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Student Education

The evidence based clinician: part 1, asking answerable questions

BMJ 2002; 325 doi: https://doi.org/10.1136/sbmj.0209313 (Published 01 September 2002) Cite this as: BMJ 2002;325:0209313
  1. Christopher Ball, project director1
  1. 1Centre for Evidence-based Medicine, Oxford OX3 7JX

It's quite shocking to realise that there is an awful lot of rubbish behind a lot of clinical practice. Many doctors will swear that their choice of management is effective. "But," asks Christopher Ball, "where is the evidence?"

Clinicians suffer from information overload. Hundreds of medical articles and textbooks are published weekly, but most are of poor quality and already out of date. The internet contains opinion intermingled with scientific fact, usually with no clear distinction between the two. Experts cite selectively and may twist facts to suit their viewpoint.

Evidence based medicine offers a way of cutting through the garbage to good quality material, but many clinicians do not have time to learn critical appraisal and statistical analysis in detail. Fortunately numerous resources are now available that have done the hard work already, allowing clinicians to move rapidly from question to answer and improve the quality of care that they provide for their patients.

This series of articles will focus on how to ask answerable questions, where to look, and, finally, how to customise the information to your patient, without spending hours learning complex techniques or reading long winded papers.

Using evidence in your practice will make you better at diagnosing conditions, increase the chance that you start the right treatment and avoid harm, and help you better advise your patients on likely outcomes. Plenty of studies have shown that patients who receive evidence based care have better outcomes, and patients who don't have worse ones, so it is worth the effort. The goal is to improve your patients' care, so you won't find any statistics or research methodology mentioned, only practical strategies for frontline clinicians.

Let's get real

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