Evidence-based medicine (EBM) requires the integration of the best
research evidence with our clinical expertise and our patient$B!G(Bs unique
values and circumstances.
a.. By best research evidence we mean valid and clinically relevant
research, often from the basic sciences of medicine, but especially from
patient-centered clinical research into the accuracy of diagnostic tests
(including the clinical examination), the power of prognostic markers, and
the efficacy and safety of therapeutic, rehabilitative, and preventive
regimens. New evidence from clinical research both invalidates previously
accepted diagnostic tests and treatments and replaces them with new ones
that are more accurate, more efficacious, and safer.
b.. By clinical expertise we mean the ability to use our clinical skills
and past experience to rapidly identify each patient$B!G(Bs unique health
state and diagnosis, their individual risks and benefits of potential
interventions, and their personal circumstances and expectations.
c.. By patient values we mean the unique preferences, concerns and
expectations each patient brings to a clinical encounter and which must be
integrated into clinical decisions if they are to serve the patient.
d.. By patient circumstances we mean their individual clinical state and
the clinical setting.