Evidence-Based Practice (EBP) is the framework for your clinical decision-making process. It is the integration of
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?
Strength of the Recommendation and Grade of Quality of the Evidence
Restrepo, R. D. (2010). AARC Clinical Practice Guidelines: from “reference-based” to “evidence-based”.
- Review the Situation (Assess)
- Define the clinical problem as a question (Ask)
- Select resources, design a strategy, and search for the
- Summarize the evidence yield (Appraise)
- Apply the evidence (Apply)
A hierarchy of the likely best evidence.
Systematic Review: High-level overview of primary research on a using a systematic search strategy, . One of the highest levels of infomation. a literature review, which summarizes evidence on a . Cochrane (Systematic) Reviews are recognized as having the highest level of evidence.
Meta-analysis: The use of quantitative/statistical methods to summarize data from studies included in a systematic review. Not all systematic reviews include a meta-analysis.
Overview of other study designs
|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|