Why do we need EBM?

Physicians’ information needs

When asked by patients:

• we need information about 2 x a

week

books
• we get it from ________and
colleagues
_____________.
Physicians’ information needs
When 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
_______.
Physicians’ information needs
Why?
• Our textbook are out of date by the
day they are published
• our journals are disorganized and
inaccessible to us.
CLINICAL PERFORMANCE
DETERIORATES WITH TIME
 In summary ...

• clinicians need information about

medical practice, but our information
needs are not met-- textbooks out
of ___and
date disorganized
journals are _________.

• Consequently our knowledge and

use of best practice deteriorates with
time.
Some possible ways forward:

• learn how to practice evidence

based medicine.
• seek and apply appraisals of
studies into clinical practice
prepared by the others.
What are some possible
ways forward???
What is Evidence Based Medicine

It is the integration of available

medical evidence from systematic
search, clinical experience and
patient value in clinical decisions.
In effect...

updated
1. It will help us keep _______.
scientific in
2. It will make us more _______
our clinical decision making.
3. It will help us avoid wasting
resources.
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.
In effect...

7. It will make information more

accessible.
8. It will improve our understanding
of research.
So where do we start...

Users’ Guide
• simple guide to help clinicians
appraise research papers or clinical
practice guidelines.
Need for Users’ Guide
• Medical practice is constantly
changing
• New information is always being
added to the literature.
• They identify high quality research
and guidelines.
Need for Users’ Guide

• Users’ guides help clinicians appraise

information
• they help identify research or
guidelines of relevance to patient care.
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
Effects of Users’ Guide

• more empowered and less reliant

on conflicting recommendations of
clinical “experts”.
THE EBM CYCLE

1. Formulate a Question
2. Search the Literature
3. Appraising the Evidence
4. Integrating the Data in the
making a clinical decision
5. Evaluate results
EBM is not ….
 The COST of not knowing
and missing to learn the art of
medicine is the LIFE of our
patients….