Skip to main content

Evidence-Based Health Care

How to find the most up-to-date and reliable scientific evidence on which to base patient care decisions

What is Evidence-Based Medicine and Evidence-Based Practice?

Evidence-Based Medicine (EBM) is defined as: "The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients." (Sackett, Straus, Richardson, Rosenberg, & Haynes, 1996). What this means is that whenever you are caring for a patient, you should base your decisions on the most up-to-date and reliable scientific evidence. Evidence-Based Practice (EBP) is simply the method you would follow to translate EBM into practice. EBP also takes into account patient preferences, as illustrated by the graphic below:

EBP diagram

The Evidence Pyramid

The evidence pyramid is one way to organize the different types of evidence you would use in making a decision about the care of a patient. Below is an image of the evidence pyramid and to the left are pages of links to databases and websites where you can find “filtered” resources and expert opinion. “Filtered” resources, such as systematic reviews (the top of the pyramid), judge the quality of information produced from studies and often make recommendations for practice. As you may not always be able to find information on your topic in the “filtered” literature, then you’ll need to search the primary or “unfiltered” literature at various levels down the pyramid. Your job will be to try to evaluate the information you find to determine if it is valid and reliable. Remember, as you go down the pyramid the level of evidence decreases.

Evidence-Based Practice Five Steps

1. Ask  a searchable clinical question;
2. Find the best evidence to answer the question;
3. Appraise the evidence;
4. Apply the evidence with clinical expertise, taking the patient's wants/needs into consideration;

5. Evaluate the effectiveness and efficiency of the process.