Clinical guidelines and evidence-based medicine /
Ricardo S. Guanzon
Evidence-based medicine (EBM) enjoins systematically finding, appraising, and using contemporaneous research findings as the basis for clinical decisions. There are simple steps in doing EBM. Two good examples of EBM output are the production of guidelines. These may be the Foresighted Practice (FP) and the Hindsighted Practice (HP) models. FP has a greater demand for computer technology and may find it difficult for application in the rural areas whereas HP may be found in written application form. EBMs popularity can be gleamed from a literature survey done in June 1997 using the Internet (Medline) with database from 1993 to 1997. Results showed the following entries: 92 (61%) were in the form of letters, editorials and comments, 31 (20%) were reviews/highlights of reports and 26 (17%) were protocols or research outputs (practice guidelines). Only 3 (2%) were programs or Foresighted practice. Ratings of evidence in evaluating diagnostic tests, studies of prognosis or rating review articles have different levels. The BMJ and the Canadian groups give good examples of how to rate the evidences. Sackett et al similarly have given the hierarchy of evidence of the different approaches to research design. Example of Guidelines for referees are also presented.
The Filipino Family Physician, 1998 36 (2) pages 61-69