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Evidence-Based Medicine: What is Evidence-Based Practice?

Evidence-based practice is the integration of scientific evidence, patients' values, and one's own clinical judgment in order to make the best possible health care decision.

David Sackett defines evidence-based medicine as "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, D. Evidence-based Medicine - What it is and what it isn't. BMJ 1996; 312:71-72.)

Please note: This guide uses the phrase evidence-based medicine interchangeably with evidence-based practice.

EBM/EBP Steps

1. ASK - Convert the need for information into a focused clinical question. Use the PICO framework. 

2. ACQUIRE - Track down the best evidence with which to answer that question.

3. APPRAISE - Critically appraise the evidence for its validity, impact, and applicability.

4. APPLY - Integrate the evidence with your clinical expertise and your patient's characteristics and values. 

5. ASSESS - Assess the results of your intervention. 


Two Cardinal Rules of EBM

1. Not all evidence is created equal - A hierarchy of evidence guides clinical decision-making.

2. Evidence alone is never enough - Competent physicians balance risks and benefits of management strategies in the context of patient values and preferences. 

Evidence-based medicine is at the intersection of clinical judgment, relevant scientific evidence, and patient values and preferences.

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