View source for 13. Evidence-based medicine and prevention

* Evidence-based medicine (EBM) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.”
** = the process of turning clinical problems into questions and then systematically locating, appraising, and using contemporaneous research findings as the basis for clinical decisions
* EBM is the gold standard of clinical practice
* Uses information gathered from randomized control trials, case controls, cohort studies, etc.
* Meta-analyses and systemic review combine the result of multiple trials into the strongest evidence
* Process of EBM
** A patient problem occurs
** A clinical or preventional question is formulated
** Evidence is searched for or produced
** The evidence is critically evaluated
** The results are integrated into clinical practice
* Some clinical practices which changed due to evidence-based medicine
** Antiarrhythmic drugs much less used
** Thalidomide contraindicated in pregnancy
* Grading of evidence shows the quality of evidence which underlies a clinical recommendation
** Grade A refers to a recommendation which is the result of many randomized clinical trials
** Grade B refers to a recommendation which is the result of one randomized trial, or multiple nonrandomized trials
** Grade C refers to a recommendation which is based on expert consensus, without good clinical trials
* Classification of evidence shows the strength of the clinical recommendation
** A class I recommendation is one where the procedure or treatment is recommended, as the evidence shows that the procedure or treatment is clearly beneficial
** A class IIa recommendation is one where the procedure or treatment should be considered, as the evidence shows that the procedure or treatment is beneficial in most cases
** A class IIb recommendation is one where the procedure or treatment may be considered, as the evidence shows that the procedure or treatment is beneficial in some cases
** A class III recommendation is one where the procedure or treatment is not recommended, as the evidence shows that the procedure or treatment is ineffective or harmful

[[Category:Public health 2 - General epidemiology and demography]]