Some definitions
Evidence Based Practice (EBP) describes the practice of making decisions about patients and treatments based upon up to date and reliable evidence. For healthcare practitioners, this consists of "producing evidence; making evidence available; [and] using evidence" (Gray 2001, p14).
The following definitions come from the Centre for Evidence Based Medicine.
- Systematic ReviewAn article in which the authors have systematically searched for, appraised, and summarised all of the medical literature for a specific topic.
- Critically appraised topicA short summary of an article from the literature, created to answer a specific clinical question.
- Randomised controlled clinical trialA group of patients is randomised into an experimental group and a control group. These groups are followed up for the variables/outcomes of interest.
- Cohort studyInvolves the identification of two groups (cohorts) of patients, one which did receive the exposure of interest, and one which did not, and following these cohorts forward for the outcome of interest.
- Case-control studyInvolves identifying patients who have the outcome of interest (cases) and control patients without the same outcome, and looking to see if they had the exposure of interest.
- Meta-analysis:A systematic review which uses quantitative methods to summarise the results
Evidence pyramid
EBM Pyramid copyright 2006 Trustees of Dartmouth College and Yale University. All rights reserved.
There are many different versions of the evidence pyramid but the main thing it does is demonstrates the evolution of the literature. An idea conceived in a lab turns into therapies and diagnostic tools tested with laboratory models, then in animals and finally in humans. The human testing begins with volunteers and goes through several phases of clinical trials before the therapy or tool can be authorised for use within the general population.
Randomised controlled trials are done next to further test the effectiveness and efficacy of a drug or therapy.
The amount of literature decreases as you move up the pyramid but increases in its relevance to the clinical setting. As you move up the pyramid, the study design is more rigorous and allows for less bias or systematic error.
Using EBP in Nursing
- Information Literacy for Evidence-Based Nursing Practice: An Introduction
This tutorial from Western Connecticut State University consists of multiple modules that will serve as a guide to information literacy for evidence-based practice.
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