EBC includes five fundamental steps.Step 1: Formulating a well-built PICO question. The acronym PICO assists in remembering the steps (P, patient or problem; I, intervention; C, comparison intervention; O, outcomes).Step 2: Identifying articles and other evidence-based resources that answer the questionStep 3: Critically appraising the evidence to assess its validityStep 4: Applying the evidenceStep 5: Re-evaluating the application of evidence and areas for improvementAn example would be this. “In a 55-year-old man with a 35-year-old history of chronic smoking, would the administration of bupropion (Zyban, Wellbutrin) as compared to a nicotine replacement therapy (NRT) be a better therapy in causing long-term abstinence from smoking?”P (Patient) - 55-year-old man with a 35-year-old history of chronic smokingI (Intervention) - administration of bupropion therapyC (Comparison intervention) - replacement therapy (NRT)O (Outcome) - long-term abstinence from smokingAfter successfully formulating the clinical question you need to find relevant evidence. Evidence is not one study, but a number of studies coming to the same or a similar conclusion to a certain question. Consider looking at a filtered source, such as Cochrane Database of Systematic Reviews www2.cochrane.org/reviews, or the ADA Evidence-Based Dentistry (EBD) site, ebd.ada.org, and www.ada.org/276.aspx. After applying the evidence, you must evaluate the effectiveness and efficacy of your intervention in direct relation to your patient. Was the diagnosis and treatment successful? Is there new information/data in the literature? How can I improve and/or update my clinical decisions?Click here to view "an EBDM Model for Dental Hygiene."1999 Forrest and Miller. National Center for Dental Hygiene Research, Permission Requested.Other resources
Agency for Healthcare Research and Quality: www.ahrq.gov/clinic/epcix.htmFor a detailed tutorial, visit www.biomed.lib.umn.edu/learn/ebp.For a detailed tutorial, visit www.hsl.unc.edu/services/tutorials/ebm/ebp_tutorial.pdf.
Agency for Healthcare Research and Quality: www.ahrq.gov/clinic/epcix.htmFor a detailed tutorial, visit www.biomed.lib.umn.edu/learn/ebp.For a detailed tutorial, visit www.hsl.unc.edu/services/tutorials/ebm/ebp_tutorial.pdf.
