Sackett, a clinical epidemiologist and one of the founders of modern evidence-based medicine (EBM), defined it as1:
the conscientious, explicit and judicious use of current best evidence about the care of individual patients.
This definition reflects certain key concepts.
• "Conscientious" implies an active process which requires learning, doing and reflection.
• "Explicit" implies that we can describe the process that we use to practice EBM.
• "Current" implies being up to date.
• "Best" implies that we should seek the most reliable evidence source to inform practice.
As Chapter 12 elaborates, perhaps the most important and frequently forgotten phrase in this definition is "the care of individual patients". This is crucial - the place for EBM is not in trying to score intellectual points in the literature or in humiliating colleagues at journal clubs; it is at the bedside or in the outpatient consulting room. As chapter 12 emphasises, EBM is a way of thinking and working, with the improved health of our patients as its central aim.
Nowadays, the term evidence-based practice is often used instead of EBM. This reflects the doing rather than talking about EBM, and may be defined as Integrating one's clinical expertise with the best external evidence from systematic research.2 Evidence-based dermatology simply implies the application of EBM principles to people with skin problems.3
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