Evidence-Based Practice

The classic definition of Evidence-Based Practice (EBP) is from Dr. David Sackett. EBP is “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.”²

Evidence-Based Practice (EBP) has developed over time to now integrate the best research evidence, clinical expertise, the patient's individual values and circumstances, and the characteristics of the practice in which the health professional works.3

The process of integrating EBP with your experience, skills and training while considering a patient’s situation and values (eg., social support, financial situation) in the practice context (e.g., limited funding) is known as clinical reasoning. When you consider all these four elements in a way that allows you to make decisions about the care of a patient, you are engaging in EBP.4

Why is Evidence-Based Practice important?

Evidence-Based Practice (EBP) is important because it:

- aims to provide the most effective care that is available, with the aim of improving patient outcomes. Patients expect to receive the most effective care based on the best available evidence.

- promotes an attitude of inquiry in health professionals and encourages regulated members to reflect on: "Why am I doing this in this way?" / "Is there evidence that can guide me to do this in a more effective way?" 
 
- plays a role in ensuring that finite health resources are used wisely, and that relevant evidence is considered when decisions are made about funding health services.⁵

What happened before Evidence-Based Practice?

Before EBP, health professionals relied what they were taught as students, on their own intuition and on the advice of more experienced colleagues, often taken at face value. Experience is subject to flaws of bias and what we learned as students can quickly become outdated. Relying on older, more knowledgeable colleagues as a sole information source  provide dated, biased and incorrect information. This is not to say that clinical experience is not important - it is in fact part of the definition of EBP. 

Rather than relying solely on clinical experience for decision making, health professionals need to use clinical experience together with other types of evidence-based information.⁶

Doesn't all published research have good quality? 

Not all research has sufficient quality to inform clinical decision making. You need to critically appraise evidence before using it. The three major aspects of evidence that you need to critically appraise are:

1. Validity - can you trust it?
2. Impact - are the results clinically important?
3. Applicability - can you apply it to your patient?

What is the difference between Evidence-Based Practice and Evidence-Informed Practice?

The term, evidence-informed, typically uses the same principles as evidence-based.

1. https://canberra.libguides.com/evidence
2. Sackett, D., Rosenberg, W., Gray, J., et al. (1996). Evidence based medicine: what it is and what it isn't: it's about integrating individual clinical expertise and the best external evidence. BMJ, 312, 71-72. doi: http://dx.doi.org/10.1136/bmj.312.7023.7
3. Mayer, D. (2010). Essential evidence-based medicine (2nd ed.). Cambridge: Cambridge University Press.
4. Hoffman, T., Bennett, S., & Del Mar, C. (2013). Evidence-based practice: across the health professions (2nd ed.). Chatswood, NSW: Elsevier.
5. Straus, S., Glasziou, P., Richardson, W., & Haynes, R. (2011). Evidence-based medicine: how to practice and teach it (4th ed.). Edinburgh: Churchill Livingstone Elsevier
6. Bushell, M. (2019). Supporting your practice: Evidence-based medicine. Australian Pharmacist, 38, 3, 46-55.