Introduction to Evidence Based Practice (EVP)
Evidence Based Practice (EVP) requires skills including efficient literature searching and the application of formal rules of evidence in evaluating the clinical literature.
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Definition
A common definition of Evidence Based Practice (EBP) is from Sackett, et al., who define EBP as “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of the individual patient...integrating individual clinical expertise with the best available external clinical evidence from systematic research.” (Sackett D, 1996). Clinical expertise refers to the clinician’s cumulated experience, education, and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology. (Sackett, 2002).
Evidence can help support the patient care process. The full integration of these three components into clinical decisions enhances the opportunity for optimal clinical outcomes and quality of life. The practice of EBP is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, and/or the etiology of disorders.
Steps of Evidence Based Practice
Steps used in Evidence Based Practice are illustrated in the following image.
Sources: Sackett, D.L. et al. (1996). Evidence based medicine; what it is and what it isn't. BMJ. Jan 13;312(7023):71-2. doi: 10.1136/bmj.312.7023.71; Sackett, D.L. et al. (2002). The architecture of diagnostic research. BMJ, 324(7336), 539-541.