"Evidence-based medicine (EBM) is the integration of best research evidence with clinical expertise and patient
- 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
When these three elements are integrated, clinicians and patients form a diagnostic and therapeutic
alliance which optimizes clinical outcomes and quality of life."
Centre for Evidence Based Medicine
Evidence-based medicine is the "conscientious, explicit and judicious
use of current best evidence in making decisions about the care of
individual patients" (Sackett, DL. BMJ. 1996 Jan 13;312(7023):71-2).