chapter  4
The practicalities of evidence-based medicine
ByTony Lockett
Pages 9

This chapter reviews the practical aspects of evidence-based medicine (EBM) and how to introduce it into a clinical setting. The development of EBM places a distinct hierarchy on the value of evidence. The practice of EBM is having an impact on medical practice. Questions are key to the process of developing an evidence-based approach. The questions asked can relate to the diagnosis, treatment, quality or economics of care. Once the question is formulated then the evidence to support the question is needed. This requires the searching of databases. These databases are relatively cheap but are very dependent upon the search strategies used to generate the bibliography. Once the data has been collected then its quality must be appraised. The screens that are applied to appraise data have been summarized as critical appraisal methods. Without the questions it is impossible to find the needed evidence or appraise the results.