Evidence-based medicine: useful tools for decision making

Evidence-based medicine (EBM) integrates clinical experience and patient va lues with the best available research information. There are four steps in incorporating the best available research evidence in decision making: asking answerable questions; accessing the best informa tion; appraising the information for validity and relevance; and applying t he information to patient care. Applying EBM to individual patients requires drawing up a balance sheet of benefits and harms based on research and individual patient data. The most realistic and efficient use of EBM by clinicians at the point of c are involves accessing and applying valid and relevant summaries of researc h evidence (evidence-based guidelines and systematic reviews). The future holds promise for improved primary research, better EBM summarie s, greater access to these summaries, and better implementation systems for evidence-based practice. Computer-assisted decision support tools for clinicians facilitate integrat ion of individual patient data with the best available research data.