The term evidence based medicine is widely credited to have been coined by Dr. David Eddy of Kaiser Permanente. It is believed that its philosophical base dates back to the post-revolutionary France and may have origins in China, B.C.
Evidence Based Medicine has been defined by Dr. David Sackett and his colleagues at McMasters University in Ontario, Canada in 1996 as ‘The judicious use of the best current evidence in making decisions about the care of the individual patients.’ Evidence-based medicine (EBM) aims to integrate clinical expertise with the best available research evidence and patient values.
When should EBM be used? Whenever there is evidence that something works, is good and benefits the patient, use it; there is evidence that something does not work, is harmful, does not benefit the patient, do not use it; there is insufficient evidence, be conservative and rely on your own clinician expertise.
The old way of depending on a combination of informed guesswork, unsystematic observation, common sense, the consensus views of clinical experts, and the so-called “standard and accepted practice”, meaning the treatments and procedures used by most other clinicians in a local community – was fine, but with the addition of enormous amounts of available information, practice of EBM is becoming popular which is the current best evidence of up-to-date information from relevant and valid research about the effects of different forms of healthcare, the potential for harm from exposure to particular agents, the accuracy of diagnostic tests, and the predictive power of prognostic factors.
Premier evidence resources are:
– Systems: EMR with decision support
– Summaries: Clinical Evidence, PIER, UpToDate, Dynamed
– Synopses: ACP Journal Club, EBM
– Syntheses: via BMJUpdates+
– Studies: via BMJUpdates+, PubMed Clinical Queries
Other resources are medical journals, literature databases, medical text books, practice guidelines, EBM resources like Cochrane database of systematic reviews and clinical evidence (www. cochrane.org), CDSS tools, PubMed for published medical information and journals, online books and medical databases.
Some other interesting websites for further understanding of EBM are: