Evidence Based Medicine (EBM) Resources

• EBM Guide
• EBM Tutorial
• Evidence Based Practice Internet guide
• How to find evidence - the basics (a 90 minute web based course)
• Epidemiology Online Supercourse
• CMAJ Evidence based medicine series

Introduction to evidence based medicine

What is EBM and why do we need it?

Evidence Based Medicine (EBM) is the "conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research" (Sackett et al. 1996). EBM is a movement which aims to increase the use of high quality clinical research in clinical decision making.

EBM had its roots in 19th century Paris, but really got going in the 1990s when the explosion of medical information and information technology made it feasible to search computerised databases easily and rapidly for the best, most up to date evidence. Now, it is also driven by the involvement of consumers in medicine and the move towards shared clinical decision-making.

Practically, EBM is about finding out what the patient wants to know and the best possible evidence on which to base answers. The sorts of questions patients ask have, over time, driven clinically relevant research into (for example):

• the accuracy and precision of diagnostic tests (including the clinical examination),
• the power of prognostic markers, and
• the efficacy and safety of therapeutic and preventive interventions

The University of Sydney has recognised the importance of producing graduates with skills in EBM and is one of a small number of Universities that teach EBM to undergraduate students. This enables students to develop EBM skills from the outset of their clinical training, and to foster an ongoing desire to practice EBM.

The practice of EBM entails a process of life long self directed learning in which caring for patients creates the need for clinically important information and we then:

• Convert these information needs into answerable questions
• Track down efficiently the best evidence with which to answer them
• Critically appraise that evidence for its validity (closeness to truth) and usefulness
• Apply the results to patient care

References
Sackett, D.L. et al (1996). Evidence based medicine: what it is and what it isn't. BMJ; 312:71-72.