BMJ 1996;312:71-72 (13January)

Editorials

Evidence based medicine: what it is and what it isn't

It's about integrating individual clinical expertise and thebest external evidence

Evidence based medicine, whose philosophical origins extendback to mid-19th century Paris and earlier, remains a hot topicfor clinicians, public health practitioners, purchasers, planners,and the public. There are now frequent workshops in how to practiceand teach it (one sponsored by the BMJ will be held in Londonon 24 April); undergraduate1 and postgraduate2 training programmesare incorporating it3 (or pondering how to do so); British centresfor evidence based practice have been established or plannedin adult medicine, child health, surgery, pathology, pharmacotherapy,nursing, general practice, and dentistry; the Cochrane Collaborationand Britain's Centre for Review and Dissemination in York areproviding systematic reviews of the effects of health care;new evidence based practice journals are being launched; andit has become a common topic in the lay media. But enthusiasmhas been mixed with some negative reaction.456 Criticism hasranged from evidence based medicine being old hat to it beinga dangerous innovation, perpetrated by the arrogant to servecost cutters and suppress clinical freedom. As evidence basedmedicine continues to evolve and adapt, now is a useful timeto refine the discussion of what it is and what it is not.

Evidence based medicine is the conscientious, explicit, andjudicious use of current best evidence in making decisions aboutthe care of individual patients. The practice of evidence basedmedicine means integrating individual clinical expertise withthe best available external clinical evidence from systematicresearch. By individual clinical expertise we mean the proficiencyand judgment that individual clinicians acquire through clinicalexperience and clinical practice. Increased expertise is reflectedin many ways, but especially in more effective and efficientdiagnosis and in the more thoughtful identification and compassionateuse of individual patients' predicaments, rights, and preferencesin making clinical decisions about their care. By best availableexternal clinical evidence we mean clinically relevant research,often from the basic sciences of medicine, but especially frompatient centred clinical research into the accuracy and precisionof diagnostic tests (including the clinical examination), thepower of prognostic markers, and the efficacy and safety oftherapeutic, rehabilitative, and preventive regimens. Externalclinical evidence both invalidates previously accepted diagnostictests and treatments and replaces them with new ones that aremore powerful, more accurate, more efficacious, and safer.

Good doctors use both individual clinical expertise and thebest available external evidence, and neither alone is enough.Without clinical expertise, practice risks becoming tyrannisedby evidence, for even excellent external evidence may be inapplicableto or inappropriate for an individual patient. Without currentbest evidence, practice risks becoming rapidly out of date,to the detriment of patients.

This description of what evidence based medicine is helps clarifywhat evidence based medicine is not. Evidence based medicineis neither old hat nor impossible to practice. The argumentthat "everyone already is doing it" falls before evidence ofstriking variations in both the integration of patient valuesinto our clinical behaviour7 and in the rates with which cliniciansprovide interventions to their patients.8 The difficulties thatclinicians face in keeping abreast of all the medical advancesreported in primary journals are obvious from a comparison ofthe time required for reading (for general medicine, enoughto examine 19 articles per day, 365 days per year9) with thetime available (well under an hour a week by British medicalconsultants, even on self reports10).

The argument that evidence based medicine can be conducted onlyfrom ivory towers and armchairs is refuted by audits from thefront lines of clinical care where at least some inpatient clinicalteams in general medicine,11 psychiatry (J R Geddes et al, RoyalCollege of Psychiatrists winter meeting, January 1996), andsurgery (P McCulloch, personal communication) have providedevidence based care to the vast majority of their patients.Such studies show that busy clinicians who devote their scarcereading time to selective, efficient, patient driven searching,appraisal, and incorporation of the best available evidencecan practice evidence based medicine.

Evidence based medicine is not "cookbook" medicine. Becauseit requires a bottom up approach that integrates the best externalevidence with individual clinical expertise and patients' choice,it cannot result in slavish, cookbook approaches to individualpatient care. External clinical evidence can inform, but cannever replace, individual clinical expertise, and it is thisexpertise that decides whether the external evidence appliesto the individual patient at all and, if so, how it should beintegrated into a clinical decision. Similarly, any externalguideline must be integrated with individual clinical expertisein deciding whether and how it matches the patient's clinicalstate, predicament, and preferences, and thus whether it shouldbe applied. Clinicians who fear top down cookbooks will findthe advocates of evidence based medicine joining them at thebarricades.

Some fear that evidence based medicine will be hijacked by purchasersand managers to cut the costs of health care. This would notonly be a misuse of evidence based medicine but suggests a fundamentalmisunderstanding of its financial consequences. Doctors practisingevidence based medicine will identify and apply the most efficaciousinterventions to maximise the quality and quantity of life forindividual patients; this may raise rather than lower the costof their care.

Evidence based medicine is not restricted to randomised trialsand meta-analyses. It involves tracking down the best externalevidence with which to answer our clinical questions. To findout about the accuracy of a diagnostic test, we need to findproper cross sectional studies of patients clinically suspectedof harbouring the relevant disorder, not a randomised trial.For a question about prognosis, we need proper follow up studiesof patients assembled at a uniform, early point in the clinicalcourse of their disease. And sometimes the evidence we needwill come from the basic sciences such as genetics or immunology.It is when asking questions about therapy that we should tryto avoid the non-experimental approaches, since these routinelylead to false positive conclusions about efficacy. Because therandomised trial, and especially the systematic review of severalrandomised trials, is so much more likely to inform us and somuch less likely to mislead us, it has become the "gold standard"for judging whether a treatment does more good than harm. However,some questions about therapy do not require randomised trials(successful interventions for otherwise fatal conditions) orcannot wait for the trials to be conducted. And if no randomisedtrial has been carried out for our patient's predicament, wemust follow the trail to the next best external evidence andwork from there.

Despite its ancient origins, evidence based medicine remainsa relatively young discipline whose positive impacts are justbeginning to be validated,1213 and it will continue to evolve.This evolution will be enhanced as several undergraduate, postgraduate,and continuing medical education programmes adopt and adaptit to their learners' needs. These programmes, and their evaluation,will provide further information and understanding about whatevidence based medicine is and is not.

Professor NHS Research and Development Centre for Evidence BasedMedicine, Oxford Radcliffe NHS Trust, Oxford OX3 9DU

Clinical tutor in medicine Nuffield Department of Clinical Medicine,University of Oxford, Oxford

Director of research and development Anglia and Oxford RegionalHealth Authority, Milton Keynes

Professor of medicine and clinical epidemiology McMasterUniversity,Hamilton, OntarioCanada

Clinical associate professor of medicineUniversity of RochesterSchool of Medicine and Dentistry, Rochester, New York, USA

David L Sackett, William M C Rosenberg, J A Muir Gray, R Brian Haynes, W Scott Richardson

  1. British Medical Association. Report of the working party on medical education. London: BMA, 1995.
  1. Standing Committee on Postgraduate Medical and Dental Education. Creating a better learning environment in hospitals. 1. Teaching hospital doctors and dentists to teach. London: SCOPME, 1994.
  1. General Medical Council. Education committee report. London: GMC, 1994.
  1. Grahame-Smith D. Evidence based medicine: Socratic dissent. BMJ 1995;310:1126-7.[FreeFullText]
  1. Evidence based medicine; in its place [editorial]. Lancet 1995;346:785.[Medline]
  1. Correspondence. Evidence based medicine. Lancet 1995;346:1171-2.
  1. Weatherall DJ: The inhumanity of medicine. BMJ 1994;309;1671-2.
  1. House of Commons Health Committee. Priority setting in the NHS: purchasing. First report sessions 1994-95. London: HMSO, 1995. (HC 134-1.)
  1. Davidoff F, Haynes B, Sackett D, Smith R. Evidence based medicine: a new journal to help doctors identify the information they need. BMJ 1995;310:1085-6.[FreeFullText]
  1. Sackett DL. Surveys of self-reported reading times of consultants in Oxford, Birmingham, Milton-Keynes, Bristol, Leicester, and Glasgow. In: Rosenberg WMC, Richardson WS, Haynes RB, Sackett DL. Evidence-based medicine. London: Churchill Livingstone (in press).
  1. Ellis J, Mulligan I, Rowe J, Sackett DL. Inpatient general medicine is evidence based. Lancet 1995;346:407-10.[Medline]
  1. Bennett RJ, Sackett DL, Haynes RB, Neufeld VR. A controlled trial of teaching critical appraisal of the clinical literature to medical students. JAMA 1987;257:2451-4.[Abstract]
  1. Shin JH, Flaynes RB, JohnstonME. Effect of problem-based, self-directed undergraduate education on life-long learning. Can Med Assoc J 1993;148:969-76.[Abstract]

Related Articles

Evidence based prescribing

Simon R J Maxwell
BMJ 2005 331: 247-248. [Extract][Full Text]

Evidence based medicine: does it make a difference?: Use wisely

Benjamin Druss
BMJ 2005 330: 92. [Extract][Full Text]

This article has been cited by other articles:

  • DeBonis, D. A., Moncrieff, D. (2008). Auditory Processing Disorders: An Update for Speech-Language Pathologists. AJSLP 17: 4-18 [Abstract][Full text]
  • Glancy, G. D. (2008). Evidence-Based Practices Applied to Forensic Psychiatry: Intoduction to Special Issue. BRIEF TREAT CRISIS INTERVEN 0: mhm030v1-mhm030 [Abstract][Full text]
  • Dartnell, J., Hemming, M., Collier, J., Ollenschlaeger, G. (2008). Putting evidence into context: some advice for guideline writers. Evid. Based Nurs. 11: 6-8 [Full text]
  • Brackenbury, T., Burroughs, E., Hewitt, L. E. (2008). A Qualitative Examination of Current Guidelines for Evidence-Based Practice in Child Language Intervention. LSHSS 39: 78-88 [Abstract][Full text]
  • Rizzo Parse, R. (2008). Truth for the Moment: Personal Testimony as Evidence. Nurs Sci Q 21: 45-48 [Abstract]
  • Gu, W., Utzinger, J., Novak, R. J. (2008). Habitat-Based Larval Interventions: A New Perspective for Malaria Control. Am J Trop Med Hyg 78: 2-6 [Abstract][Full text]
  • Cirrin, F. M., Gillam, R. B. (2008). Language Intervention Practices for School-Age Children With Spoken Language Disorders: A Systematic Review. LSHSS 39: S110-S137 [Abstract][Full text]
  • Chiappelli, F., Cajulis, O. S. (2007). Transitioning Toward Evidence-Based Research in the Health Sciences for the XXI Century. Evid Based Complement Alternat Med 0: nem123v1-nem123 [Abstract][Full text]
  • Braunschweig, C., Lown, D. (2007). Evidence-Based Medicine for Nutrition Support: An Overview of the Process. Nutr Clin Pract 22: 599-601 [Abstract][Full text]
  • Whitley, R. (2007). Cultural Competence, Evidence-Based Medicine, and Evidence-Based Practices. Psychiatr. Serv. 58: 1588-1590 [Abstract][Full text]
  • Verhoef, M. J., Mulkins, A., Carlson, L. E., Hilsden, R. J., Kania, A. (2007). Assessing the Role of Evidence in Patients' Evaluation of Complementary Therapies: A Quality Study. Integr Cancer Ther 6: 345-353 [Abstract]
  • Stead, M., McDermott, L., Hastings, G. (2007). Towards evidence-based marketing: the case of childhood obesity. Marketing Theory 7: 379-406 [Abstract]
  • Sicras-Mainar, A., Serrat-Tarres, J., Navarro-Artieda, R., Llausi-Selles, R., Ruano-Ruano, I., Gonzalez-Ares, J. A. (2007). Adjusted Clinical Groups use as a measure of the referrals efficiency from primary care to specialized in Spain. Eur J Public Health 17: 657-663 [Abstract][Full text]
  • Leatherman, S., Sutherland, K. (2007). Designing national quality reforms: a framework for action. Int J Qual Health Care 19: 334-340 [Abstract][Full text]
  • NAY, R., FETHERSTONHAUGH, D. (2007). Evidence-Based Practice: Limitations and Successful Implementation. Ann. N. Y. Acad. Sci. 1114: 456-463 [Abstract][Full text]
  • Gupta, S., Warner, J. (2007). A NICE mess. J. R. Soc. Med. 100: 442-443 [Full text]
  • Dartnell, J., Hemming, M., Collier, J., Ollenschlaeger, G. (2007). Putting evidence into context: some advice for guideline writers. Evid. Based Med. 12: 130-132 [Full text]
  • Salbach, N. M, Korner-Bitensky, N. (2007). Author Response. ptjournal 87: 1305-1306 [Full text]
  • Salbach, N. M, Jaglal, S. B, Korner-Bitensky, N., Rappolt, S., Davis, D. (2007). Practitioner and Organizational Barriers to Evidence-based Practice of Physical Therapists for People With Stroke. ptjournal 87: 1284-1303 [Abstract][Full text]
  • Klett, R., Lange, U., Haas, H., Voth, M., Pinkert, J. (2007). Radiosynoviorthesis of medium-sized joints with rhenium-186-sulphide colloid: a review of the literature. Rheumatology (Oxford) 46: 1531-1537 [Abstract][Full text]
  • Matthys, J., De Meyere, M., van Driel, M. L., De Sutter, A. (2007). Differences Among International Pharyngitis Guidelines: Not Just Academic. Ann Fam Med 5: 436-443 [Abstract][Full text]
  • Raymond, J., Trop, I. (2007). The Practice of Ethics in the Era of Evidence-based Radiology. Radiology 244: 643-649 [Abstract][Full text]
  • Shortell, S. M., Rundall, T. G., Hsu, J. (2007). Improving Patient Care by Linking Evidence-Based Medicine and Evidence-Based Management. JAMA 298: 673-676 [Full text]
  • Bell, S. C, Robinson, P. J (2007). Exacerbations in cystic fibrosis: 2 {middle dot} Prevention. Thorax 62: 723-732 [Abstract][Full text]
  • Costa, J. (2007). Reflections About Evidence-Based Pathology. INT J SURG PATHOL 15: 230-232
  • Gerber, A., Hentzelt, F., Lauterbach, K. W (2007). Can evidence-based medicine implicitly rely on current concepts of disease or does it have to develop its own definition?. J. Med. Ethics 33: 394-399 [Abstract][Full text]
  • Hollingworth, W., Jarvik, J. G. (2007). Technology Assessment in Radiology: Putting the Evidence in Evidence-based Radiology. Radiology 244: 31-38 [Abstract][Full text]
  • Boothroyd, A. (2007). Adult Aural Rehabilitation: What Is It and Does It Work?. TRENDS AMPLIF 11: 63-71 [Abstract]
  • Ammenwerth, E., de Keizer, N. (2007). A Viewpoint on Evidence-based Health Informatics, Based on a Pilot Survey on Evaluation Studies in Health Care Informatics. J. Am. Med. Inform. Assoc. 14: 368-371 [Abstract][Full text]
  • Malone, D. E., Staunton, M. (2007). Evidence-based Practice in Radiology: Step 5 (Evaluate)--Caveats and Common Questions. Radiology 243: 319-328 [Abstract][Full text]
  • Halligan, S., Altman, D. G. (2007). Evidence-based Practice in Radiology: Steps 3 and 4--Appraise and Apply Systematic Reviews and Meta-Analyses. Radiology 243: 13-27 [Abstract][Full text]
  • Chapman, R. L. (2007). Educational Perspectives: Strategies for Teaching and Practicing Evidence-based Neonatology. NeoReviews 8: e105-e109 [Full text]
  • Hamlin, R. G. (2007). An Evidence-Based Perspective on HRD. Advances in Developing Human Resources 9: 42-57 [Abstract]
  • Braye, S., Preston-Shoot, M. (2007). On Systematic Reviews in Social Work: Observations from Teaching, Learning and Assessment of Law in Social Work Education. Br J Soc Work 37: 313-334 [Abstract][Full text]
  • Taylor, B. J., Dempster, M., Donnelly, M. (2007). Grading Gems: Appraising the Quality of Research for Social Work and Social Care. Br J Soc Work 37: 335-354 [Abstract][Full text]
  • Rubin, A., Parrish, D. (2007). Views of Evidence-Based Practice Among Faculty in Master of Social Work Programs: A National Survey. Research on Social Work Practice 17: 110-122 [Abstract]
  • Gibbs, L. (2007). Applying Research to Making Life-Affecting Judgments and Decisions. Research on Social Work Practice 17: 143-150 [Abstract]
  • Malone, D. E. (2007). Evidence-based Practice in Radiology: An Introduction to the Series. Radiology 242: 12-14 [Full text]
  • Kampen, W. U., Voth, M., Pinkert, J., Krause, A. (2007). Therapeutic status of radiosynoviorthesis of the knee with yttrium [90Y] colloid in rheumatoid arthritis and related indications. Rheumatology (Oxford) 46: 16-24 [Abstract][Full text]
  • Grypdonck, M. H. F. (2006). Qualitative health research in the era of evidence-based practice.. Qual Health Res 16: 1371-1385 [Abstract]
  • Smith, B. J., Tang, K. C., Nutbeam, D. (2006). WHO Health Promotion Glossary: new terms. HEALTH PROMOT INT 21: 340-345 [Abstract][Full text]
  • Fairhurst, K., May, C. (2006). What General Practitioners Find Satisfying in Their Work: Implications for Health Care System Reform. Ann Fam Med 4: 500-505 [Abstract][Full text]
  • Rodrigo, G. J. (2006). Rapid effects of inhaled corticosteroids in acute asthma: an evidence-based evaluation.. Chest 130: 1301-1311 [Abstract][Full text]
  • Kelly, B. D., Feeney, L. (2006). What every psychiatrist should know. Adv. Psychiatr. Treat. 12: 462-468 [Abstract][Full text]
  • Ratner, N. B. (2006). Evidence-Based Practice: An Examination of Its Ramifications for the Practice of Speech-Language Pathology. LSHSS 37: 257-267 [Abstract][Full text]
  • Gillam, S. L., Gillam, R. B. (2006). Making Evidence-Based Decisions About Child Language Intervention in Schools. LSHSS 37: 304-315 [Abstract][Full text]
  • Norberg, A. (2006). The meaning of evidence-based nursing.. Nurs Ethics 13: 453-454
  • Kelly, B. D., Feeney, L. (2006). Psychiatry: no longer in dissent?. Psychiatr. Bull. 30: 344-345 [Full text]
  • Geddes, J. (2006). Providing the best available evidence: INVITED COMMENTARY ON... THE ANTIDEPRESSANT TALE. Adv. Psychiatr. Treat. 12: 327-328 [Abstract][Full text]
  • Polin, R. A., Lorenz, J. M., Bateman, D. A. (2006). Evidence-based Neonatology. NeoReviews 7: e474-e485 [Full text]
  • Palisano, R. J (2006). A Collaborative Model of Service Delivery for Children With Movement Disorders: A Framework for Evidence-Based Decision Making. ptjournal 86: 1295-1305 [Abstract][Full text]
  • Cremonesi, A., Setacci, C., Bignamini, A., Bolognese, L., Briganti, F., Di Sciascio, G., Inzitari, D., Lanza, G., Lupattelli, L., Mangiafico, S., Pratesi, C., Reimers, B., Ricci, S., de Donato, G., Ugolotti, U., Zaninelli, A., Gensini, G. F. (2006). Carotid Artery Stenting: First Consensus Document of the ICCS-SPREAD Joint Committee. Stroke 37: 2400-2409 [Abstract][Full text]
  • Lenfant, C. (2006). Will Lung Volume Reduction Surgery Be Widely Applied?. Ann. Thorac. Surg. 82: 385-387 [Full text]
  • Smith, F. G., Tong, J. L, Smith, J. E (2006). Evidence-based medicine. Contin Educ Anaesth Crit Care Pain 6: 148-151 [Full text]
  • Weissman, M. M., Verdeli, H., Gameroff, M. J., Bledsoe, S. E., Betts, K., Mufson, L., Fitterling, H., Wickramaratne, P. (2006). National survey of psychotherapy training in psychiatry, psychology, and social work.. Arch Gen Psychiatry 63: 925-934 [Abstract][Full text]
  • Hurwitz, S. R., Tornetta, P. III, Wright, J. G. (2006). An AOA Critical Issue How to Read the Literature to Change Your Practice: An Evidence-Based Medicine Approach. JBJS 88: 1873-1879 [Full text]
  • Dracup, K., Bryan-Brown, C. W. (2006). Evidence-based practice is wonderful ... Sort of.. Am J Crit Care 15: 356-358 [Full text]
  • Jackson, R., Ameratunga, S., Broad, J., Connor, J., Lethaby, A., Robb, G., Wells, S., Glasziou, P., Heneghan, C. (2006). The GATE frame: critical appraisal with pictures. Evid. Based Nurs. 9: 68-71 [Full text]
  • Nail-Chiwetalu, B. J., Ratner, N. B. (2006). Information literacy for speech-language pathologists: a key to evidence-based practice.. LSHSS 37: 157-167 [Abstract][Full text]
  • Waldman, M. H. (2006). Evidence-based medicine: how to translate research into patient care.. J. Am. Podiatr. Med. Assoc. 96: 374-377 [Abstract][Full text]
  • Gibson, M., Santa, J. (2006). The Drug Effectiveness Review Project: An Important Step Forward. Health Aff (Millwood) 25: W272-W275 [Abstract][Full text]
  • McElwee, N. E., Ho, S. Y., McGuigan, K. A., Horn, M. L. (2006). Evidence-Based Coverage Decisions? Primum Non Nocere. Health Aff (Millwood) 25: W279-W282 [Abstract][Full text]
  • Gottrup, F. (2006). Evidence is a challenge in wound management.. INT J LOW EXTREM WOUNDS 5: 74-75
  • Lempp, H., Scott, D., Kingsley, G. (2006). The personal impact of rheumatoid arthritis on patients' identity: a qualitative study. Chronic Illness 2: 109-120 [Abstract]
  • Riehl, C. (2006). Feeling Better: A Comparison of Medical Research and Education Research. EDUCATIONAL RESEARCHER 35: 24-29 [Abstract]
  • Hinze, A., Buchanan, G., Jung, D., Adams, A. (2006). HDLalert - a healthcare DL alerting system: from user needs to implementation.. Health Informatics Journal 12: 121-135 [Abstract]
  • Staller, K. M. (2006). Railroads, Runaways, & Researchers: Returning Evidence Rhetoric to Its Practice Base. Qualitative Inquiry 12: 503-522 [Abstract]
  • French, J, Steel, A, Clements, R, Lewis, S, Wilson, M, Teasdale, B, Mackenzie, R, Black, J (2006). Best Bets: A call for scrutiny.. Emerg. Med. J. 23: 490-490 [Full text]
  • Woolf, S. H. (2006). Weighing the evidence to formulate dietary guidelines.. J. Am. Coll. Nutr. 25: 277S-284S [Abstract][Full text]
  • Lai, T. Y. Y., Leung, G. M., Wong, V. W. Y., Lam, R. F., Cheng, A. C. O., Lam, D. S. C. (2006). How Evidence-Based Are Publications in Clinical Ophthalmic Journals?. IOVS 47: 1831-1838 [Abstract][Full text]
  • Gambrill, E. (2006). Evidence-Based Practice and Policy: Choices Ahead. Research on Social Work Practice 16: 338-357 [Abstract]
  • Pincus, T., Sokka, T. (2006). Should aggressive therapy for rheumatoid arthritis require early use of weekly low-dose methotrexate, as the first disease-modifying anti-rheumatic drug in most patients?. Rheumatology (Oxford) 45: 497-499 [Full text]
  • Jackson, R., Ameratunga, S., Broad, J., Connor, J., Lethaby, A., Robb, G., Wells, S., Glasziou, P., Heneghan, C. (2006). The GATE frame: critical appraisal with pictures. Evid. Based Med. 11: 35-38 [Full text]
  • Gluud, L. L. (2006). Bias in Clinical Intervention Research. Am J Epidemiol 163: 493-501 [Abstract][Full text]
  • Mccormack, B. (2006). Evidence-based practice and the potential for transformation. Journal of Research in Nursing 11: 89-94
  • Rycroft-Malone, J. (2006). The politics of the evidencebased practice movements: Legacies and current challenges. Journal of Research in Nursing 11: 95-108 [Abstract]
  • Gilgun, J. F. (2006). The Four Cornerstones of Qualitative Research. Qual Health Res 16: 436-443 [Abstract]
  • Cohen, A.M., Hersh, W.R., Peterson, K., Yen, P.-Y. (2006). Reducing Workload in Systematic Review Preparation Using Automated Citation Classification. J. Am. Med. Inform. Assoc. 13: 206-219 [Abstract][Full text]
  • Maier, R. V. (2006). What the surgeon of tomorrow needs to know about evidence-based surgery.. Arch Surg 141: 317-323 [Full text]
  • Thornhill IV, J. T., Tong, L. (2006). From Yoda to Sackett: The Future of Psychiatry Medical Student Education. Acad. Psychiatry 30: 23-28 [Abstract][Full text]
  • Johnson, C. J. (2006). Getting started in evidence-based practice for childhood speech-language disorders.. AJSLP 15: 20-35 [Abstract][Full text]
  • Bauchner, H. (2006). Atoms. Arch. Dis. Child. 91: 95-95 [Full text]
  • Thorne, S. (2006). Reflections on "Helping practitioners understand the contribution of qualitative research to evidence-based practice". Evid. Based Nurs. 9: 7-8 [Full text]
  • Best, M, Neuhauser, D (2005). Pierre Charles Alexandre Louis: Master of the spirit of mathematical clinical science. Qual Saf Health Care 14: 462-464 [Full text]
  • Murray, I R, Murray, S A, MacKenzie, K, Coleman, S, Cullen, M (2005). How evidence based is the management of two common sports injuries in a sports injury clinic? * Commentary. Br. J. Sports. Med. 39: 912-916 [Abstract][Full text]
  • Burkiewicz, J. S, Vesta, K. S, Hume, A. L (2005). Update in Handheld Electronic Resources for Evidence-Based Practice in the Community Setting. The Annals of Pharmacotherapy 39: 2100-2103 [Abstract][Full text]
  • Brophy, R. H., Gardner, M. J., Saleem, O., Marx, R. G. (2005). An Assessment of the Methodological Quality of Research Published in The American Journal of Sports Medicine. Am J Sports Med 33: 1812-1815 [Abstract][Full text]
  • Carney, S. (2005). Competences for the foundation programme--part 3: Evidence based medicine. BMJ CAREER FOCUS 331: 231-232 [Full text]
  • Wolff, A. C., Desch, C. E. (2005). Clinical Practice Guidelines in Oncology: Translating Evidence Into Practice (and back). J Oncol Pract 1: 160-161 [Full text]
  • Alper, B. S., White, D. S., Ge, B. (2005). Physicians Answer More Clinical Questions and Change Clinical Decisions More Often With Synthesized Evidence: A Randomized Trial in Primary Care. Ann Fam Med 3: 507-513 [Abstract][Full text]
  • Staunton, M., Dodd, J. D., McCormick, P. A., Malone, D. E. (2005). Finding Evidence-based Answers to Practical Questions in Radiology: Which Patients with Inoperable Hepatocellular Carcinoma Will Survive Longer after Transarterial Chemoembolization?. Radiology 237: 404-413 [Abstract][Full text]
  • Scott Richardson, W, Dowding, D. (2005). Teaching evidence-based practice on foot. Evid. Based Nurs. 8: 100-103 [Full text]
  • Lorenz, K. A., Ryan, G. W., Morton, S. C., Chan, K. S., Wang, S., Shekelle, P. G. (2005). A qualitative examination of primary care providers' and physician managers' uses and views of research evidence. Int J Qual Health Care 17: 409-414 [Abstract][Full text]
  • Sedrakyan, A. (2005). Improving clinical outcomes in coronary artery bypass graft surgery. Am J Health Syst Pharm 62: S19-S23 [Abstract][Full text]
  • Aoun, S. M, Kristjanson, L. J (2005). Challenging the framework for evidence in palliative care research. Palliat Med 19: 461-465 [Abstract]

Rapid Responses: