People are motivated to buy and store possessions for many reasons, only one of which is a functional need for an object.</li></ul>To figure out what maintains your behavior, ask yourself: Why you buy and keep hold of things you do not use?What prompts these desires? How do you feel right after you have acquired an item or made the decision to keep something?

What To Do

<ul><li>Make a concrete commitment to change your buying and storing habits.</li><li>Identify the environmental and emotional causes and consequences of your behavior.</li><li>Develop a plan to resist buying items you don't need.</li><li>Use a one-minute rule when making purchasing or discarding decisions: allow yourself only one minute to decide.</li><li>Track what you buy, store, and discard.</li><li>Reward yourself for meeting your goals.</li></ul>

How to Have Less Stuff

Consider what your recipients really want and need. The best way to do that is to ask them.If you'd like to gift something to a person who has stated that they prefer others make a charity donation, then, by all means, donate to that charity if you agree with its values.

The Stuff We Buy For Others

Do your possessions hold too much power over you? Learn to regain control – and benefit your wallet and the planet

Understand yourself and those around you.

psychology

Psychology

moneyandinvestments

Money & Investments

How to have less stuff | Psyche Guides

DeFi is the name given to the suite of financial tools that blockchain technology enables. These tools include lending, borrowing, and yield farming. Blockchain technology allows these tools to be utilized without needing permission from a centralized entity (i.e. banks).

Qualifying for a loan in the first place is uncertain, usually requiring a high enough credit score and good debt-to-income ratio. Once approved, on average you can expect to pay 10%-30% in interest.DeFi let’s you collateralize your crypto holdings in order to pull a loan against it. For example, if you are holding $1,000 of bitcoin, a DeFi platform will let you pull out a loan on anywhere from 25%-75% of that balance. And this is all permissionless, meaning that no background check is required. What’s more, interest rate payments on DeFi loans range from only 1%-8%.

Borrowing

With DeFi, you may also opt to lend your crypto and earn interest on it. Most DeFi platforms and decentralized exchanges (DEXs) have a staking mechanism or liquidity pool where you can lock your crypto into the platform and earn interest. Lending helps DeFi platforms to continue facilitating transactions through increased liquidity. Interest earnings within DeFi are surprisingly high, ranging anywhere from 5%-400%+ in yearly earnings. Comparatively, centralized banks usually offer interest rates as high as .07% yearly on savings accounts. It’s clear why DeFi is becoming so popular.

Lending

Lending mechanisms on DeFi platforms have opened up the practice of yield farming, which is where crypto holders routinely seek the highest interest rates on the market to earn passive income.

Yield farming

So how is all of this facilitated on decentralized platforms? Through the use of smart contracts, DeFi platforms are able to process transactions without the need of a middleman or centralized entity holding funds in custody and keeping track of ledgers. Instead, crypto traders lock tokens into liquidity pools and smart contracts use this liquidity to mint new tokens and facilitate transactions.

Smart contracts

From smart contracts, a blockchain project called Maker was able to create a stablecoin known as DAI. And with DAI, holders of ethereum were able to collateralize their tokens in exchange for the stablecoin.Another big innovation that Ethereum enabled were ICOs.While the ICO craze led to many scams, there were a handful of great projects that survived the 2017 bubble. Most notably, in terms of DeFi, was AAVE, which is now one of the most popular DeFi platforms to-date. AAVE is an open-source DeFi protocol that allows borrowing and earning interest on collateralized tokens.

History of DeFi

DeFi saw huge growth in the middle of 2020 but declined a bit later in the year. Despite drops in the token value of popular DeFi projects, their usage and development continued well into 2021. Now, many are speculating a “DeFi Summer 2.0” as the Ethereum blockchain is slated to release an important upgrade in July 2021.The new upgrade, EIP-1559, is expected to help lower gas fees substantially. What’s more, mainstream adoption is steadily on the rise with the popularity of <a href="https://dgtlzen.com/2021/03/21/non-fungible-tokens-nfts-and-their-use-cases/">NFTs </a>, the recent Coinbase listing, and the surge in the price of Dogecoin.

The future of DeFi

The impact that the Ethereum blockchain has had on the blockchain and crypto industries cannot go understated. Operating as a "world computer," Ethereum enables the use of smart contracts, which allow decentralized applications (DApps) to be built. Smart Contracts have evolved over the last few years to spawn an entirely new set of financial protocols…

crypto

Cryptocurrency

Everything You Need to Know About Decentralized Finance (DeFi)

Debt can be an excellent option for some, but it's not for everyone. If taking on any amount of debt means that your anxiety will go through the roof and <a href="https://www.inc.com/ami-kassar/how-to-choose-your-growth-lane-sleep-well-at-night.html">prevent you from sleeping</a>, then don't take it. Debt can be evil if you misuse it, but it can be a great tool to grow if used correctly.

The Two Sides Of Debt

Having a set monthly payment is a predictable way to manage the remainder of your cash flow each month in case of emergencies and to preserve future profits.You don't have to wait for your cash flow to skyrocket to grow, and you don't have to sell equity to grow and try to become a unicorn. But, in the media, you always see the entrepreneurs highlighted who were able to grow their company at an incredible speed, and sometimes you may wonder, why not me? Why can't I do that?

A Limited Income Every Month

Many of us don't have the tolerance for high risk and speed. Maybe we did at one point, when we had nothing to lose, but now there's everything to lose. There are plenty of growth lanes in the middle, and you should never be ashamed of taking one of those. This is your business, so do what works for you.

Risky Business

Business owners should remain open-minded and take in all the information they can that could benefit their company and lead to a better life for them and their employees. That's what you owe to yourself and the company. By educating yourself about debt, you will gain perspective and clarity on what other options are available for you to grow your business in a way that feels authentic and safe. You would know another way to finance your company's growth without sacrificing control and future profits.

Being Open-Minded About Debt

It may seem like a worn-out concept, but don't compare yourself with others in business. Instead, educate yourself, gain perspective, and choose a growth lane that fits your risk tolerance. This will help you sleep better at night, and it will help you feel better about where your company is at.

You Are Unique

Equity can be more appealing than debt, but it's also almost always more expensive.

Debt, Used Well, Is Not Evil

GI is a legal label marking in which region a product comes from. GIs can be domestic or international. Domestic GIs are protected by local governments and international GIs are protected by the TRIPS agreement, which is part of the World Trade Organisation (WTO). Once a GI status is approved, the label functions similar to trademarks.

Geographical indication (GI)

<ul><li>Consumers: GIs act as a quality guarantee that meets certain production standards.</li><li>Producers: GIs can help local communities to invest in their unique production process and raise prices.</li></ul>

GIs can benefit consumers and producers

Legal labels that mark where a product is from can be big business for local food producers.

food

Food

marketingandsales

Marketing & Sales

What the heck is a geographical indication?

“Don’t be afraid to say no to projects. Prove that you’re serious about specialization by turning down work that falls outside your area of expertise. The more people you say no to, the more referrals you’ll get to people who need your product or service.”

If you focus on doing one thing well and hire specialists in that area, the quality of your work will improve and you will stand out among your competitors.

Don’t generalize. Specialize

Relying too heavily on one client is risky and will turn off potential buyers. Make sure that no one client makes up more than 15 percent of your revenue.

Don't rely too much on just one client

<ul><li>Owning a process makes it easier to pitch and puts you in control. Be clear about what you’re selling, and potential customers will be more likely to buy your product.</li><li>Don’t become synonymous with your company. If buyers aren’t confident that your business can run without you in charge, they won’t make their best offer.</li></ul>

Owning a process puts you in control

“To sell your business, you need to demonstrate to a buyer that you have a sales engine that will produce predictable, recurring revenue."

<ul><li>Take some time to figure out how many pipeline prospects will likely lead to sales. This number will become essential when you go to sell because it allows the buyer to estimate the size of the market opportunity.</li><li>Two sales reps are always better than one. Often competitive types, sales reps will try to outdo each other. And having two on staff will prove to a buyer that you have a scalable sales model, not just one good sales rep.</li><li>Hire people who are good at selling products, not services. These people will be better able to figure out how your product can meet a client’s needs.</li></ul>

Sales and sales reps

Find an adviser for whom you will be neither their largest nor their smallest client. Make sure they know your industry.Avoid an adviser who offers to broker a discussion with a single client. You want to ensure there is competition for your business and avoid being used as a pawn for your adviser to curry favor with his or her best client.

About finding an advisor

If you want to be a sellable, product-oriented business, you need to use the language of one. Change words like “clients” to “customers” and “firm” to “business.” Rid your website and customer-facing communications of any references that reveal you used to be a generic service business.

Using the right language

<ul><li>They are “teachable” to employees (like the Stapleton Agency’s Five-Step Logo Design Process) or can be delivered through technology;</li><li>They are “valuable” to your customers, which allows you to avoid commoditization;</li><li>They are “repeatable,” meaning customers need to return again and again to buy (e.g., think razor blades, not razors).</li></ul>

Scalable things meet three criteria

Run your company. Don’t let it run you. Most business owners started their company because they wanted more freedom—to work on their own schedules, make the kind of money they deserve, and eventually retire on the fruits of their labor. Unfortunately, according to John Warrillow, most owners find that stepping out of the picture is extremely difficult because their business relies too heavily on their personal involvement. Without them, their company—no matter how big or profitable—is essentially worthless. But the good news is that entrepreneurs can take specific steps—no matter what stage a business is in—to create a valuable, sellable company. Warrillow shows exactly what it takes to create a solid business that can thrive long into the future.

entrepreneurship

Entrepreneurship

business

Business

books

Books

Run your company. Don’t let it run you. Most business owners started their company because they wanted more freedom—to work on their own schedules, make the kind of money they deserve, and eventually retire on the fruits of their labor. Unfortunately, according to John Warrillow, most owners find that stepping out of the picture is extremely difficult because their business relies too heavily on their personal involvement. Without them, their company—no matter how big or profitable—is essentially worthless. But the good news is that entrepreneurs can take specific steps—no matter what stage a business is in—to create a valuable, sellable company. Warrillow shows exactly what it takes to create a solid business that can thrive long into the future.

John Warrillow

Built to Sell

Investing in your 20s is one of the greatest steps you can take toward being a bona fide, successful adult. It pays to get a jumpstart on saving for financial goals like retirement, especially because of compound returns.

Why to Invest in Your 20's?

As The topic comes of Investing many people avoid Themself by saying that, I Don’t Earn so I Don’t Invest. I Hope every Month you are Get Pocket Money, Right. So Some Portion it. You have to save. Stop doing UnWanted Expenditure, If you cant then start to Reduce It Month by Month. It Will help you to Save Money As well as you can Invest that Money.

1. Save money as you can:

Nowadays we all are getting very strictly Bonded with time. So we Prefer to have a Personal Bike or Car. The best way to solve this problem is to Book A Cab or Bike Rider, This thing is now getting Popular Day by Day. But if You think you won it then whenever wherever whatever you can do with it. So if you want to purchase then purchase second hand, it will help to your pocket. You can have your new bikes and cars if you are setting on the peak of your finances then you can go with it.

2. Don't buy bikes and cars (if you want to purchase then purchase second hand):

Debt, Loan, Credit Card; these 3 things are very Dangerous financial Enemies of our Youth. Do take a Personal Loan or any kind of loan if it is not very important, especially when you are a Student. Same with Credit Card.

3. Stay away from debt, loans, credit:

Again very Important But many people & Youth are Ignoring it. Especially it is very important in the period of This kind of Pandemics. As a youth, if assume if something is Happened to you (May God Keep you Well) But if you needed to hospitalized then you know how the bills come Right. So Plz make sure to have Health insurance for you & your Family Along with your Term Insurance. It Will Helps your Family & You.

4. Health insurance:

As a Student, you have to do this by Investing not Trading. One of the major benefits of investing in the stock market is that investors get the chance to earn more money Over time if the stock market rises in value, the prices of a particular stock can rise or fall. However, investors who have put their money in stable companies will see profit growth. If you Don’t have the time to make Research then Invest in those products which u use in your daily life.

5. Invest in the stock market (invest in those products which u use in daily life):

As Now I am Assuming that you are 18+ then make sure to manage your Portfolio by yourself. Because when you invest & after some time you will forget it. So Managing a portfolio is Important.

6. Managing portfolio:

So, why is budgeting important? In short, budgeting is important because it helps you control your spending, track your expenses, and save more money. Additionally, budgeting can help you make better financial decisions, prepare for emergencies, get out of debt, and stay focused on your long-term financial goals.

7. Budgeting:

Investing in yourself will boost your confidence in your abilities and have a positive impact on your self-esteem. As well as equipping you with new knowledge and skills, focusing on your personal development will help you get to know yourself better. Simply you can do this By Following our Profiles where we post this Kind of Content that will Add Value to your Life.

8. Invest in yourself (must):

"You have to Learn how to Spend the money Before How to Save the Money"

Hope You Enjoyed reading & Got some Impact-full Learnings from this article, If you Did then Hit the like button & put a comment. This helps us to work harder & Smarter Day by Day. & it motivates us to make this kind of content... Now this Article is Available in Audio Format as Well, Also we are “AudioBook Media Center” now Available on All Popular Podcast Streaming Platforms Like:- <a href="https://open.spotify.com/show/7AKP8QnzAOzT5J2aBD2sFT?si=68fa619da4474eb0">Spotify</a>,<a href="https://podcasts.apple.com/in/podcast/audio-book-media-centre/id1566519844"> Apple Podcast</a>, <a href="https://podcasts.google.com/feed/aHR0cHM6Ly9hbmNob3IuZm0vcy81OWUwNjkyMC9wb2RjYXN0L3Jzcw==">Google Podcast</a>, <a href="https://anchor.fm/audiobookmediacenter">Anchor</a>, <a href="https://radiopublic.com/audio-book-media-centre-6Ngnmg">radiopublic</a>, <a href="https://pca.st/crhwmh5o">Pocket Casts</a> & <a href="https://www.breaker.audio/audio-book-media-centre">Breaker</a>. <h3>© Copyright 2021-22, All Rights Reserved, AudioBook Media Centre</h3>

Promo

Its never the late for investing.  Because Age is just. a Number.

You Can Still Do this If you Want. at any Age.

Investing in your 20s is one of the greatest steps you can take toward being a bona fide, successful adult. It pays to get a jumpstart on saving for financial goals like retirement, especially because of compound returns.

How to Invest in your 20's? | Complete Guide

<ol><li>Rich people believe “I create my life.” Poor people believe that “Life happens to me.”</li></ol>If you want to create wealth, you must believe that you are at the steering wheel of your life, especially your financial life.

6 Secrets of Wealthy People

2. Rich people play the money game to win. Poor people play the money game to not lose.If you shoot for the stars, you’ll at least hit the moon. ” Poor people don’t even shoot for the ceiling in their house, and then they wonder why they’re not successful.

Play to Win

3. Rich people are committed to being rich. Poor people want to be rich.﻿Rich people are totally clear that they want wealth. They are unwavering in their desire. They are fully committed to creating wealth.

Commitment to being Rich

4. Rich people think big. Poor people think small.The factor that presents the biggest challenge for most people is quantity.Another way of stating this is, how many people do you actually serve or affect?

Think Big

5. Rich people focus on opportunities. Poor people focus on obstacles.“Is the glass half empty or half full?” We’re talking about your habitual perspective on the world.Poor people make choices based on fear. Their minds are constantly scanning for what is wrong or could go wrong in any situation.

Focus on opportunities

6. Rich people admire other rich and successful people. Poor people resent rich and successful people.  “Bless that which you want.” Drive around or buy magazines, look at beautiful homes, and gorgeous cars, and read about successful businesses.Whatever you see that you like, bless it, and bless the owners or the people involved.

Rich admire

Secrets of the Millionaire Mind reveals the missing link between wanting success and achieving it! Have you ever wondered why some people seem to get rich easily, while others are destined for a life of financial struggle? Is the difference found in their education, intelligence, skills, timing, work habits, contacts, luck, or their choice of jobs, businesses, or investments? The shocking answer is: None of the above! In his groundbreaking Secrets of the Millionaire Mind, T. Harv Eker states: "Give me five minutes, and I can predict your financial future for the rest of your life!" Eker does this by identifying your "money and success blueprint." We all have a personal money blueprint ingrained in our subconscious minds, and it is this blueprint, more than anything, that will determine our financial lives. You can know everything about marketing, sales, negotiations, stocks, real estate, and the world of finance, but if your money blueprint is not set for a high level of success, you will never have a lot of money—and if somehow you do, you will most likely lose it! The good news is that now you can actually reset your money blueprint to create natural and automatic success. Secrets of the Millionaire Mind is two books in one. Part I explains how your money blueprint works. Through Eker's rare combination of street smarts, humor, and heart, you will learn how your childhood influences have shaped your financial destiny. You will also learn how to identify your own money blueprint and "revise" it to not only create success but, more important, to keep and continually grow it. In Part II you will be introduced to seventeen "Wealth Files," which describe exactly how rich people think and act differently than most poor and middle-class people. Each Wealth File includes action steps for you to practice in the real world in order to dramatically increase your income and accumulate wealth. If you are not doing as well financially as you would like, you will have to change your money blueprint. Unfortunately your current money blueprint will tend to stay with you for the rest of your life, unless you identify and revise it, and that's exactly what you will do with the help of this extraordinary book. According to T. Harv Eker, it's simple. If you think like rich people think and do what rich people do, chances are you'll get rich too!

personaldevelopment

Personal Development

#1 New York Times, Wall Street Journal, and USA Today Bestseller!Secrets of the Millionaire Mind reveals the missing link between wanting success and achieving it!Have you ever wondered why some people seem to get rich easily, while others are destined for a life of financial struggle? Is the difference found in their education, intelligence, skills, timing, work habits, contacts, luck, or their choice of jobs, businesses, or investments?The shocking answer is: None of the above!In his groundbreaking Secrets of the Millionaire Mind, T. Harv Eker states: "Give me five minutes, and I can predict your financial future for the rest of your life!" Eker does this by identifying your "money and success blueprint." We all have a personal money blueprint ingrained in our subconscious minds, and it is this blueprint, more than anything, that will determine our financial lives. You can know everything about marketing, sales, negotiations, stocks, real estate, and the world of finance, but if your money blueprint is not set for a high level of success, you will never have a lot of money—and if somehow you do, you will most likely lose it! The good news is that now you can actually reset your money blueprint to create natural and automatic success.Secrets of the Millionaire Mind is two books in one. Part I explains how your money blueprint works. Through Eker's rare combination of street smarts, humor, and heart, you will learn how your childhood influences have shaped your financial destiny. You will also learn how to identify your own money blueprint and "revise" it to not only create success but, more important, to keep and continually grow it.In Part II you will be introduced to seventeen "Wealth Files," which describe exactly how rich people think and act differently than most poor and middle-class people. Each Wealth File includes action steps for you to practice in the real world in order to dramatically increase your income and accumulate wealth.If you are not doing as well financially as you would like, you will have to change your money blueprint. Unfortunately your current money blueprint will tend to stay with you for the rest of your life, unless you identify and revise it, and that's exactly what you will do with the help of this extraordinary book. According to T. Harv Eker, it's simple. If you think like rich people think and do what rich people do, chances are you'll get rich too!

T. Harv Eker is an author, businessman and motivational speaker known for his theories on wealth and motivation. He is the author of the book Secrets of the Millionaire Mind published by HarperCollins.

T. Harv Eker

Secrets of the Millionaire Mind

"Spending money to show people how much money you have is the fastest way to have less money."

"I love Voltaire's observation that "History never repeats itself; man always does."

"Planning is important, but the most important part of every plan is to plan on the plan not going according to plan.

"Nothing is as good or as bad as it seems."

"Money's greatest intrinsic value-and this can't be overstated-is its ability to give you control over your time."

"Independence, to me, doesn't mean you'll stop working. It means you only do the work you like with people you like at the times you want for as long as you want."

"Be nicer and less flashy. No one is impressed with your possessions as much as you are. You might think you want a fancy car or a nice watch. But what you probably want is respect and admiration."

Key Lesson from "Psychology of money" written by Morgan Housel

Amazon.in - Buy The Psychology of Money book online at best prices in India on Amazon.in. Read The Psychology of Money book reviews & author details and more at Amazon.in. Free delivery on qualified orders.

motivationandinspiration

Motivation & Inspiration

 The Psychology of Money 

Creating wealth is a skill. Not an identity. Naval is confident that even if all his wealth is taken away right now he will regain all of it in 10 years or less. Because creating wealth is a skill and fortunately, he has learned the skillset. You can too. Your way of creating wealth should include these three points.

1. You can get rich without getting lucky

It means you should run after assets rather than money. The assets will in turn make money for you.

2. Run after wealth, not money

You have to create something that the people want. That too with scalability. Create a product or service that can be distributed to many people and creates lots of value. If you create a product that has lots of value for fewer people, it is as effective as a product with less value for more people. <a href="https://www.businessinsider.com/elon-musk-advice-to-companies-maximize-curve-of-customer-happiness-2020-4">Elon Musk calls it the area under the curve. </a>

3. You can’t get rich selling your time

Learn to create a product or learn to sell it. If you know how to do both, you are unstoppable.

4. Learn to create and sell

One way to make money is to acquire a portion of a business. Generally, when new startups are made they give some portion of the business to its founding employees. When the business is successful the founder along with those employees become rich. If you don’t have the ownership you only earn exactly proportionate to your time input.

5. Wealth is created by equity, not by selling your time

Compounding doesn’t only work for money. It also works in knowledge and relationships. For example: <a href="https://growth.eladgil.com/book/cofounders/managing-your-board-an-interview-with-naval-ravikant-part-1/">Naval says he likes to work with Elad Gil </a>. Because he has done so many deals in the past with him that they both are confident that they ensure the mutual profit.

6. Understand Compounding

We should build valuable skills. Selling skills for example. If you can create a product, you also need someone who can market it and sell it to the public. Also, you can be that person for a partnership with someone else who creates the product. What would Apple be today without the marketing and branding skills of Steve Jobs? Specific knowledge comes from your passion.

7. Find and build specific knowledge/skills

To achieve massive wealth in life, you need to be in massive action. Many talks but less do. Execution is scarce and valuable. If you can think of something and execute it, you can do anything. These are the principles that Naval Ravikant used to create the wealth that he owns now which nets around 70 million. Anyone can follow these and be financially successful. As Naval said, Intentions do not matter, actions do. So let’s go do it. Thank you for reading this. You can follow me on <a href="https://twitter.com/this_topian">twitter </a>if you want.

8. Intentions do not matter, actions do

Thinking to grow your wealth? Read these snippets.

Naval Ravikant is a millionaire with net worth of about 70 Million. According to him he used the following principles to create the massive wealth.

startup

Startups

5 Principles of Creating Wealth

EBM is the integration of evidence, clinical expertise, and patient values and preferences. Factors influencing clinical expertise include judgement, clinical skills and personal experience. EBM requires life-long self-monitored learning to stay up-to-date with the most recent clinical interventions and techniques, as this information is constantly changing.

So you Want to Know About EBM... (Evidence-Based Medicine)

EBM aims to improve patient care quality and produce optimal patient outcomes. It is identifying and promoting clinical practices that work, and eliminating those that don't. Additionally, the precision, accuracy and power of the intervention must be critically assessed. This process furthers the development of critical thinking.

Why use EBM?

According to AK Akobeng, there are five main steps to properly practise EBM. The next few blocks will explore this concept.

The 5-Step Model

Formulate Answerable Clinical Questions (CQs)The key is to translate the clinical problem into an answerable clinical question (CQ) – e.g. “Is treatment A effective in irradicating disease B?”. CQs should be clear, focus directly on the presenting complaint, and be answerable in terms of clinical evidence available.Form clinical questions using the PICO method.“P” - the Patient themself and the Problem i.e. their medical history and presenting complaint.“I” - Intervention i.e. the treatment / test used.“C” - Comparison of various interventions.“O” - Outcome i.e. the predicted result.

STEP 1

Find the Evidence : SourceLook for evidence that will answer your CQ. Clinical databases (e.g. Archimedes) are relatively reliable and timesaving sources, compared to traditional textbooks and oral sources. The Cochrane Database - a collection of system reviews - is also widely used in the medical field.

STEP 2A

Find the Evidence : SearchBeing able to search these databases is another skill in and of itself. Firstly, extract keywords from your PICO framework e.g. Problem is Thrombosis and Intervention is Aspirin, therefore the search will include the words “Thrombosis Aspirin”. When conducting the search, use the operating word “AND” for search results including all keywords and “OR” for either/some of the keywords.

STEP 2B

Appraise the EvidenceNot all research evidence is made the same – some is high-quality and thorough, some isn’t. It is thus paramount that research evidence is appraised in terms of validity, importance, and applicability. The CASP (Critical Appraisal Skills Programme) tools developed by Oxford Univ. incorporate all of these factors and provide a framework for your appraisal.

STEP 3

Apply the EvidenceEstablish the efficacy, risks, availability, and cost of the proposed treatment/test/intervention, and discuss with the patient before proceeding. This establishes trust between the health care practitioner and the patient - a "therapeutic alliance" as Akobeng says.

STEP 4

Evaluate PerformanceSelf-monitoring and -auditing are fundamental in EBM practice. Ask yourself, "Am I following all 5 steps to the best of my ability?". This ensures that you are always providing the best possible patient care, and that favourable patient outcomes are strived for and ultimately, achieved.

STEP 5

A comprehensive summary of AK Akobeng's article on the Principles of Evidence Based Medicine.

health

Health

problemsolving

Problem Solving

Principles of Evidence Based Medicine - A K Akobeng (as summarised by S Carstens)

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