Evidence Based Medicine is defined in different ways, depending on the discipline. While the core of the message remains the same, one of the best known definitions of evidence based medicine is by Dr. David Sackett, considered by many to be one of the "fathers of ebm." Dr. Sackett wrote in a 1996 BMJ article:
"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."
Dr. Sackett also stated in the same article what EBM was not. He stated:
"Evidence based medicine is not 'cookbook' medicine. Because it requires a bottom up approach that integrates the best external evidence with individual clinical expertise and patients' choice, it cannot result in slavish, cookbook approaches to individual patient care..."
So instead of relying on anecdotal experiences to treat patients, evidence from studies is used to treat patients. You can read his article here.
1. 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. doi:10.1136/bmj.312.7023.71
There are a number of presentations related to levels of evidence. Below are some illustrative models. The key point is that the more something is reviewed and analyzed, the higher the level of evidence.
Citation: Chapter 5 Finding Current Best Evidence, Guyatt G, Rennie D, Meade MO, Cook DJ. Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed; 2015. Available at: https://jamaevidence.mhmedical.com/content.aspx?sectionid=69031461&bookid=847 Accessed: July 31, 2020 Copyright © 2020 American Medical Association. All rights reserved
Another representation of levels of evidence is called the Pyramid of Evidence: this pyramid illustrates that the amount of review, the higher the level of evidence.
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Produced by Jan Glover, David Izzo, Karen Odato and Lei Wang.
PICO is a template to break down a clinical question to generate terms or concepts to search.
For example: A patient who has a rotator cuff injury would like to know whether surgery or physical therapy would yield him a better outcome. Below how the clinical question can be broken down into core concepts. Not all questions fit into PICO but it provides a good framework with which to begin.
P - rotator cuff injury
I - surgery
C - physical therapy
O - treatment outcome