Evidence-based health care and systematic reviews

 Are scientific methods used to determine which drugs and procedures are best for treating diseases? The answers may surprise you. Modern healthcare is undergoing a long-overdue and dramatic evolution.

Evidence-based health care

• Evidence-based health care is the conscientious use of current best evidence in making decisions about the care of individual patients or the delivery of health services. Current best evidence is up-to-date information from relevant, valid research about the effects of different forms of health care, the potential for harm from exposure to particular agents, the accuracy of diagnostic tests, and the predictive power of prognostic factors [1].
• Evidence-based clinical practice is an approach to decision-making in which the clinician uses the best evidence available, in consultation with the patient, to decide upon the option which suits that patient best [2].
• Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research [3].

The Evidence-based Medicine Triad
Source: Florida State University, College of Medicine. Retrieved 08.07.11.

Browse our Webliography of resources for evidence-based health care to find books, articles, databases, tutorials & much more.

Systematic reviews

A systematic review is a high-level overview of primary research on a particular research question that tries to identify, select, synthesize and appraise all high quality research evidence relevant to that question in order to answer it.ⁱ

Key Points:

1. Systematic reviews seek to collate all evidence that fits pre-specified eligibility criteria in order to address a specific research question
2. Systematic reviews aim to minimise bias by using explicit, systematic methods
3. The Cochrane Collaboration prepares, maintains and promotes systematic reviews to inform healthcare decisions: Cochrane Reviews
   

• Read more about what a systematic review is, and why systematic reviews are needed in health care, in the Cochrane Handbook for Systematic Reviews of Interventions (Chapter 1.2).
• Read about why protocol and trial registration is important for high-quality systematic reviews, here.ⁱⁱ
  

Further reading

[1] Cochrane AL. Effectiveness and Efficiency : Random Reflections on Health Services. London: Nuffield Provincial Hospitals Trust, 1972. Reprinted in 1989 in association with the BMJ. Reprinted in 1999 for Nuffield Trust by the Royal Society of Medicine Press, London, ISBN 1-85315-394-X.

[2] Gray JAM. 1997. Evidence-based healthcare: how to make health policy and management decisions. London: Churchill Livingstone.

[3] Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS. 1996. Evidence based medicine: what it is and what it isn't. BMJ 312: 71–2 [3] [Full text]

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ⁱ http://en.wikipedia.org/wiki/Systematic_review#cite_note-CEBM_about-0
ⁱⁱThe PLoS Medicine Editors (2011) Best Practice in Systematic Reviews: The Importance of Protocols and Registration. PLoS Med 8(2): e1001009. doi:10.1371/journal.pmed.1001009

Cochrane Collaboration Disclaimer about external links

Views expressed on the websites and resources listed on this page are not necessarily shared by The Cochrane Collaboration. The "quality" of information presented online by these websites can vary, and is in no way endorsed or recommended by The Cochrane Collaboration. This page is intended simply as a starting point for readers to do their own searching and reading about the topic of Evidence-Based Medicine and systematic reviews.

While "evidence" can be essential in evaluating effectiveness of healthcare interventions, well-informed decisions also require information, and judgments about needs, resources and values; as well as judgments about the quality and applicability of evidence. Relying only on evidence about the effects of health care alone can be inappropriate. Care and compassion are vital, and understanding the nature and basis of disease and the way that interventions work remains important. The Cochrane Collaboration is not responsible for the results of decisions based on information found in sources listed on this page.