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Medicine & Health

Evidence-based practice

What's the difference between "evidence-based practice" and "evidence-based medicine"?

It's all about the evidence, the research and the patient.

Evidence-based practice (EBP) is used widely by allied health professionals and is the conscientious use of current best evidence in making decisions about patient care (Sackett & Rosenberg 1996). It uses clinical decision‐making that combines research evidence, clinical expertise, and patient preferences and characteristics.

Evidence-based medicine (EBM) considers the patients views and integrates the best research evidence and clinical expertise when making a decision. (Guyatt G, et al 1992).

Evidence‐based practice stems from evidence-based medicine (EBM), however, it's interdisciplinary and used in the fields of allied health, education, psychology and others. 

You will come across both EBP and EBM throughout your studies or research in Medicine and Health. Below are databases that are entirely about EBP and EBM.

Sources

  • Sackett, D.L., Rosenberg, W.M., Gray, J.M., Haynes, R.B. and Richardson, W.S., 1996. Evidence based medicine: what it is and what it isn't.
  • 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.

  Systematic Review Literature Review
Definition High-level overview of primary research on a focused question that identifies, selects, synthesises, and appraises all high quality research evidence relevant to that question Qualitatively summarises evidence on a topic using informal or subjective methods to collect and interpret studies
Goals Answer a focused, clinical question
Eliminate bias
Provide summary or overview of topic
Question Clearly defined and answerable clinical question
Recommend using PICO as a guide
Can be a general topic or a specific question
Components Pre-specified eligibility criteria
Systematic search strategy
Assessment of the validity of findings
Interpretation and presentation of results
Reference list
Introduction
Methods
Discussion
Conclusion
Reference list
Number of Authors Three or more One or more
Timeline Months to years
Average eighteen months
Weeks to months
Requirements Thorough knowledge of topic
Perform searches of all relevant databases
Statistical analysis resources (for meta-analysis)
Understanding of topic
Perform searches of one or more databases
Value Connects practicing clinicians to high quality evidence
Supports evidence-based practice
Provides summary of literature on a topic

Kysh, Lynn (2013): Difference between a systematic review and a literature review. [figshare]. Available at: http://dx.doi.org/10.6084/m9.figshare.766364

Search and keep track of the evidence for your systematic literature review using these resources:

PRISMA is an evidence-based minimum set of items for reporting in systematic reviews and meta-analyses.

A PEO research question focuses on non-numerical data, or qualitative research. Here, relationships and associations are explored. For example, a PEO question can try to explore whether there is a correlation between taking baby aspirin and a lowered risk of heart attacks.


PEO stands for:

  • Population: Who are you studying? Infants? Males who are between the ages of 55 and 60? Adolescent females?
  • Exposure: What is your population exposed to? Baby aspirin? Soy supplements? Peanuts?
  • Outcome: What is the result of the exposure on your population? Lowered risk for heart attacks? Food allergies? Increased menstrual cramps?


Further information on PEO can be found in the article: Clinical Questions: PICO and PEO Research.
 

The PICO framework is useful for developing an answerable clinical question.

PICO framework
P I C O
Population (Patient) Intervention  Comparison  Outcome
What are the characteristics of the patient or population? OR 
What is the condition or disease you are researching?
What is the main intervention or therapy you wish to consider? Is there an alternative treatment to compare? What is the relevant, clinical outcome?

PROSPERO is an international register for prospective systematic literature reviews.

  • Includes protocol details for systematic reviews relevant to health, social care, welfare, public health, education, crime, justice, and international development (where there is a health related outcome).
  • Protocols can include any type of any study design.