Evidence based medicine.ppt

Evidence-Based Medicine Applying the Concepts to Pediatric Nutrition Practice and Consultation What evidence-based medicine is: Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. Sacket et al. BMJ 1996 What evidence-based medicine is: The practice of EBM requires the integration of l individual clinical expertise with the l best available external clinical evidence from systematic research. Producing Evidence Making evidence available Using Evidence: getting research into practice For individual patients For populations Evidence Based Medicine is Not: l Cook-book medicine l Cost cutting medicine l Restricted to randomized trials and meta-analysis “ If no randomized trials have been carried out for our patient ’ s predicament, we follow the trail to the next best external evidence and go from there. ” Sacket et al. BMJ 1996 Why EBM? l Clinicians need information l If asked: ? we need it twice a week, ? we get it from our text books & journals. Clinicians really need information! If shadowed: l they need it up to 60 times per week but only 30% of it l and es from passers-by ?“ my textbooks are out of date ”?“ my journals too anized ” Medical textbooks are out-of-date l Fail to mend Rx up to ten years after it ’ s been shown to be efficacious. l Continue to mend therapy up to ten years after it ’ s been shown to be useless. Three solutions Clinical performance can keep up to date: 1 by learning how to practice evidence- based medicine ourselves. 2 by seeking and applying evidence- based medical summaries generated by others. 3 by accepting evidence-based practice protocols developed by our colleagues.