36 Questions
What can a doctor not do, even if they have time to read all published articles and studies?
Evaluate the value of the study
What does 'explicit' mean in the context of evidence-based practice?
Being up-front, open, clear and transparent
What is the ultimate goal of evidence-based medicine?
To integrate the experience of the clinician, the values of the patient, and the best available scientific information
What does 'judicious' mean in the context of evidence-based practice?
Using good judgement and common sense
What is evidence-based practice?
The conscientious, explicit, and judicious use of current best evidence
What is a result of the change in the way physicians practice medicine due to evidence-based medicine?
Physicians practice, teach, and learn in a new way
When was the term 'Evidence-Based Medicine' first proposed?
1991
What led to the development of Evidence-Based Medicine?
Unsystematic clinical experience and pathophysiological rationale
Who led the group that consolidated and named the approach as Evidence-Based Medicine in 1992?
Gordon Guyatt
What is a characteristic of medical knowledge?
It grows every day
What is an impact of the shift to Evidence-Based Medicine?
A change in the way physicians practice medicine
What was the original purpose of the committee formed in 1970?
To understand how health professionals learn and keep up-to-date after they graduate
What is a key feature of Evidence-Based Medicine?
Emphasis on evidence collected from research
Where was the Department of Clinical Epidemiology and Biostatistics located?
McMaster University in Ontario, Canada
What is a characteristic of Cochrane Systematic Reviews?
They answer a specific clinical question
What is the primary difference between Cochrane Systematic Reviews and Non-Cochrane Systematic Reviews?
The method of critically appraising the literature
What is the purpose of Critically Appraised Articles?
To critically evaluate single research articles
When would you need to access Unfiltered Information Resources?
When there is no filtered information on your topic
What is MEDLINE?
A premier source for biomedical journal articles
Why do research articles in journals require critical evaluation?
Because they are not evaluated for quality
What is the main difference between filtered and unfiltered information resources?
The level of quality evaluation
What is an example of an Unfiltered Information Resource?
Research article found in a journal
What is the first step in the 5 As technique of Evidence-Based Medicine?
Clinical Question
What is the primary purpose of critical appraisal in EBM?
To evaluate evidence for quality and usefulness
What does PICO stand for in the context of critical appraisal?
Population, Intervention, Comparison, Outcome
Which of the following is NOT a key question to consider during critical appraisal?
What is the researcher's opinion on the topic?
What is the ultimate goal of the 5 As technique in Evidence-Based Medicine?
To implement useful findings in clinical practice
Why is critical appraisal necessary in Evidence-Based Medicine?
To evaluate the quality and usefulness of evidence
What is the primary goal of a well-framed clinical question in EBM?
To identify the problem and clarify the clinical issue
Which of the following is NOT a characteristic of a good clinical question in EBM?
Involve a question of personal preference
What does the 'P' in PICO stand for?
Patient
What is the purpose of the 'I' in PICO?
To specify the clinical intervention
What is the main difference between PICO and PECO?
PICO is used for therapeutic interventions, while PECO is used for environmental exposures
Which of the following is an example of an 'O' in PICO?
Reduced blood pressure
What is the primary benefit of using a framework like PICO to frame a clinical question?
It clarifies the clinical issue and identifies the problem
Why is it important to ask good clinical questions in EBM?
To improve patient outcomes and provide evidence-based care
Study Notes
Evidence-Based Medicine (EBM)
- EBM originated in the late 1980s, and was first proposed in medical literature in 1991 as a new way of teaching the practice of medicine.
- It was consolidated and named EBM in 1992 by a group led by Gordon Guyatt from McMaster University in Ontario, Canada.
- EBM is a change in the way physicians practice medicine, teach, and learn, and handle research.
Definition of EBM
- EBM is the conscientious, explicit, and judicious use of current best evidence in helping individual patients make decisions about their care.
- It integrates the experience of the clinician, the values of the patient, and the best available scientific information to guide decision-making about clinical management.
- Conscientious means being careful and thorough, explicit means being up-front, open, and clear, and judicious means using good judgement and common sense.
Need for EBM
- Medical knowledge grows every day, and medical research is continually discovering improved treatment methods and therapies.
- Practitioners must keep up to date with current research, but not all studies are equally well-designed, conducted, or interpreted.
- Doctors lack the time to evaluate the value of each study, its methodology, outcome, and transparency.
Five Basic Steps of EBM
- Step 1: Clinical Question (ASK)
- Framing the question using PICO/PECO (Patient, Intervention, Comparison, Outcome)
- Examples: 47-year-old male with DM2 and cellulitis toe, 25-year-old female with DVT and chest pain
- Step 2: Find Best Evidence (Acquire)
- Filtered information resources: Cochrane Systematic Reviews, Non-Cochrane Systematic Reviews, Critically Appraised Articles
- Unfiltered information resources: Journal Articles, Research articles found in journals (e.g., MEDLINE)
- Step 3: Critical Appraisal (APPRAISE)
- Evaluate evidence for quality and usefulness
- Appraisal principles: PICO, methodology, bias, results, and relevance
- Step 4: Apply the Evidence (Apply)
- Implement useful findings in clinical practice
- Step 5: Evaluate (Assess)
- The information, intervention, and EBM process
Test your knowledge of Evidence-Based Medicine, its components, and importance, with this quiz designed by Dr. Nelly Hegazy, Lecturer of Public Health and Community Medicine.
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