The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.
SMJ // Article
Review
Application of the Principles of Evidence-Based Medicine to Patient Care
Abstract
Evidence-based medicine (EBM) is the conscientious and judicious use of the best evidence available collected from clinical trials, guidelines, and consensus statements. This article provides simple ways to practice EBM using five steps (assess the patient, ask a clearly focused clinical question, acquire the best evidence available from the medical literature, appraise the evidence, and apply the evidence to patient care) and how to execute each step properly, multiple examples of how to apply EBM to patient care, and examples of how to apply the PICO mnemonic (patient, intervention, comparison, and outcome) to the process of EBM.This content is limited to qualifying members.
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References
1. Sackett DL, Rosenberg WM, Gray JA, et al. Evidence based medicine: what it is and what it isn’t. BMJ 1996; 312: 71–72.
2. Packer M, Carver JR, Rodeheffer RJ, et al. Effect of oral milrinone on mortality in severe chronic heart failure. The PROMISE Study Research Group. N Engl J Med 1991; 325: 1468–1475.
3. Guyatt GH, Haynes RB, Jaeschke RZ, et al. Users’ guides to the medical literature: XXV. Evidence-based medicine: principles for applying the users’ guides to patient care. JAMA 2000; 284: 1290–1296.
4. Haynes R. Of studies, syntheses, synopses, summaries, and systems: the “5S” evolution of information services for evidence-based health care decisions. ACP J Club 2006; 145: A8.
5. National Collaborating Centre for Chronic Conditions. Chronic obstructive pulmonary disease. National clinical guideline on management of chronic obstructive pulmonary disease in adults in primary and secondary care. Thorax 2004; 59 (1 suppl): 1–232.
6. Mansi I, Huang J, Carden D. Pharmacolocic treatment of chronic systolic heart failure: past, present, and future. Adv Stud Med 2005; 5: 81–89.
7. Mansi I, Reddy P, Carden D. Caveats and controversies in interpretation of cardiac troponins. Johns Hopkins Adv Stud Med 2005; 5: 428–435.
8. Rose G, Barker D. Epidemiology for the Uninitiated. 3rd ed. London, BMJ Publishing Group, 1994.
9. Greenhalgh T. Assessing the methodological quality of published papers. BMJ 1997; 315: 305–308.
10. Young JM, Solomon MJ. How to critically appraise an article. Nat Clin Pract Gastroenterol Hepatol 2009; 6: 82–91.
11. Heneghan C, Badenoch D. Evidence-Based Medicine Toolkit. 2nd ed. Oxford, Blackwell Scientific, 2006.
12. 12. Falzer P. Shared decision making, quality of care, and the healthcare relationship. Paper presented at the International Communication Asssociation meeting. Dresden, Germany. March 14, 2011.
13. Coomarasamy A, Khan KS. What is the evidence that postgraduate teaching in evidence based medicine changes anything? A systematic review. BMJ 2004; 329: 1017.
14. Straus SE, Jones G. What has evidence based medicine done for us? BMJ 2004; 329: 987–988.
15. Banks DE, Shi R, Timm DF, et al. Decreased hospital length of stay associated with presentation of cases at morning report with librarian support. J Med Libr Assoc 2007; 95: 381–387.
16. Johnson JE, Mosher BD, Morrison CA, et al. A disciplined approach to implementation of evidence-based practices decreases ICU and hospital length of stay in traumatically injured patients. J Surg Res 2010; 163: 327–330.
17. Riordan FA, Boyle EM, Phillips B. Best paediatric evidence; is it accessible and used on-call? Arch Dis Child 2004; 89: 469–471.
18. Hurwitz SR, Slawson DC. Should we be teaching information management instead of evidence-based medicine? Clin Orthop Relat Res 2010; 468: 2633–2639.
19. Wilffert B, Swen J, Mulder H, et al. From evidence based medicine to mechanism based medicine. Reviewing the role of pharmacogenetics. Pharm World Sci 2010 [E-pub ahead of print].
20. Klinkman M, van Weel C. Prospects for person-centred diagnosis in general medicine. J Eval Clin Pract 2011; 17: 365–370.
