Evidence-based health care is the conscientious use of current best evidence in making decisions about the care of individual patients or the delivery of health services. Current best evidence is up-to-date information from relevant, valid research about the effects of different forms of health care, the potential for harm from exposure to particular agents, the accuracy of diagnostic tests, and the predictive power of prognostic factors [1]. Evidence-based clinical practice is an approach to decision-making in which the clinician uses the best evidence available, in consultation with the patient, to decide upon the option which suits that patient best [2]. Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research [3].

Further reading

Cochrane AL. Effectiveness and Efficiency : Random Reflections on Health Services. London: Nuffield Provincial Hospitals Trust, 1972. Reprinted in 1989 in association with the BMJ. Reprinted in 1999 for Nuffield Trust by the Royal Society of Medicine Press, London, ISBN 1-85315-394-X.

Gray JAM. 1997. Evidence-based healthcare: how to make health policy and management decisions. London: Churchill Livingstone. [2]

Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS. 1996. Evidence based medicine: what it is and what it isn't. BMJ 312: 71–2 [3] [Full text]

Resources

Many organizations have contributed to the development of EBM or have information on systematic reviews. Below are links to websites of just a few. Please read the disclaimer below.

Centre for Reviews and Dissemination
http://www.york.ac.uk/inst/crd/

Centre for Evidence-Based Child Health
http://www.ich.ucl.ac.uk/ich/html/academicunits/paed_epid/cebch/about.html

Centre for Evidence-Based Medicine
http://www.medlib.iupui.edu/ebm/home.html

Bandolier - Evidence-Based Healthcare
http://www.jr2.ox.ac.uk/bandolier/index.html

Berkeley Systematic Reviews Group
http://www.medepi.org/meta/index.html

The ScHARR Guide
A guide to evidence-based practice on the Internet
http://www.nettingtheevidence.org.uk

(Oxford) Centre for Evidence Based Medicine
http://www.cebm.net

Clinical Evidence
Clinical Evidence, produced by the BMJ, is a compendium of evidence for effective health care organized for easy reference.
http://www.clinicalevidence.org

National Health Service (UK) - Health Technology Assessment
The HTA program actively seeks out the questions which meet the NHS's research needs, commissions research to meet those needs, and communicates the findings to the NHS and its users.
http://www.hta.nhsweb.nhs.uk

The James Lind Library (formerly 'Controlled Trials from History')
This is a joint project of the UK Cochrane Centre and the Royal College of Physicians of Edinburgh to introduce people to the characteristics of fair tests, and to illustrate how these tests have evolved.
http://www.jameslindlibrary.org

Society for Clinical Trials
http://www.sctweb.org

Cochrane Collaboration Disclaimer about external links

Views expressed on the websites and resources listed on this page are not necessarily shared by the Cochrane Collaboration. The "quality" of information presented online by these websites can vary, and is in no way endorsed or recommended by the Cochrane Collaboration. This page is intended simply as a starting point for readers to do their own searching and reading about the topic of Evidence-Based Medicine.

While "evidence" can be essential in evaluating effectiveness of healthcare interventions, well-informed decisions also require information, and judgments about needs, resources and values; as well as judgments about the quality and applicability of evidence. Relying only on evidence about the effects of health care alone can be inappropriate. Care and compassion are vital, and understanding the nature and basis of disease and the way that interventions work remains important. The Cochrane Collaboration is not responsible for the results of decisions based on information found in sources listed on this page.

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Comments for improvement or correction are welcome.
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