What is Evidence-Based Medicine?

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“Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” Sackett 1996. http://www.cebm.net/index.aspx?o=1014

The practice of evidence-based medicine means integrating:

1.  individual clinical expertise with 
2.  best available clinical evidence with
3. patient values and choices

1. Clinical expertise refers to the clinician's judgment made through the accumulation of experience, education and clinical skills. It recognized the clinician’s expertise in identifying and understanding patient preferences, rights and individual circumstances and how they play a role in patient centered care.

2. The best available clinical evidence is usually found in clinically relevant research that has been conducted using sound methodology.  EBM is NOT just about RCTs and meta-analyses.  It involves tracking down the best external evidence with which to answer our clinical questions.  In determining the accuracy of a diagnostic tool or test, cross-sectional studies of patients who are suspected of having the diagnosis is needed.  A cohort study is best for questions of prognosis.  RCTs and meta-analyses are best when determining the most effective treatment, determining the relative risk or the potential harm of a treatment.  Sometimes, there is no relevant information with the “best evidence” for a particular type of question – therapy, prognosis, diagnosis, harm, etc.  Then there is a need to investigate further for the next available evidence.  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.

3. Patient values and choices include the patient’s personal and unique experiences, awareness of his or her own body, their concerns, expectations, and values. Clinical evidence or guideline must be integrated with the physician’s clinical expertise in deciding whether and how that evidence or guideline matches the patient's clinical state, predicament, and preferences, and ultimately, whether it should be applied.

For more information, see our sections on

©     Databases for EBM which will not only provide links to some free databases but also some searching tips and articles,

©     Websites About EBM to learn more about how others are teaching courses in EBM, and provide some additional resources,

©     Websites with EBM Tools such as How to Construct a Clinical Questions, and abstracts of relevant clinical evidence, and

©     EBM Specialties such as Evidence-Based Nursing, Evidence-Based Laboratory Medicine, and Evidence-Based Physical Therapy.