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Evidence-Based Medicine/Evidence-Based Practice

Evidence-Based Medicine/Evidence-Based Practice

A Brief History of EBP/EBM

The term Evidence-Based Medicine (EBM) was coined in the 1990s and clearly defined by Dr. David Sackett (1996) as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients" and recommended that clinicians formulate a diagnosis based on evidence and research and that it should also incorporate individual patient preference, values, and beliefs into the process (Sackett et al., 1996).

Evidence-Based Practice (EBP) is an offshoot of Evidence-Based Medicine. Historically, EBM primarily involved physicians and focused on the “treatment” aspect of medicine. EBM was later adopted by other healthcare professions under the term Evidence-Based Practice (Mackey & Bassendowski, 2017). Evidence-Based Practice takes a more multidisciplinary approach, it includes nurses, clinicians, nurse practitioners, physician's assistants, physical & occupational therapists, etc., and includes many facets of health such as etiology, prevention, diagnosis, treatment and more (What is the difference, 2023).

There are some who believe that Evidence-Based Practice began with Florence Nightingale and her work in military hospitals during and after the Crimean War. However, most of the literature traces the inception of Evidence-Based Medicine back to Archie Cochrane in the 1970s with his promotion of randomized clinical trials as evidence of effectiveness (Aravind & Chung, 2010). Cochrane wote the book Effectiveness and Efficiency (1972) on the topic of the biases and inconsistencies in medicine. He believed that medical therapies were not based on fundamentally sound evidence. Prior to that time, much of the decision-making regarding patient care was based on individual physician assessment and choice (Mackey & Bassendowski, 2017). Cochrane criticized the lack of reliable evidence behind many commonly accepted healthcare interventions at the time and believed clinicians should utilize procedures with the most proven evidence of effectiveness (Shah & Chung, 2009; Mackey & Bassendowski, 2017). He believed that randomized controlled trials (RCTs) provided the most reliable form of evidence and his promotion of RCTs provided a foundation of health care decision-making that evolved into the Evidence-Based Medicine movement (Shah & Chung, 2009; Mackey & Bassendowski, 2017; Aravind & Chung, 2009).

The advent of EBM facilitated the development of systematic reviews and meta-analyses, research methods by which researchers identify multiple studies on a topic, select the best ones, and critically analyze them to summarize the best available evidence (Masic et al., 2008).

This humerous music video encourages health professionals to use evidence to help reach treatment decisions in partnership with patients. Lyrics and video production: James McCormack, University of British Columbia.