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Evidence-Based Medicine (EBM)

Evidence-based medicine will play a central role with the advent of the Affordable Care Act

The information on evidence-based medicine presented in the EBM decision tree is based on two seminal texts written primarily by scientists at McMaster University, Ontario, Canada and other prestigious institutions.* All scientific practitioners and academic physicians should have these texts readily available. You, as a potential healthcare recipient, want your physician, surgeon, or therapist to know how to practice evidence-based medicine (EBM). The integration and use of evidence-based medicine principles represents the highest level of ethical, professional, and clinical practice in an ever-changing healthcare marketplace.  

The five steps of evidence-based medicine (EBM)

Evidence-based medicine (EBM) is practiced in five sequential steps:

1. Asking answerable clinical questions

2. Acquiring the highest quality evidence available

3. Appraising the clinical relevance and validity of the evidence in the current clinical environment

4. Applying evidence-based interventions in the current clinical environment

5. Assessing the efficacy and utility of EBM practice

The three modes of using evidence-based medicine (EBM)

There are three different "modes" of using EBM in any given clinical environment:

1. The "doing" mode where all steps of EBM are completed.

2. The "using" mode where all steps of EBM are applied with the exception of Step 3, where pre-appraised evidence is delivered or sought out.

3. The "replicating" mode where the opinion of leaders and peers in the field are utilized rather than acquiring and appraising evidence (Steps 2 and 3).

Click on the Asking Clinical Questions button to continue.
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*Guyatt G, Rennie D, Meade MO, Cook DJ. Users' guides to the medical literature: A manual for evidence-based clinical practice. Chicago: AMA press; 2008.
*Straus SE, Glasziou P, Richardson WS, Haynes RB. Evidence-based medicine: How to practice and teach it. Edinburgh: Churchill Livingstone; 2011. 

There are five steps used in evidence-based medicine: Asking clinical questions, acquiring clinical evidence, appraising clinical evidence, applying clinical evidence, and assessing clinical practice.

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