Definitions of Evidence Based Practice

Evidence Based Clinical Practice

• Quotation: "Evidence based clinical practice (EBCP) is an approach to health care practice in which the clinician is aware of the evidence that bears on her clinical practice, and the strength of that evidence". Source: http://hiru.mcmaster.ca/ebm/default.htm#What_is_Evidence_Based_Medicine (McMaster University)
• Quotation: "Evidence based clinical practice is an approach to decision making in which the clinician uses the best evidence available, in consultation with the patient, to decide upon the option which suits that patient best". Source: Muir Gray JA. (1997) Evidence-based healthcare: how to make health policy and management decisions. London: Churchill Livingstone.

Evidence Based Medicine

• Quotation: "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. By individual clinical expertise we mean the proficiency and judgement that individual clinicians acquire through clinical experience and clinical practice. Increased expertise is reflected in many ways, but especially in more effective and efficient diagnosis and in the more thoughtful identification and compassionate use of individual patients' predicaments, rights, and preferences in making clinical decisions about their care. By best available external clinical evidence we mean clinically relevant research, often from the basic sciences of medicine, but especially from patient centred clinical research into the accuracy and precision of diagnostic tests (including the clinical examination), the power of prognostic markers, and the efficacy and safety of therapeutic, rehabilitative, and preventive regimens. External clinical evidence both invalidates previously accepted diagnostic tests and treatments and replaces them with new ones that are more powerful, more accurate, more efficacious, and safer."  Source: Sackett, D.L. et al. (1996) Evidence based medicine: what it is and what it isn't. BMJ 312 (7023), 13 January, 71-72). This paper is also available on the Web at: http://cebm.jr2.ox.ac.uk/ebmisisnt.html
•  Quotation: "Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. Without clinical expertise, practice risks becoming tyrannised by evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. Without current best evidence, practice risks becoming rapidly out of date, to the detriment of patients". Source: Sackett, D.L. et al. (1996) Evidence based medicine: what it is and what it isn't. BMJ 312 (7023), 13 January, 71-72). This paper is also available on the Web at: http://cebm.jr2.ox.ac.uk/ebmisisnt.html
• Quotation: "This description of what evidence-based medicine is helps clarify what evidence-based medicine is not. Evidence-based medicine is neither old-hat nor impossible to practice. The argument that everyone already is doing it falls before evidence of striking variations in both the integration of patient values into our clinical behaviour [7] and in the rates with which clinicians provide interventions to their patients [8]". Source: Sackett, D.L. et al. (1996) Evidence based medicine: what it is and what it isn't. BMJ 312 (7023), 13 January, 71-72). This paper is also available on the Web at: http://cebm.jr2.ox.ac.uk/ebmisisnt.html
• Quotation: "Evidence-based medicine is not "cook-book" medicine. Because it requires a bottom-up approach that integrates the best external evidence with individual clinical expertise and patient-choice, it cannot result in slavish, cook-book approaches to individual 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". Source: Sackett, D.L. et al. (1996) Evidence based medicine: what it is and what it isn't. BMJ 312 (7023), 13 January, 71-72). This paper is also available on the Web at: http://cebm.jr2.ox.ac.uk/ebmisisnt.html
• Quotation: "Evidence-based medicine is not cost-cutting medicine. Some fear that evidence-based medicine will be hijacked by purchasers and managers to cut the costs of health care. This would not only be a misuse of evidence-based medicine but suggests a fundamental misunderstanding of its financial consequences. Doctors practising evidence-based medicine will identify and apply the most efficacious interventions to maximise the quality and quantity of life for individual patients; this may raise rather than lower the cost of their care". Source: Sackett, D.L. et al. (1996) Evidence based medicine: what it is and what it isn't. BMJ 312 (7023), 13 January, 71-72). This paper is also available on the Web at: http://cebm.jr2.ox.ac.uk/ebmisisnt.html
• Quotation: "Evidence-based medicine is not restricted to randomised trials and meta-analyses. It involves tracking down the best external evidence with which to answer our clinical questions.....if no randomised trial has been carried out for our patient’s predicament, we follow the trail to the next best external evidence and work from there". Source: Sackett, D.L. et al. (1996) Evidence based medicine: what it is and what it isn't. BMJ 312 (7023), 13 January, 71-72). This paper is also available on the Web at: http://cebm.jr2.ox.ac.uk/ebmisisnt.html
• Quotation: "Evidence-based medicine (EBM) is an approach to health care that promotes the collection,

interpretation, and integration of valid, important and applicable patient-reported, clinician-observed, and research-derived evidence. The best available evidence, moderated by patient circumstances and
preferences, is applied to improve the quality of clinical judgments." Source:  McKibbon, K.A. et al. (1995) The medical literature as a resource for evidence based care. Working Paper from the Health Information Research Unit, McMaster University, Ontario, Canada. This paper is also available on the Web at http://hiru.mcmaster.ca/hiru/medline/asis-pap.htm
• Quotation: "Evidence-based medicine is ...a set of procedures, pre-appraised resources and information tools to assist practitioners to apply evidence from research in the care of individual patients".   Source: McKibbon, K.A.
• Quotation: "Evidence based medicine requires you not only to read the right papers at the right time and then to alter your behaviour (and, what is often more difficult, the behaviour of other people) in the light of what you have found". Source: Greenhalgh, T (1997). How to read a paper: the basics of evidence based medicine. London: BMJ. p. 2
• Quotation: "Evidence-based medicine involves evaluating rigorously the effectiveness of healthcare interventions, disseminating the results of evaluation and using those findings to influence clinical practice.  It can be a complex task, in which the production of evidence, its dissemination to the right audiences, and the implementation of change can all present problems". Source: Appleby J, Walshe K and Ham C (1995).  Acting on the Evidence (NAHAT Research Paper No. 17). Birmingham: NAHAT.
• Quotation: "Evidence-Based Medicine: the process of systematically finding, appraising, and using contemporaneous research findings as the basis for clinical decisions.  Evidence-based medicine ask questions, finds and appraises the relevant data, and harnesses that information for everyday clinical practice.  Evidence-based medicine follows four steps: formulate a clear clinical question from a patient’s problem; search the literature for relevant clinical articles; evaluate (critically appraise) the evidence for its validity and usefulness; implement useful findings in clinical practice.  The term "evidence based medicine" (no hyphen) was coined at McMaster Medical School in Canada in the 1980’s to label this clinical learning strategy, which people at the school had been developing for over a decade". Source: Medical Subject Heading (MeSH) scope note in MEDLINE database , from Rosenberg W.  Donald A (1995). Evidence based medicine: an approach to clinical problem solving. BMJ  310 (6987):1122-1126, Apr 25
• Quotation: "Evidence-based medicine (EBM) involves caring for patients by explicitly  integrating clinical research evidence with pathophysiologic reasoning, caregiver experience, and patient preferences....EBM is a style of practice and teaching which may also help plan future research".  Source: Cook, DJ and Levy MM. Crit Care Clin 1998 Jul;14(3):353-8.
• Quotation: "It is also a way of ensuring that clinical practice is based on the best available evidence through the use of strategies derived from clinical epidemiology and medical informatics". Source: Geddes, J et al (1997)  British Journal of Psychiatry 171: 220-225

 

Evidence Based Healthcare

• Quotation: "Evidence-based healthcare is the conscientious use of current best evidence in making decisions about the care of individual patients or the delivery of health services. Current best evidence is up-to-date information from relevant, valid research about the effects of different forms of health care, the potential for harm from exposure to particular agents, the accuracy of diagnostic tests, and the predictive power of prognostic factors." Source: First Annual Nordic Workshop on how to critically appraise and use evidence in decisions about healthcare, National Institute of Public Health, Oslo, Norway, 1996.
• Quotation: "Evidence based health care promotes the collection, interpretation, and integration of valid,

important and applicable patient-reported, clinician-observed, and research-derived evidence. The best available evidence, moderated by patient circumstances and preferences, is applied to improve the quality of clinical judgements and facilitate cost-effective health care". Source: Evidence-Based Medicine Informatics Project
• Quotation: Evidence-based healthcare "takes place when decisions that affect the care of patients are taken with due weight accorded to all valid, relevant information". Source: Hicks, N. (1997). Evidence based healthcare. Bandolier 4 (39): 8.
• Quotation: "a conscientious, explicit, and judicious use of the current best evidence to make a decision about the care of patients." Source: Marwick C (1997). Proponents Gather to Discuss Practicing Evidence-Based Medicine. Journal of the American Medical Association. 278 (7): 531-532.
• Quotation: "Evidence-Based Health Care extends the application of the principles of Evidence-Based Medicine (see above) to all professions associated with health care, including purchasing and management". Source: Centre for Evidence Based Medicine Glossary. http://cebm.jr2.ox.ac.uk/docs/glossary.html

 

Evidence Based Practice

• Quotation: "Evidence-based practice (EBP) is an approach to health care wherein health professionals use the best evidence possible, i.e. the most appropriate information available, to make clinical decisions for individual patients. EBP values, enhances and builds on clinical expertise, knowledge of disease mechanisms, and pathophysiology.  It involves complex and conscientious decision-making based not only on the available evidence but also on patient characteristics, situations, and preferences.  It recognizes that health care is individualized and ever changing and involves uncertainties and probabilities.  Ultimately EBP is the formalization of the care process that the best clinicians have practiced for generations".  Source: McKibbon KA (1998). Evidence based practice. Bulletin of the Medical Library Association 86 (3): 396-401.