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Evidence-based medicine - a new approach to teach medicine: a basic review for beginners

Sanchaya Selvaraj, Yeshwant Kumar NNT, Elakiya M, Prarthana Saraswathi C, Balaji D, Nagamani P, Surapaneni Krishna Mohan

No clinician would consider entering clinical practice without knowing the rudiments of history-taking and physical examination, nor would clinicians consider independent practice without a basic understanding of how the drugs they prescribe act on their patients. Yet, traditionally, clinicians have started practice without an ability to understand evidence about how they should interpret what they find on history and physical examination, or the magnitude of the effects they might expect when they offer patients medication. Evidence-based medicine (EBM) provides a remedy for this problem. Our Aim of this article is to introduce EBM to the beginners. Evidence-based medicine is the integration of best research evidence with clinical expertise and patient values. The EBM approach seeks to apply evidence from rigorous clinical research to the care of individual patients and has been defined as the “conscientious explicit and judicious use of current best evidence in making decisions about the care of individual patients”. It consists of five related steps. Step 1: Asking focused clinical questions that arise in caring for patients. Step 2: Acquiring the best available evidence through electronic searching. Step 3: Appraising the quality of the evidence acquired against explicit methodological criteria. Step 4: Applying the evidence appropriately to the clinical management of individuals. Step 5: Assessing performance in relation to the previous four steps. 1) Universal to the practice of medicine 2) Shortage of coherent, consistent scientific evidence 3) Difficulties in applying evidence to the care of individual patients 4) Barriers to the practice of high-quality medicine 5) The need to develop new skills 6) Limited time and resources