What is Evidence Based Medicine

The most commonly used definition for EBM is that "Evidence-based medicine is 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 DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ. 1996;312(7023):71-72.

The Five "A"s of the Decision Making Cycle

The 5 "A's" will help you to remember the EBP process:

ASK: Information needs from practice are converted into focused, structured questions.
ACCESS / ACQUIRE: The focused questions are used as a basis for literature searching in order to identify relevant external evidence from research.
APPRAISE: The research evidence is critically appraised for validity.
APPLY: The best available evidence is used alongside clinical expertise and the patient's perspective to plan care.
ASSESS / AUDIT: Performance is evaluated through a process of self reflection, audit, or peer assessment.

Please note, there are several models for EBP with various named and numbered steps. This guide will detail the first three steps ASK, ACCESS/ACQUIRE, APPRAISE. Some models include a 6th step for DISSEMINATE.

* This box and graphic was created by Diane Giebink-Skoglind of ThedaCare. Used by permission. The graphic is adapted from Melnyk, BM & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best pracatice. (2nd ed.) Philadephia: Wolters-Kluwer/Lippincott Williams & Wilkins

Centre for Evidence-Based Medicine (Toronto)

The goal of this website is to help develop, disseminate, and evaluate resources that can be used to practice and teach EBM for undergraduate, postgraduate and continuing education for health care professionals from a variety of clinical disciplines. This site also serves as support for the book entitled, Evidence-based Medicine: How to Practice and Teach EBM by Sharon E. Straus, W. Scott Richardson, Paul Glasziou and R. Brian Haynes (3rd edition).

Center of Evidence Based Medicine Study Design Flow Chart

https://www.cebm.ox.ac.uk/resources/ebm-tools/study-designs

Levels of Evidence

https://s3.amazonaws.com/libapps/accounts/58167/images/pyramid2.gif;2019.6.10

Understanding 'Levels of Evidence'

Developed by the Physiotherapy Association of British Columbia this tutorial explains the levels of evidence, based on research study design, so that you can find the best evidence for your practice using a database

Evidence Based Practice Toolkit

Guide from Krueger Library

https://libguides.winona.edu/ebptoolkit/Levels-Evidence (accessed 5/8/2023)

TDNet Discover

Evidence Based Medicine

What is Evidence Based Medicine

Understanding 'Levels of Evidence'