Evidence-based medicine

Evidence-based prescribing can be defined as making prescribing decisions on the basis of a systematic review and critical appraisal of clinical research findings in order to provide the optimum standard of care for individual patients. In practice, individual prescribers rarely have the opportunity to undertake this work to inform their prescribing decisions. Instead, they rely on the work of nationally funded clinical guidelines developers but they have to know where to access the results of this work in order to make sure that it informs local practice. They also have to be aware that much of the evidence considered is derived from large clinical trials with strict entry criteria that involved selected populations of patients with very careful follow-up. They may not reflect ‘real world’ practice. In addition, there are many therapeutic problems for which evidence from high-quality randomised trials is not available, and in such cases the prescriber has to use clinical judgement and whatever evidence is available. 

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