Evidence-Based Medicine Information

Evidence-Based Medicine is the integration of best research evidence with clinical expertise and patient values.

Best research evidence refers to clinically relevant research, often from the basic health and medical sciences, but especially from patient-centered clinical research
Clinical expertise means the ability to use clinical skills and past experience to rapidly identify each patient's unique health state and diagnosis, individual risks and benefits of potential interventions, and personal values and expectations
Patient values refers to the unique preferences, concerns, and expectations that each patient brings to a clinical encounter and that must be integrated into clinical decisions if they are to serve the patient.

CME Courses on Evidence Based Practice

Levels of Evidence

Levels of Evidence (in PDF format) - This document identifies the various types of studies conducted and lists what would constitute a given level for each type of study.
Levels of Evidence: A Step Forward on the Road to Better Practice? (in PDF format) This article introduces levels of evidence. It defines the five different levels of evidence, identifies potential uses, and discusses implications and effects of using levels of evidence.

Grades of Recommendation

Grades of Recommendation- This page list the various grades of recommendations that would be applied to reviews or summaries of orthopaedic surgical studies.

Evidence Based Medicine Resources

Table of Resources - This table contains information about external resources related to Evidence-Based Medicine.

Understanding Guideline Language

Guideline Language	Recommendation Grade	Level of Evidence
We RECOMMEND	Strong	Level I
We SUGGEST	Moderate	Level II or Level III
Treatment X is an OPTION	Weak	Level IV or Level V
We are unable to recommend FOR OR AGAINST treatment X	Inconclusive	There is insufficient or conflicting evidence not allowing a recommendation for or against intervention.
In the absence of reliable Evidence, it is the opinion of the work group…*	Consensus*	None*

* For the work group to make a consensus-based recommendation, the recommendation must be supported by a rationale that follows specific rules.

The Language of Evidence Based Medicine (in PDF format) - This pamphlet offers details behind the classification of clinical practice guidelines based on evidence.

Library of Clinical Quality Improvement Products

For more information about EBM please contact Fareeha Shuttari-Khan, AAOS Evidence-Based Medicine Coordinator at shuttari@aaos.org.