International Oncology Subject Guide: Evidence Based Practice (EBP)

Evidence-based practice (EBP) is the application of the principles of evidence-based medicine (EBM) in patient care. It's goal is to improve the quality and effectiveness of health care. To better understand the concept of EBP, it is necessary to identify the principles of EBM. Evidence-based medicine consists of the following three fundamental principles (sackett):

1. Application of current best evidence (the best current available evidence, considering patient circumstances and preferences)
2. Conscientious, explicit, and judicious (being careful, transparent, and good use of judgment)
3. Decision making (integrate the evidence with the clinician's expertise/experience and  patients needs, preferences, and values). 

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​The Evidence-Based Medicine Triad (Sakett at el., BMJ 1996;312: 71-72)

"The practice of evidence-based medicine is a process of life-long, self-directed learning in which caring for our own patients creates the need for clinically important information about diagnosis, prognosis, therapy, and other clinical and health care issues."
 

How to use evidence-based medicine to make a clinical decision?

 The following five steps for clinicians that are practicing evidence-based medicine in their patient care described by Sackett:

1. Convert the need for information about specific patient/case into a specific, structured and answerable question.
2. Find the best evidence to answer the question (whether from the clinical examination, the diagnostic laboratory from research evidence, or other sources).
3. Critically evaluate the evidence for its validity and clinical applicability.
4. Integrate the clinical evaluation with clinical expertise and knowledge of the patient, and apply in practice.
5. Re-evaluating the previous four steps to determine the effectiveness and efficiency of the process (performance evaluation).

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