Evidence based medicine: an approach to clinical problem-solving
- PMID: 7742682
- PMCID: PMC2549505
- DOI: 10.1136/bmj.310.6987.1122
Evidence based medicine: an approach to clinical problem-solving
Abstract
Doctors within the NHS are confronting major changes at work. While we endeavour to improve the quality of health care, junior doctors' hours have been reduced and the emphasis on continuing medical education has increased. We are confronted by a growing body of information, much of it invalid or irrelevant to clinical practice. This article discusses evidence based medicine, a process of turning clinical problems into questions and then systematically locating, appraising, and using contemporaneous research findings as the basis for clinical decisions. The computerisation of bibliographies and the development of software that permits the rapid location of relevant evidence have made it easier for busy clinicians to make best use of the published literature. Critical appraisal can be used to determine the validity and applicability of the evidence, which is then used to inform clinical decisions. Evidence based medicine can be taught to, and practised by, clinicians at all levels of seniority and can be used to close the gulf between good clinical research and clinical practice. In addition it can help to promote self directed learning and teamwork and produce faster and better doctors.
Comment in
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Evidence based medicine. Example was flawed.BMJ. 1995 Jul 22;311(6999):257; author reply 259. doi: 10.1136/bmj.311.6999.257a. BMJ. 1995. PMID: 7627053 Free PMC article. No abstract available.
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Evidence based medicine. Megatrials are subordinate to medical science.BMJ. 1995 Jul 22;311(6999):257; author reply 259. doi: 10.1136/bmj.311.6999.257b. BMJ. 1995. PMID: 7627054 Free PMC article. No abstract available.
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Evidence based medicine. Must be applied critically.BMJ. 1995 Jul 22;311(6999):257; author reply 259. doi: 10.1136/bmj.311.6999.257c. BMJ. 1995. PMID: 7627055 Free PMC article. No abstract available.
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Evidence based medicine. Quality cannot always be quantified.BMJ. 1995 Jul 22;311(6999):258. doi: 10.1136/bmj.311.6999.258a. BMJ. 1995. PMID: 7627056 Free PMC article. No abstract available.
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Evidence based medicine. No guidance is provided for situations for which evidence is lacking.BMJ. 1995 Jul 22;311(6999):258; author reply 259. doi: 10.1136/bmj.311.6999.258. BMJ. 1995. PMID: 7627057 Free PMC article. No abstract available.
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Evidence based medicine. Accurate references are important.BMJ. 1995 Jul 22;311(6999):259. doi: 10.1136/bmj.311.6999.259. BMJ. 1995. PMID: 7627060 Free PMC article. No abstract available.
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Evidence based medicine.BMJ. 1995 Apr 29;310(6987):1085-6. doi: 10.1136/bmj.310.6987.1085. BMJ. 1995. PMID: 7742666 Free PMC article. No abstract available.
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Evidence based medicine: Socratic dissent.BMJ. 1995 Apr 29;310(6987):1126-7. doi: 10.1136/bmj.310.6987.1126. BMJ. 1995. PMID: 7742683 Free PMC article. No abstract available.
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