Why evidence based medicine

What is the Cochrane Collaboration? Published daily. The acclaimed POEMs process applies specific criteria for validity and relevance to clinical practice. About 1 in 40 studies qualifies. National Guideline Clearinghouse Storehouse of most clinical practice guidelines, some evidence-based, some specialty based, from the AHRQ. US Preventative Services Task Force An independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services.

Use online ePSS Tool. These resources combine many of the above resources into one tool that searches multiple resources, then organizes the results by category representing the type of question you have. Essential Evidence Plus Collection of systematic review, calculators, and other evidence based resources.

Available on PDA. DynaMed DynaMed contains clinically organized summaries of nearly 1, topics and is updated daily from review of the research literature. Slawson, et al. Critical Appraisal Worksheets. Evidence Based Medicine Tool Kit. What sort of evidence are we looking for? Current best evidence. Not perfect evidence, simply the best there is. But not old or out-of-date evidence; we need to find modern, up-to-date current evidence. How is this to be done? In a conscientious, explicit and judicious way.

Again, the words are important. If you are going to practice in this way, you have to be able to find evidence from scientific studies that are relevant to your patients. You then have to understand those studies and be able to appraise them not all studies will be relevant to your patient and even if they are, they may not be good studies.

And finally you have to apply those results when making decisions about your patient. This means being able to integrate the evidence with your patients personal needs, their values and beliefs and their wishes. When researchers look at whether a treatment works, they look at many more patients than a single doctor will ever treat. Sometimes the evidence can't tell you which treatment is best for you, so it's important that you weigh up the benefits and harms of treatments carefully. Why evidence from research is so important All evidence is not alike.

Here are some examples: Fifty years ago, women were often given an enema while they were in labour. This is uncomfortable and unpleasant. But doctors thought that enemas would reduce the risk of infection for the woman and her baby. Some hospitals gave soapy enemas, which were painful for women. When doctors studied the results from the research they found there was no evidence that enemas prevented infections.

Two studies showed that enemas made more of a mess, and women felt embarrassed by the enema. Resting in bed used to be recommended for many conditions. But now we know that it can often do more harm than good.

People who have had a heart attack, for example, do better both physically and mentally if they begin exercising as soon as they feel well enough. How to weigh other sorts of evidence What friends and family say When you aren't well, your family and friends often give you advice and tell you about their experiences. You do not need to make a decision on the basis of one study. How could this treatment help me? Has it been studied in people like me?

Is it likely that this drug will harm me? Am I more likely to get side effects than other people? For example, older people sometimes have more side effects. How strong is the evidence that this treatment works? Are the results of the research published in a medical journal? Is just one person telling their story on television? What are the alternatives to the treatment being offered?

What are the costs of the treatment? These can include financial and non-financial costs, such as inconvenience. Evidence based medicine: what it is and what it isn't. Enemas during labor Cochrane review. In: The Cochrane Library, Issue 2, Update Software, Oxford, UK. What Is Cancer? Cancer Statistics. Cancer Disparities. Cancer Causes and Prevention.

Risk Factors. Cancer Prevention Overview. Cancer Screening Overview. Screening Tests. Diagnosis and Staging. Questions to Ask about Your Diagnosis. Types of Cancer Treatment. Side Effects of Cancer Treatment. Clinical Trials Information. A to Z List of Cancer Drugs. Questions to Ask about Your Treatment. Feelings and Cancer. Adjusting to Cancer. Day-to-Day Life. Support for Caregivers.

Questions to Ask About Cancer. Choices for Care. Talking about Your Advanced Cancer. Planning for Advanced Cancer. Advanced Cancer and Caregivers. Questions to Ask about Advanced Cancer. Managing Cancer Care. Finding Health Care Services. Advance Directives. Using Trusted Resources. Coronavirus Information for Patients.

Clinical Trials during Coronavirus. Adolescents and Young Adults with Cancer.