Existing knowledge can prevent…. Waste Errors Poor quality clinical care Poor patient experience Adoption of interventions of low value Failure to adopt interventions of high value
Poor quality clinical care
Poor patient experience
Adoption of interventions of low value
Failure to adopt interventions of high value
Source: Sir Muir Gray, Chief Knowledge Officer of Britain’s National Health Service. Quoted on http://www.nks.nhs.uk/.
“Evidence-based medicine is the integration of best research evidence with clinical expertise and patient values”Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS: Evidence based medicine: what it is and what it isn’t. BMJ 1996;312:71-2.
What is EBM?
Randomized controlled trials are considered the best studies for assessing therapeutic interventions.
Source: Sackett, D.L., Richardson, W.S., Rosenberg, W.M.C., & Haynes, R.B. (1996). Evidence-Based Medicine: How to practice and teach EBM. London: Churchill-Livingstone.
POC Tools: Up-to-date, Dynamed, FIRSTConsult, ACP PIER
ACP Journal Club
Evidence Based Ophthalmology
Cochrane and other Systematic Reviews (OVID EBMR)
MEDLINE Searches with Clinical Queries
SOURCE: Haynes, R. B. (2001). Of studies, syntheses, synopses, and systems: the “4S” evolution of services for finding current best evidence. Evidence-Based Medicine, 6 (2), 36-38. Retrieved 2-07-07 from http://ebm.bmj.com/cgi/reprint/6/2/36
Developing and using a rubric for evaluating evidence-based medicine point-of-care tools. Journal of the Medical Library Association, Volume 99, No. 3, July 2011
Speed of updating online evidence based point of care summaries: prospective cohort analysis. BMJ 2011;343:doi:10.1136/bmj.d5856 (Published 23 September 2011)
Grade the quality of evidence based on the design of the clinical study
Variety of hierarchies in use
American Academy of Family Physicians Rating System for assessing therapeutic interventions.
Systematic reviews of randomized controlled trials including meta-analyses
Good-quality randomized controlled trials
Good-quality nonrandomized clinical trials
Systematic reviews not in Level A
Lower-quality randomized controlled trials not in Level A
Other types of study: case control studies, clinical cohort studies, cross sectional studies, retrospective studies, and uncontrolled studies
Evidence-based consensus statements and expert guidelines