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Evidence Based Medicine : Intro to EBM

The Evidence Cycle

Image from the Duke University EBP guide 

The patient is at the center of evidence-based medicine decision-making. 

  1. Assess the patient with a thorough clinical evaluation to gather all the pertinent data about the patient(s) or population(s)
  2. Ask  patient-oriented, relevant, answerable questions about the health status and context of patients or populations 
  3. Acquire the best available evidence to answer the question 
  4. Appraise the evidence critically for validity and applicability to the problem at hand
  5. Apply the evidence by engaging in collaborative health decision-making with the patient(s) or population(s) 

Evidence cycle description from the Duke Program on Teaching Evidence-Based Practice 


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Leslie Christensen

What is Evidence Based Medicine?

Image from the Duke University EBP guide

Evidence-based medicine (EBM) is the integration of best research evidence with clinical expertise and patient values.

  • by best research evidence we mean clinically relevant research, often from the basic sciences of medicine, but especially from patient centered 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. New evidence from clinical research both invalidates previously accepted diagnostic tests and treatments and replaces them with new ones that are more powerful, more accurate, more efficacious, and safer.
  • by clinical expertise we mean the ability to use our clinical skills and past experience to rapidly identify each patient's unique health state and diagnosis, their individual risks and benefits of potential interventions, and their personal values and expectations.
  • by patient values we mean the unique preferences, concerns and expectations each patient brings to a clinical encounter and which must be integrated into clinical decisions if they are to serve the patient.

Straus, S. E., Glasziou, P., Richardson, W. S., & Haynes, R. B. (2019). Evidence-based medicine: How to practice and teach EBM.


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