Evidence-Based Medicine

It is no longer considered acceptable for medical practice to be based largely on clinical anecdotes and expert opinion. Rather, medical decisions should be based on best available evidence. Evidence-based medicine (EBM) is now recognized as a practice that should be learned and practiced by all radiologists, and indeed, all physicians. When practiced effectively, EBM integrates clinical expertise, patients' values, and best evidence, and promotes optimal patient care. The process of EBM has five components: (1) formulation of a clinical question based on a relevant and immediate clinical problem; (2) selection of appropriate resources and conduction of a literature search; (3) appraisal of the literature for its validity and applicability; (4) integration of the information with clinical expertise and unique patient needs; and (5) self-evaluation of one's performance with a specific patient. Each clinical problem is different, and the resources available to solve each problem vary. Radiologists must search for the best evidence but understand that in some circumstances there may be no good evidence to support clinical judgment.