of 20
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Why do we need EBM?
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Physicians information needs
When asked by patients:
we need information about 2 x a
week
we get it from ________and_____________.
books
colleagues
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Physicians information needsWhen shadowed (in doubt):
we need information 60 x per week(twice for every three patients).
but we only get 30%of it
and usually this comes from asking_______.colleagues
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Physicians information needs
Why?
Our textbook are out of date by theday they are published
our journals are disorganized andinaccessible to us.
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CLINICAL PERFORMANCE
DETERIORATES WITH TIME
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In summary ...
clinicians need information about
medical practice, but our informationneeds are not met-- textbooks out
of ___and journals are _________.
Consequently our knowledge and
use of best practice deteriorates withtime.
date disorganized
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Some possible ways forward:
learn how to practice evidencebased medicine.
seek and apply appraisals ofstudies into clinical practice
prepared by the others.
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What are some possible
ways forward???
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What is Evidence Based Medicine
It is the integration of availablemedical evidencefrom systematic
search, clinical experienceandpatient valuein clinical decisions.
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In effect...
1. It will help us keep _______.2. It will make us more _______ in
our clinical decision making.
3. It will help us avoid wasting
resources.
updated
scientific
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In effect...4. It will provide information for
improving communication with
patients.
5. It will lead to safer and more
effective care.
6. It will improve our reading habits.
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In effect...
7. It will make information more
accessible.
8. It will improve our understanding
of research.
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So where do we start...
Users Guide
simple guide to help clinicians
appraise research papers or clinical
practice guidelines.
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Need for Users Guide
Medical practice is constantly
changing
New information is always being
added to the literature.
They identify high quality researchand guidelines.
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Need for Users Guide
Users guides help clinicians appraise
information
they help identify research or
guidelines of relevance to patient care.
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Effects of Users Guide
less reliance on throw away journals
and commercial sources and more
reliance on valid information more systematic approach to clinical
problem solving and decision making
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Effects of Users Guide
more empowered and less reliant
on conflicting recommendations of
clinical experts.
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THE EBM CYCLE
1. Formulate a Question2. Search the Literature3. Appraising the Evidence4. Integrating the Data in the
making a clinical decision
5. Evaluate results
1. Formulate a Question2. Search the Literature3. Appraising the Evidence4. Integrating the Data in the
making a clinical decision
5. Evaluate results
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EBM is not .
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The COST of not knowing
and missing to learn the art of
medicine is the LIFE of our
patients.