Evidence based medicine is a hot topic for clinicians. While most agree that it makes for better medicine, there are misunderstandings as to what it is and how to utilize it. Evidence based practice can be defined as the integration of the current best research evidence with clinical expertise and patient values.
Best Research Evidence: To determine the best available evidence, you need to incorporate the best evidence from well-designed studies. There are a variety of rating systems and hierarchies of evidence that grade the strength or quality of evidence generated from a research study or report. Being knowledgeable about evidence-based practice and levels of evidence is important to every clinician as clinicians need to be confident about how much emphasis they should place on a study, report or clinical practice guideline when making decisions about a patient’s care.
Clinician’s Expertise: By individual clinical expertise we mean the proficiency and judgment that individual clinicians acquire through clinical experience, skill acquisition, accumulation of knowledge, patient care experience and clinical practice. Increased expertise is reflected in many ways, but especially in more effective and efficient diagnosis and treatment, while taking into consideration a patients’ rights and preferences in making clinical decisions about their care.
Patient’s Values: Finally, the patient’s needs, wants and beliefs should be given equal consideration. Patient preferences can be religious or spiritual values, social and cultural values, thoughts about what constitutes quality of life, personal priorities, and beliefs about health.
Evidence based medicine integrates the best external evidence with individual clinical expertise and patients’ choice, in its approach to individualized patient care. External clinical evidence can inform, but can never replace, individual clinical expertise, and it is this expertise that decides whether the external evidence applies to the individual patient at all and, if so, how it should be integrated into a clinical decision.