Evidence-based medicine and the Cochrane Collaboration.
Providing evidence-based care to patients involves turning a clinical problem into an answerable question, systematically searching for the best evidence relevant to the question, critically appraising that evidence, and, finally, using the evidence as the basis for clinical decisions to solve the problem. While the overload of medical information today presents a demanding challenge to physicians to sort and identify relevant and valid evidence, it is vitally important to translate that evidence into clinically useful terms. To apply evidence to patient clinical management, it is critical to discuss with patients the evidence, the benefits and the harms, and the alternative treatments, such that they understand and can fully participate in the decision-making process. The framework of evidenced-based medicine provides a concrete methodology to address these issues, here, framed and detailed in five steps. The Cochrane Collaboration has been at the forefront of applying the methods of evidence-based medicine (EBM) in the treatment and management of musculoskeletal and other disorders.
Tanjong-Ghogomu
Elizabeth
E
University of Ottawa, Ottawa, Canada. cmsg@uottawa.ca
Tugwell
Peter
P
Welch
Vivian
V
D022126:Access to Information; D002983:Clinical Competence; D003299:Cooperative Behavior; D019992:Databases as Topic / Q000592:standards; D020000:Decision Support Systems, Clinical; D019317:Evidence-Based Medicine / Q000592:standards; D006801:Humans; D007255:Information Services / Q000592:standards; D007391:International Cooperation; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000628:therapy; D018579:Patient Selection; D012216:Rheumatic Diseases / Q000175:diagnosis / Q000628:therapy; D018570:Risk Assessment; D016896:Treatment Outcome