Evidence-Based Practice Committee

Saving Time and Money with Evidence-Based Practice: Symposium Introduction

AAOS Symposium
February 7, 2003

Michael J. Goldberg, MD
Chairman, Department of Orthopaedic
Tuft-New England Medical Center

Evidence-based practice is the integration of the 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 the clinical skills and past experience to rapidly identify each patient’s health state, and individual risks and benefits of potential interventions. Patient values refers to the unique preferences; concerns and expectations that each patient brings to a clinical encounter, and that must be integrated into the clinical decisions if they are to serve the patient.

A recent survey of the membership of the American Academy of Orthopaedic Surgeons indicates that there are significant knowledge gaps and confusion regarding evidence-based practice. The terms "evidence-based practice" and "evidence-based medicine" are often used interchangeably, leading to a lack of clarity for both the novice and beginner in this field. The definition of evidence-based practice is specifically relevant to the practicing orthopaedic surgeon. Keeping that definition in the forefront, our speakers today will discuss evaluating the literature; the perspective of Board certification and recertification; the government’s perspective on quality assurance; and the perspective of the health insurer.