Introduction

It is important that clinical care decisions be supported by the best available scientific evidence in order to maximize the potential for successful patient care outcomes.  Evidence has always contributed to clinical decision-making; however, with the proliferation of clinical studies and journal publications, keeping current with relevant research is nearly impossible.  Because we rely on well-designed research studies to demonstrate the efficacy and effectiveness of diagnostic tests, treatment strategies, new materials, and products, the scientific literature is an essential component for "evidence-based decision-making" (EBDM) in clinical practice.

Based on the original definition of Evidence-Based Medicine (EBM),¹ the American Dental Association (ADA) defines "evidence-based dentistry" (EBD) as:
…an approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to patient's oral and medical condition and history, with the dentists' clinical expertise and the patient's treatment needs and preferences.²

The current EBM definition is now stated as "the integration of best research evidence with clinical expertise and patient values,"³ which explicitly recognizes the patient's role.  Regardless of the definition used, the intent is that the use of current best evidence does not replace clinical skills, judgment, or experience but provides another dimension to the decision-making process that also considers the patient's preferences.  (Figure 1)

Translating this definition into action requires the following five steps:

1. Converting information needs/problems into clinical questions so they can be answered
2. Conducting a computerized search with maximum efficiency for finding the best external evidence with which to answer the question
3. Critically appraising the evidence for its validity and usefulness (clinical applicability)
4. Applying the results of the appraisal, or evidence, in clinical practice
5. Evaluating the process and your performance

The purpose of this article is to introduce evidence-based concepts and demonstrate how to find valid evidence to answer clinical questions.  Steps involved in structuring a question and conducting the search will be outlined along with a discussion of the type of question and type of evidence for which you will be searching.  A case scenario will demonstrate the application of the skills involved.  Practice tips and learning activities are provided along with online resources related to searching the literature and levels of evidence.

Click Here To Navigate Within Article >> Abstract Introduction Evidence Based Concepts Evidence-Based Decision-Making in Action Applying the PICO Process Structuring the PICO Question Conducting an Evidence-based Search Secondary Sources of Evidence Practice Tips Conclusions References About the Authors
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Citation Number: Vol. 3, No. 3, Page 011