Evidence-based medicine in ENT.

Using a clinical example we discuss the reasons why some of our colleagues associate unpleasant feelings with the term Evidence-Based Medicine (EBM). We demonstrate what EBM can contribute to solve day-to-day clinical problem s and discuss the six formal steps for implementation of EBM into the day-t o-day practise. 1. To transform the clinical problem into an answerable 4-p art question. 2. To answer this question based on your internal evidence. 3 . To search for external evidence to answer this question. 4. To critically appraise the found evidence with respect to it's validity, importance and applicability. 5. To integrate the appraised external evidence into your ex isting internal evidence in order to come to a new decision if the addition al new external evidence in convincing. 6. To assess the benefit which was gained for the patient.