Translating evidence-based decision making into practice: appraising and applying the evidence

Abstract

This is the second of 2 articles that focus on strategies to integrate an evidence-based decision-making (EBDM) approach into your practice. The previous article provided an overview of EBDM concepts and identified strategies for finding evidence to answer clinical questions, the first 2 steps in the evidence-based process. The next steps are to determine the credibility and usefulness of the evidence and to apply the evidence to patient care. The purpose of this article is to discuss those steps by reviewing the critical appraisal criteria used to assess the methodological quality of a study. A case scenario will be used to demonstrate how appraising the evidence helps to answer questions and how to translate the evidence into everyday practice. Characteristics of an evidence-based practice and educational tips are provided along with a glossary of terms related to appraising the literature. Together, the two articles can serve as a primer for integrating EDBM into your practice. Generally, the most frequently asked clinical questions are related to the effectiveness of a certain technique, medication, diagnostic test, treatment, material, or product. The type of scientific evidence may include systematic reviews and critically appraised topics; clinical practice guidelines and protocols; article reviews; pharmaceutical and drug interaction information; and individual studies addressing questions about therapy, prevention, diagnosis, prognosis, and harm/etiology. Once the most current evidence has been found, the next step in the EBDM process is to understand what you have and its relevance to your patient.