Evidence-Based Practice (EBP) is the framework for your clinical decision-making process. It is the integration of
- Review the Situation (Assess)
- Define the clinical problem as a question (Ask)
- Select resources, design a strategy, and search for the
answer (Acquire)
- Summarize the evidence yield (Appraise)
- Apply the evidence (Apply)
Therapy - What is the treatment for a disease?
Diagnosis - power of a test to differentiate between those with and without a disease?
Prognosis - a patient’s likely course over time due to factors other than interventions?
Etiology/Harm - effects of potentially harmful agents on the patient?
Levels of Evidence help you target the likely best type of evidence.
Level of Evidence | Type of Study |
1a | Systematic reviews of randomized controlled trials (RCTs) |
1b | Individual RCTs with narrow confidence interval |
2a | Systematic reviews of cohort studies |
2b | Individual cohort studies and low-quality RCTs |
3a | Systematic reviews of case-control studies |
3b | Case-controlled studies |
4 | Case series and poor-quality cohort and case-control studies |
5 | Expert opinion |
Physiopedia. (2018). Grades and levels of evidence. Retrieved from http://www.physio-pedia.com/grades_and_levels_of_evidence
Type of Question | Suggested Best Type of Study |
Therapy | RCT > prospective cohort |
Diagnosis | Prospective, blind comparison to a gold standard |
Etiology/Harm | RCT > cohort > case control > case series |
Prognosis | cohort study > case control > case series |
Prevention | RCT > cohort study > case control > case series |
Clinical Exam | prospective, blind comparison to gold standard |
Cost | economic analysis |