Evidence-based physical diagnosis is an essential part of the bedside curriculum. By using the likelihood ratio, a simple measure of diagnostic accuracy, teachers can quickly adapt this approach to their bedside teaching. Six recurring themes in evidence-based physical diagnosis are fully reviewed, with examples, in this article.
Objectives: Evidence-based medicine (EBM) skills are important to daily practice, but residents generally feel unskilled incorporating EBM into practice. The Kolb experiential learning theory, as applied to curricular planning, offers a unique methodology to help learners build an EBM skill set based on clinical experiences. We sought to blend the…
Surrogate endpoints are biomarkers that are intended to substitute for clinical endpoints. They have been used to find novel therapeutic targets, improve the statistical power and shorten the duration of clinical trials, and control the cost of conducting research studies. The more generalized use of surrogate endpoints in clinical decision…
Evidence-based medicine (EBM) is the judicious use of current best evidence with sound methodology and appropriate application to patient care.1 EBM has been widely accepted by medical schools and postgraduate medical education as a cornerstone in both medical education and medical practice. It has been incorporated into the curricula of…
In a time when the circumstances surrounding the health of the nation and health care as its costly consequence, the Southern Medical Association (SMA) recognized the absolute necessity to publish a body of work which solidifies the concept of evidence-based medicine (EBM). EBM has been an abstract cliché for far…
Declaring that a causal and not solely a correlative relation exists between a risk factor and a disease creates significant implications for patients and physicians. No matter the forum, when investigators or clinicians make such a claim, it is essential to explain how this determination was made so that appropriate…
In this issue, the Southern Medical Journal presents a series of articles to help students of medicine understand the principles of evidence-based medicine. These articles are not meant to be a comprehensive review, but rather an easy-to-read primer. In this final article, the authors offer suggestions to aid the reader…
Many different study designs are used to address different types of clinical questions. The two broad categories are the experimental study, which is the randomized controlled trial, and observational studies, which includes all of the other basic study designs (cohort [prospective and retrospective] studies, case-control [etiologic] studies, cross-sectional [prevalence] studies,…
In this issue, the Southern Medical Journal presents several articles about understanding and applying evidence-based medicine in clinical practice. One of the more challenging areas for clinicians is statistics. Experienced editors of medical journals have complained of difficulties in understanding all aspects of statistical methods and applications.1 Several medical journals…
Part I of this two-part article provides a foundation of statistical terms and analyses for clinicians who are not statisticians. Types of data, how data are distributed and described, hypothesis testing, statistical significance, sample size determination, and the statistical analysis of interval scale (numeric) data were reviewed. Some data are…
It is impossible to answer every potential clinical question through randomized controlled trials. Hence, assumptions, rational thinking, logic, and reasoning are used in making recommendations; however, these methods may interfere with the judicious application of evidence-based medicine and, as discussed in this article, may result in logical fallacies. We also…
The concept of evidence-based medicine (EBM), defined as the integration of best research evidence with clinical expertise and patient values, is essential to the review, understanding, and application of clinical principles into the practice of medicine. Critical appraisal includes recognizing and evaluating various study designs and their ranking in order…
We present information describing how to search to identify those reports that provide insight into the answer to the query. We have presented a reasonable approach to searching, with our end-point being the identification of published articles which appear to answer our queries. The decision as to whether these articles…
Evidence-based medicine (EBM) for clinicians: do we need it? Would it not be enough to connect clinicians to an authoritative database source that would supply them with brief summaries of final recommendations? Would the executive summaries of clinical and academic society guidelines be a sufficient source? We would argue that…
This issue of the Southern Medical Journal is devoted to a topic of great importance to patient care and to the evaluation of medical and scientific data published in medical journals—“Evidence-based medicine” (EBM). Originally envisioned by Archibald Cochrane more than 40 years ago as a response to the lack of…
Clinical research typically gathers sample data to make an inference about a population. Sample data carries the risk of introducing variation into the data, which can be estimated by the standard error of the mean. Data are described using descriptive statistics such as mean, median, mode, and standard deviation. The…
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…
This article reviews one of the basic tools of evidence-based medicine, the calculation and interpretation of Number Needed to Treat (NNT) and Number Needed to Harm (NNH). Especially appealing is the simplicity of extracting this information from journal articles that report binary outcomes, such as medication response or emergence of…
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