Evidence based medicine relies on the premise
that to make well informed decisions about clinical practice, clinicians
need to access the best evidence about clinical interventions.
"EBM is the integration of best research
evidence with clinical expertise and patient values" (Sackett, 1999, p.1)
"EBM is defined as the process of systematically finding,
critically appraising, and using contemporary research published in the
medical literature as a basis for making decisions regarding individual
patient care and health policy"
(Zou,
Fielding, & Ondategui-Parra, 2004 p.127)
Finding "contemporary research" is no mean feat when you
consider that medical information doubles every five years. (Ebbert,
Dupras,
& Erwin, 2003).
Why
practice evidence based medicine?
Variations in practice are becoming more evident and evidence
of harm and lack of benefit is increasing. (Pape, 2003)
Consumers are taking more responsibility for their health care
decision making and want valid answers about decision making processes
related to their condition. Evidence based practice enables clinicians
to more easily justify their decision making to patients. (Pape, 2003)
Evidence based practice promotes high quality and cost
effective intervention and treatment. (Pape, 2003)
Evidence based practice encourages, tailored, and individualized
treatment of patients and emphasizes care and outcomes that matter to
the patient. (Pape, 2003)
Accessing medical literature can be problematic given the
information explosion and the fact that thousands of articles are published
every month, many of which provide conflicting information. (Ebell,
1999)
Reliance on the "expert advice" of colleagues can mean the
application of outdated or incorrect advice, particularly when dealing
with uncommon conditions or variations of clinical conditions. (Zou,
Fielding, & Ondategui-Parra, 2004)
Knowledge can decline, the further clinicians move away from
their medical course, despite concerted CME efforts. (Ebbell,
1999)
