Evidenced-based medicine has become a topic of interest for clinicians for many reasons. Beyond the concept of bringing a scientific approach to the practice of medicine, the managed care industry and consumers are demanding the evidence behind clinical decisions. There are many definitions of evidence-based medicine. The mostly widely accepted definition is that of David Sackett, MD, of McMaster University in Hamilton, Ontario. He and his colleagues define evidence-based medicine as “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”<sup>13 Sackett D.L., Rosenberg W.M.C., Muir Gray J.A. , et al. Evidence based medicine: What it is and what it isn't. Its about integrating individual clinical expertise and the best external evidence BMJ 1996 ;  312 : 71

Cliquez ici pour aller à la section Références</sup> This definition requires that the clinician combine many different forms of external information regarding populations and, using clinical expertise, relate them to the individual.

The concept of evidence-based medicine can be traced back to 1972 when Cochrane published an article titled, “Effectiveness and efficacy: Random reflections on health services,” which advanced the concept that health care should be evaluated based on scientific evidence rather than clinical opinion.<sup>4 Cochrane A.L.   Effectiveness and Efficacy: Random Reflection on Health Services London: Nuffield Provincial Hospitals Trust (1972). 

Cliquez ici pour aller à la section Références</sup> This recommendation spawned the formation of the Cochrane Collaboration, with centers in the United Kingdom, United States, Canada, Denmark, Italy, and Australia. The Collaboration prepares, maintains, and promotes the accessability of systematic reviews of the effects of health care interventions.¹⁷ Evidence-based medicine resources are readily available from many sources, especially on the Internet.

Web addresses and their sponsors (in parenthesis) include the following:
http://www.cochrane.org (The Cochrane Collaboration) http://www.hiru.mcmaster.ca/cochrane (McMaster University) http://www.cebm.jr2.ox.ac.uk (Center for Evidence-Based Medicine—Oxford) http://www.acog.org [American College of Obstetricians and Gynecologists (ACOG)] http://www.ahcpr.gov (Agency for Health Care Policy and Research) http://www.ncbi.nlm.nih.gov [National Library of Medicine (National Institutes of Health)] http://www.bmjpg.com/data/ebm.htm [Evidence-Based Medicine (journal)] http://www.shef.ac.uk/scharr/ir/netting.htm [University of Sheffield (evidence-based medicine links)]

Often, evidence-based medicine is thought of as “cookbook medicine”; however, the compiling of a set of rules or guidelines may or may not be scientific. One can never assume that the persons who write guidelines have used evidence-based medicine principles. Although the managed care industry has touted evidence-based medicine as cost saving, there is no evidence that statement is uniformly true. In fact, in many instances, the practice of evidence-based medicine may justify more use of available resources. The practice of evidence-based medicine is not restricted to the conclusions based on randomized controlled trials (RCT) and meta-analyses but uses all available data.