Chapter Eight – Evidence-Based Medicine (EBM)

30 vocabulary flashcards covering key terms, concepts and processes related to Evidence-Based Medicine, designed to help review definitions, hierarchy of evidence, the 5-step EBM process, and advantages/limitations of evidence-based practice.

Evidence-Based Medicine (EBM)

The conscientious, explicit and judicious use of current best evidence, combined with clinical expertise and patient values, to make decisions about individual patient care.

Evidence-Based Practice (EBP)

A synonym for EBM that emphasizes applying research findings in everyday clinical practice.

Clinical Expertise

The clinician’s accumulated experience, education and clinical skills used to interpret evidence and apply it to patient care.

Best Research Evidence

Clinically relevant research—often from epidemiologic studies—performed with sound methodology that informs healthcare decisions.

Patient Values and Preferences

The unique concerns, expectations and choices each patient brings to a clinical encounter, integrated with evidence when making care decisions.

PICO Framework

A structure for formulating answerable clinical questions: Patient/Problem, Intervention, Comparison, Outcome.

Five A’s of EBM

The iterative steps of evidence-based practice: Ask, Acquire, Appraise, Apply, Assess.

Ask (Step 1)

Formulate a focused, answerable clinical question about a patient problem using PICO.

Acquire (Step 2)

Search the literature and other reliable sources for the best available evidence to answer the question.

Appraise (Step 3)

Critically evaluate evidence for validity, impact and applicability to the specific patient situation.

Apply (Step 4)

Integrate the appraised evidence with clinical expertise and patient values to guide care decisions.

Assess (Step 5)

Evaluate the effectiveness and efficiency of the applied evidence and identify ways to improve practice.

Hierarchy of Evidence

A ranking of study designs according to strength of evidence, with meta-analyses at the top and expert opinion at the bottom.

Meta-analysis

A statistical technique that combines results from multiple studies to derive overall conclusions; provides the highest level of evidence.

Systematic Review

A rigorous summary of all relevant studies on a question, using explicit methods to identify, appraise and synthesize research.

Randomized Controlled Trial (RCT)

An experimental study where participants are randomly assigned to intervention or control groups; considered the gold standard for determining treatment effect.

Cohort Study

An observational study that follows a group with shared characteristics over time to compare outcomes between exposed and non-exposed groups.

Case-Control Study

An observational design that compares patients with a condition (cases) to those without it (controls) to identify preceding exposures.

Case Series

A descriptive report of a group of patients with similar diagnoses or treatments; offers lower-level evidence.

Expert Opinion

Guidance based on clinical experience or consensus without systematic research; lowest level of evidence.

Evidence Pyramid

A visual representation of the hierarchy of evidence, ascending from animal/lab studies to meta-analyses.

Clinical Question

A focused inquiry arising from patient care that guides evidence searching and appraisal.

MEDLINE

The National Library of Medicine’s premier bibliographic database for biomedical literature, searchable via PubMed.

PubMed

A free online interface for accessing MEDLINE and related biomedical literature.

Critical Appraisal

The systematic evaluation of research evidence to judge its trustworthiness, relevance and results.

Advantages of Evidence-Based Practice

Improves quality of care, promotes proven interventions, discourages harmful or ineffective practices, and fosters critical thinking.

Limitations of Evidence-Based Practice

Requires costly, large RCTs; evidence may not generalize across populations; publication bias and lag time can affect applicability.

Therapy Question

A clinical question that seeks to determine the effect of a treatment or intervention on patient outcomes.

Constructing a Well-Built Clinical Question

Process of framing a specific, answerable query using PICO to streamline evidence searching.

Lifelong, Self-Directed Learning

The ongoing, autonomous process of updating one’s knowledge and skills—central to practicing EBM.