Evidence-based healthcare practice in Qatar: A need to move forward

Abstract

Evidence-based medicine (EBM) is considered the gold standard approach to therapeutic decision-making in modern medicine. It was first described in the 1990s as a way to improve patient outcomes by promoting rational therapeutic decision-making through translation of high quality clinical studies. 1 It was originally defined as the conscientious, explicit, and judicious use of the best available evidence to make decisions regarding the care of individual patients. 1 By translating results of high quality clinical trials into the therapeutic management of patients, better outcomes can be achieved. 2 Additionally, it allows for standardized therapeutic management of disease and evaluation using audit and feedback. The practice of EBM goes hand on hand with individual clinical expertise and the use of available evidence. The five steps of evidence-based practice are summarized in Table 1. 3 The initial step in the process involves the creation of a specific clinical question, commonly referred to as a PICO (Patient or Problem, Intervention, Comparator, Outcomes) question. Using the elements contained within the PICO question, a systematic search of available evidence would then occur (Step 2). Subsequently, critical appraisal of identified literature occurs with assessment for relevance, internal quality, interpretation of findings and applicability to the patient or problem defined by the original clinical question (Step 3). Finally, the practitioner makes an informed decision based on the evidence identified and appraised (Step 4). While these steps complete the EBM process for patient care, a final stage of evaluation and feedback may occur by auditing individual clinician's practices to benchmark evidence-based practice among peers (Step 5).