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Dental Hygiene & Assisting

Evidence Based Medicine

Evidence-Based Medicine (EBM) is the objective, balanced, and responsible use of current research and the best available data to guide healthcare decisions, so that outcomes for patients are improved. Evidence-based medicine focuses on approaches demonstrated to be effective through empirical research rather than through anecdote or professional experience alone.

An evidence-based approach involves an ongoing, critical review of research literature to determine what information is credible, and what policies and practices would be most effective given the best available evidence. It also involves rigorous quality assurance and evaluation to ensure that evidence-based practices are replicated with fidelity, and that new practices are evaluated to determine their effectiveness.

Evidence-Based Medicine seeks to integrate clinical experience and evidence to improve decision making in healthcare. EBM also strives to standardize care by encouraging clinicians to consider data and research in diagnosis and treatment, and not just their own experience. When EBM is practiced, clinicians have a solid and evidence-supported reason why they are recommending a treatment plan.

The PICO Framework

Evidence-based models use a process for framing a question; locating, assessing, and evaluating information; and repeating as needed. Asking a well-formulated research question is a starting point in evidence-based clinical practice. A well-formulated research question reflects an uncertainty that you want to try to resolve - perhaps an uncertainty about the effectiveness of an intervention or how well an intervention works in a specific patient population. It is the foundation of evidence-based medicine. An effective research question presents the idea or ideas that are to be examined. It gives information about the patients to be studied, interventions to be compared, and primary outcomes to focus on.

PICO is a framework that is widely used in health professions to help shape clinical scenarios into research questions that will deliver helpful and relevant results. Using the PICO structure for research questions is a part of practicing Evidence-Based Medicine.

  • P = Patient or Problem - How would I describe the patients experiencing a specific problem or condition?
  • I = Intervention - What main intervention, treatment, or medication am I considering?
  • C = Comparison - Is there an alternative to compare with the intervention?
  • O = Outcome - What do I hope to accomplish, measure, improve or affect?

 

 

For example:

For patients undergoing orthodontic treatment  (P) does the use of  chlorhexidine (I) reduce the future risk of oral ulcers ( (O) compared with no use of chlorhexidine (C) ?

  • P = Patient or Problem - patients undergoing orthodontic treatment
  • I = Intervention - chlorhexidine
  • C = Comparison - no comparison
  • O = Outcome - reduced future risk of oral ulcers