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Evidence Based Medicine

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'tBMJ. 1996;312(7023):71-72.




The Five "A"s of the Decision Making Cycle

The 5 A's of Evidence Based Medicine

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

  1. ASK:  Information needs from practice are converted into focused, structured questions.
  2. ACCESS / ACQUIRE:  The focused questions are used as a basis for literature searching in order to identify relevant external  evidence from research.
  3. APPRAISE:  The research evidence is critically appraised for validity.
  4. APPLY: The best available evidence is used alongside clinical expertise and the patient's perspective to plan care.
  5. 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)


Center of Evidence Based Medicine Study Design Flow Chart


EBM Venn Diagram

Levels of Evidence;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 (accessed 5/8/2023)