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the conscientious, explicit, and judicious use of the best evidence in making decisions about the care of individual patients
application of the best ______ available in medicine to the patient in your office with a particular medical problem
in the past when an answer was unknown you went to ______
the eldest provider for the answer (the most experienced)
Now when the answer is unknown we consult _______ to determine what decision is associated with the best clinical outcome
medical evidence (the best proven)
what are the 3 components to EBM
clinical problem solving, medical information systems, and critical appraisal of medical literature
statistics, epidemiology, knowledge of study design and level of evidence represent the
critical appraisal of medical lit
too many pts., too many problems, too many journals, info overload, no time, read only what your familiar with, avoid difficult issues
the 6 steps in EBM
create a clinical question (PICO), search the medical lit, find the study that will answer your question and note the effect size, perform a critical appraisal of the study to determine validity, determine if/how results will help your pt (external validity), evaluate the result in your pts.
DOE vs POEM
some studies may only review the disease but may irrelevant to your pt., some studies directly matter to your pts.
improves decision making confidence, help communication, decreases time wading through lit, fosters focused productive reading, lessens lag time for applying and finding research, dovetails with tech such as pda's and databases
advantages of EBM
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