Evidence Based Medicine: Introduction

Evidence-based medicine (EBM) is defined as, "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients."¹ The EBM cycle begins when a question arises in the course of caring for a patient.

One of the earliest appearances of the term "evidence-based medicine" in the medical literature occurred in a 1991 ACP Journal Club editorial by Dr. Gordon Guyatt.²  This was the first of a series of articles published by Dr. Guyatt, Dr. Brian Hayes, Dr. David Sackett, Dr. Deborah Cook, and other members of the Evidence-Based Medicine Working Group, which introduced and advocated for the practice of evidence-based medicine (EBM). EBM proponents take pains to point out that, "evidence is necessary but not sufficient for clinical decision making."³ EBM practitioners must combine their clinical expertise, the best available evidence and their patient's personal characteristics and preference when making decisions.

After being met with some initial resistance,¹ the EBM model gradually became widely accepted and practiced. It is now commonly included in both undergraduate and graduate medical education curricula.^4,5 The ideas and process of EBM have subsequently been adopted in many fields, including nursing, dentistry, public health and beyond, leading to the rise of the term evidence-based practice (EBP).

The aims of this guide are to provide:

• An introduction to the theory and practice of EBM
• A list of library resources to assist users in acquiring evidence-based answers to clinical questions and context for which resources are best suited to different information needs
• A selection of books and online resources to enable users to enhance their knowledge and understanding of EBM

1. Sackett DL, Rosenberg WM, Gray JM, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't.
2. Guyatt G. Evidence-based medicine [editorial]. 1991. ACP J Club. 1991;114:A16.
3. Rennie D, Meade M, Guyatt G, Cook D. Users’ guides to the medical literature : a manual for evidence-based clinical practice . Philadelphia: McGraw Hill Education Medical; 2015.
4. Blanco MA, Capello CF, Dorsch JL, Perry GJ, Zanetti ML. A survey study of evidence-based medicine training in US and Canadian medical schools. Journal of the Medical Library Association: JMLA. 2014 Jul;102(3):160.
5. Shaughnessy AF, Torro JR, Frame KA, Bakshi M. Evidence‐based medicine teaching requirements in the USA: taxonomy and themes. Journal of Evidence‐Based Medicine. 2016 May;9(2):53-8.