The process of systematically finding, appraising, and using contemporaneous research findings as the basis for clinical decisions. Evidence-based medicine asks questions, finds and appraises the relevant data, and harnesses that information for everyday clinical practice.
The term "evidence based medicine" was coined at McMaster Medical School in Canada in the 1980's
” I had considerable freedom of clinical choice of therapy: my trouble was that I did not know which to use and when. I would gladly have sacrificed my freedom for a little knowledge. I had never heard then of 'randomised controlled trials', but I knew there was no real evidence that anything we had to offer had any effect on tuberculosis, and I was afraid that I shortened the lives of some of my friends by unnecessary intervention.”
As a prisoner of war he discovered the lack of knowledge in the medical education
Medical interventions should be based on scientific knowledge, not on presumption
Effectiveness and Efficiency. Random Reflections on Health Services, 1972
Clinical decisions should be based on knowledge, not on supposition or chances.
In 1979 he wrote, " It is surely a great criticism of our profession that we have not organised a critical summary, by specialty or subspecialty, adapted periodically, of all relevant randomised controlled trials."
Cochrane Collaboration international network, 1993, Oxford
The aim : to help people make well informed decisions about health care by:
ensuring the accessibility of systematic reviews of the effects of health care interventions
Building on the enthusiasm of individuals
Keeping up to date
Selects RCT ’s - Randomized Controlled Trials and produces systematic reviews where all selected RCT’s(within the subject) are compared
Updates the systematic reviews when new studies are available
Bibliographic information to reports from International Network of Agencies for Health Technology Assessment (INAHTA), non-profit organizations like SBU ( The Swedish Council on Technology Assessment in Health Care) that evaluates healthcare technology.