intro to ebm

8/7/2019 intro to ebm

1/20

Why do we need EBM?


2/20

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Our textbook are out of date by theday they are published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.


12/20

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 .


20/20

The COST of not knowing

and missing to learn the art of

medicine is the LIFE of our

patients.

intro to ebm

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