Evidence Based Medicine

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Evidence Based Medicine
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Evidence Based Practice

• Levels of Evidence
• Association
• Cause Effect
• Effective Interventions

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Association? Cause?

• What is the difference?

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Causation

• Size of risk measured appropriately
• Association is consistent
• Different settings
• Different methods
• Specific effect
• Exposure precedes outcome
• Exposure predicts outcome
• Dose response
• Prevention (or amelioration) by appropriate
  experiment
• Biological plausibility
• Compatible with theory and knowledge
• Analogy with similar diseases

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EBM Five Steps

• Defining the question.
• Finding the best available evidence.
• Critical appraisal of that evidence.
• Application of that evidence in practice.
• Audit of performance.

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Effective interventions