Evidence Based Medicine Revisited

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The history of Evidence Based Medicine (EBM) in a few selected slides

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Evidence Based Medicine Revisited

  1. 1. EVIDENCE BASED MEDICINE (EBM) REVISITED José Fco García Gutiérrez Escuela Andaluza de Salud Pública PAHO HSS/HRH November 2011
  2. 2. The information paradox Bridging the gap between science and practice ! <ul><li>Scientific evidence </li></ul><ul><li> Patient </li></ul><ul><li> preferences </li></ul><ul><li>Clinical practice </li></ul>
  3. 3. The Toolbox EBM
  4. 4. Archie Cochrane <ul><li>“ It is surely a great criticism of our profession that we have not organised a critical summary, by specialty or sub-specialty, adapted periodically, of all relevant randomized controlled trials” </li></ul>
  5. 6. Critical Appraisal of Evidence Evaluación Crítica de la Evidencia
  6. 8. G.K. Chesterton <ul><li>“ It has not been tried and found wanting; it has been found difficult and left untried” </li></ul>
  7. 9. Which are the alternatives? <ul><li>Eminence based medicine </li></ul><ul><li>Vehemence based medicine </li></ul><ul><li>Eloquence based medicine </li></ul><ul><li>Providence based medicine </li></ul><ul><li>Diffidence based medicine </li></ul><ul><li>Nervousness based medicine </li></ul><ul><li>Confidence based medicine </li></ul>
  8. 10. <ul><li>THE </li></ul><ul><li>TOOLBOX </li></ul>
  9. 12. Evidence Based Information <ul><ul><ul><li>CATs (Clinical Q&A) </li></ul></ul></ul><ul><ul><ul><li>Systematic Reviews (SR) </li></ul></ul></ul><ul><ul><ul><li>Clinical Practice Guidelines (CPG) </li></ul></ul></ul>
  10. 18. www.qualitymeasures.ahrq.gov
  11. 20. Evidence Levels (version for dummies) <ul><li>A Meta-analisis or at least 1 RCT </li></ul><ul><li>B Other types of clinical and </li></ul><ul><li>epidemiological studies </li></ul><ul><li>C Experts opinion </li></ul>
  12. 21. Evidence Pathway
  13. 22. Evidence Mindlines Clinical Practice Patients
  14. 23. All-in-one: TRIP Database
  15. 24. Just remember two links …. <ul><li>TRIP Database </li></ul><ul><li>& </li></ul><ul><li>Medline Plus Plus </li></ul><ul><li>… and Google it! </li></ul>
  16. 26. <ul><li>Knowing is not enough; </li></ul><ul><li>we must apply </li></ul><ul><li>Willing is not enough; </li></ul><ul><li>we must do </li></ul>Goethe
  17. 27. THANKS 4 YUR ATTENTION

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