EVIDENCE BASED MEDICINE (EBM)

REVISITED

EVIDENCE BASED MEDICINE (EBM)

REVISITED

José Fco García GutiérrezEscuela Andaluza de Salud Pública

PAHO HSS/HRHNovember 2011

The information paradoxBridging the gap between science and practice !

Scientific evidence

Patient

preferences

Clinical practice

EBM

Archie Archie CochraneCochraneArchie Archie CochraneCochrane

“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”

Critical Appraisal of EvidenceEvaluación Crítica de la Evidencia

G.K. Chesterton

“It has not been tried and found wanting; it has been found difficult and left untried”

Which are the alternatives?

Eminence based medicine

Vehemence based medicine

Eloquence based medicine

Providence based medicine

Diffidence based medicine

Nervousness based medicine

Confidence based medicine

THETOOLBOX

Evidence Based Information

•CATs (Clinical Q&A)•Systematic Reviews (SR)•Clinical Practice Guidelines (CPG)

www.qualitymeasures.ahrq.gov

Evidence Levels(version for dummies)

A Meta-analisis or at least 1 RCT

B Other types of clinical and

epidemiological studies

C Experts opinion

Evidence Pathway

Evidence

MindlinesClinicalPractice

Patients

All-in-one: TRIP Database

Just remember two links ….

TRIP Database&

Medline Plus Plus

… and Google it!

Knowing is not enough;

we must apply

Willing is not enough;

we must doGoethe

THANKS

4YUR

ATTENTION