The steps in the EBM process should always begin and end with the patient. It is a patient-centered care model and is typically initiated during clinical encounters with patients where questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, or the etiology (harm) of diseases arise.
The following information and images are combined from Duke University Medical Center Library & Archives' guide on Evidence-Based Practice and Georgetown University Medical Center's Evidence-Based Medicine Resource Guide.
The 5 A's of the Evidence-Based Cycle:
The clinician must assess the patient and the problem to determine the pertinent issues, which may include a differential diagnosis, treatment decisions, or prognosis.
The clinician must draw from this evaluation and ask a clear, answerable question to be pursued.
The next step is to efficiently acquire the evidence from an appropriate source. Potential sources include original research studies, systematic reviews, evidence-based journal abstracts, textbooks and computerized decision support systems.
With a potential source in hand, the clinican must appraise the evidence to further examine its worth and reliability.
This process must conclude by returning to the individual patient, as the clinician has to decide whether it is appropriate to apply the evidence to the particular patient and their unique values and circumstances. Evidence alone is never sufficient to direct decision making. Rather, it must be put into context with a patient's values.
For more information on the 5 A's, see the following document:
Is it Evidence-Based Research?
The original peer reviewed scholarly study or work was conducted by the author(s) using the scientific method of research.
It will usually contain the phrase, "the purpose of this study..."
The articles will contain the following sections:
The following is a list of articles originally published in American Journal of Nursing as a series from the Arizona State University College of Nursing and Health Innovation's Center for the Advancement of Evidence-Based Practice.