evidence based medicine

Question 1

The primary purpose of the NHS is

Answer 1

to secure, through resources available, the greatest possible improvement in the physical and mental health of the population

Question 2

EBP - Sackett et al (1996)

Answer 2

he conscientious, explicit and judicious use of current best evidence in making nursing decisions about the care of individual patients

Question 3

EBP - Carnwell (2001)

Answer 3

systematic search for, and appraisal of, best evidence in order to make clinical decisions that might require changes in current practice, while taking into account the individual needs of the patient.

Question 4

Clinical decisions should be

Answer 4

informed by up-to-date, relevant and robust evidence

Question 5

clinical effectiveness

Answer 5

• Production of evidence through scientific research and review
• Production and dissemination of evidence based clinical guidelines
• Implementation of evidence based, cost effective practice through education and change management
• Evaluation of compliance with practice guidance through clinical audit

Question 6

who use EBM principles to formulate Health Technology Assessments (HTAs) which determine which treatments should be available within the NHS

Answer 6

NICE, Scottish Medicine Consortium, All Wales Medicine Strategy Group

Question 7

3 Principles of EBM

Answer 7

1. High quality health care rests on objective and clinically relevant information
2. There is a hierarchy of evidence where some types are stronger than others
3. Scientific data alone is not a sufficient basis for making clinical decisions about individual patients

Question 8

Applying Evidence Based Medicine

Answer 8

Use the best evidence in the scientific literature to provide the best care for an individual patient

Question 9

Why EBM is now essential

Answer 9

• Daily requirement for correct answers to questions about
– The effects of therapy
– The utility of diagnostic tests 
– The prognosis of diseases
– The etiology of disorders

Question 10

How to practise EBM

Answer 10

• Craft a clinical question (PICO)
• Search the medical literature (medical informatics)
• Find the study that will best answer the question
• Perform a critical appraisal (check for validity and bias)
• Determine how the results will help you care for your patient
• Evaluate the results in your patient or population