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Gerstein Science Information Centre

Evidence-Based Practice

What is Evidence-Based Medicine (EBM) or Evidence-Based Practice (EBP)?

“Evidence-based Medicine (EBM) is the integration of best research evidence with clinical expertise and patient values.” –Guyatt G, et al. Evidence-Based Medicine working Group. Evidence-based medicine. A new approach to teaching the practice of medicine. JAMA 1992; 268: 2420-5.

“Evidence based practice (EBP) is the conscientious use of current best evidence in making decisions about patient care.” –Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000

Evidence-Based Medicine (EBM) is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values. The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology. (Sackett D, 2002)

Evidence-Based Medical decisions are found at the intersection between clinical expertise, patient values & preferences, and the best research evidence available. 

Where is "Best Research Evidence" found?


We use various frameworks and tools in Evidence Based Medicine. One of the most important frameworks for determining where to find the best research evidence available is the EBM Pyramid. Below is the 6S Evidence Pyramid.

The EBM Pyramid

Adapted by L. Tjosvold from: DiCenso, A,Bayley, L, Haynes, RB. Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model. Evid Based Nurs 2009;12:99-101. Used with Permission. 

The most appropriate and efficient resource for finding the best evidence ALWAYS depends on your question.

Evidence for some questions will be quickly and easily found in filtered resources. Filtered resources appraise the quality of studies and often make recommendations for practice. Navigate the tabs along the top of this guide to explore various tools for finding filtered resources. 

For many questions, evidence won't be found in filtered resources. For these questions, we must search unfiltered resources for original primary research.

Evidence must be searched comprehensively and all evidence retrieved to answer a particular question must be critically appraised in order to determing whether it is the best research evidence available.