Extract
Since its inception in 1990, the term "evidence-based medicine"
has evolved to include evidence-based nursing, physiotherapy, occupational
therapy, podiatry, critical care, and surgery. Surgical subspecialties, such
as orthopaedics, have led the way in a paradigm shift favoring evidence-based
medicine over traditional
approaches1.The most sophisticated practice of evidence-based medicine requires, in
turn, a clear delineation of relevant clinical questions, a thorough search of
the literature relating to these questions, a critical appraisal of available
evidence and its applicability to the clinical situation, and a balanced
application of the conclusions to the clinical problem. The balanced
application of the evidence (i.e., clinical decision-making) is the central
point of practicing evidence-based medicine and involves, according to the
principles of evidence-based medicine, integration of our clinical expertise
and judgment with patient and societal values and the best available research
evidence (Fig.
1)2.