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Comparing the old world (before evidence based practice) and the
new world (with evidence based practice)
|Old world||New world|
|Source of knowledge||Expert opinion||Systematic analysis of the evidence|
|Nature of clinical skills||Semi-mystical||Open to systematic analysis|
|Position of research||Marginal||Central|
|Essential skills||Clinical||Clinical plus ability to appraise evidence|
|Analysis of research||Haphazard||Systematic|
|Importance of gathering new evidence on patients||Low||High|
|Type of research||Clinical (often descriptive)
|Clinical but based on epidemiological
|Essential information sources||Experts
|Electronic access to all research
|Importance of statisticians, epidemiologist, economists, etc||Low||High|
|Assumption that medical care is producing benefit||High||Low|
|Recognition that much of medical care may be ineffective or harmful||Low||High|
|Importance of keeping up to date, learning new skills||Lip service||Essential|
|Importance of access to research evidence||Low||High|
|Importance of systematic analysis of performance||Low||High|
|Organisational model||Hierarchical||Democratic, based in part on knowledge of evidence and ability to interpret it|
|Capacity of managers to get involved in the clinical process||Low||High|
|Nature of relationship to patients||Expert to pupil||Potentially much more equal|