EVIDENCE BASED MEDICINE - AN APPROACH TO CLINICAL PROBLEM-SOLVING

Doctors within the NHS are confronting major changes at work. While we endeavour to improve the quality of health care, junior doctors' hour s have been reduced and the emphasis on continuing medical education h as increased. We are confronted by a growing body of information, much of it invalid or irrelevant to clinical practice. This article discus ses evidence based medicine, a process of turning clinical problems in to questions and then systematically locating, appraising, and using c ontemporaneous research findings as the basis for clinical decisions. The computerisation of bibliographies and the development of software that permits the rapid location of relevant evidence have made it easi er for busy clinicians to make best use of the published literature. C ritical appraisal can be used to determine the validity and applicabil ity of the evidence, which is then used to inform clinical decisions. Evidence based medicine can be taught to, and practised by, clinicians at all levels of seniority and can be used to close the gulf between good clinical research and clinical practice. In addition it can help to promote self directed learning and teamwork and produce faster and better doctors.