the conscientious, explicit, and judicious use of the current best evidence to make decisions about the care of individual patients. It involves integrating individual clinical expertise with the best available external evidence from systematic research to guide diagnostic, therapeutic, preventive, and rehabilitative decisions.
Clinical expertise refers to the proficiency and judgment that healthcare professionals develop through experience and practice. External evidence consists of clinically relevant research—especially patient-centered studies evaluating diagnostic accuracy, prognostic markers, and the efficacy and safety of interventions. Evidence-based medicine also entails critically appraising research to invalidate outdated practices and adopt more effective, accurate, and safer alternatives.
The widely recognized hierarchy of evidence includes:
1. Meta-analyses and systematic reviews
2. Randomized controlled trials (RCTs)
3. Observational studies
4. Expert opinions and consensus statements
EBM has expanded beyond medicine into other health disciplines as evidence-based decision making (EBDM) or evidence-based practice (EBP).
Abbreviation: EBM
Synonyms: Evidence-Based Practice, Evidence-Informed Practice, Evidence-Based Decision Making
Example
Before prescribing a new biologic therapy for rheumatoid arthritis, a clinician reviews the most recent Cochrane systematic review and relevant randomized controlled trials. This critical appraisal of the highest-quality evidence ensures the treatment plan reflects both best research evidence and the clinician’s expertise — a direct application of EBM.