Evidence based clinical practice: an introduction for urologists
Authors:
P. Dahm
Published in the journal:
Urol List 2008; 6(4): 70-77
Summary
Introduction:
Evidence-based clinical practice (EBCP) has been defined as the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients and refers to a broad set of principles and methods intended to ensure that medical decisions, guidelines and health policy are based on well designed studies of therapeutic effectiveness and benefit.
Methods:
This article reviews the principles and practice of EBCP using examples from the urology literature. It further provides a guide to currently available web-based EBCP resources and guidelines for urologists.
Results:
EBCP integrates a hierarchy of evidence and patient's values with the practitioner's judgment to guide decision-making for the individual patient. Important steps in the EBCP process include the formulation of an answerable question and a systematic search of the literature. In absence of pre-appraised evidence or disease-specific guidelines, the practice of EBCP relies heavily on the evaluation of the primary literature by the individual urologist. Depending upon the question domain (therapy/prevention, etiology/cause/harm, diagnosis or prognosis) and study design a given study is critically appraised for its validity, impact and applicability. Evidence is then integrated with clinical judgment and a patient's individual circumstances and preferences. Finally, the practice of EBCP includes a self-assessment of the provider's performance.
Conclusion:
Knowledge, practice, and documentation of EBCP are of increasing importance to every urologist. Urologists should embrace EBCP principles by acquiring the necessary skills to critically appraise the literature for the best evidence to apply to patient care.
Key words:
evidence-based medicine, research methodology, clinical trials, bias
Zdroje
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Štítky
Paediatric urologist UrologyČlánok vyšiel v časopise
Urological Journal
2008 Číslo 4
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