Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. ... [It] means integrating individual clinical expertise with the best available external clinical evidence from systematic research." The aim of EBM is to integrate the experience of the clinician, the values of the patient, and the best available scientific information to guide decision-making about clinical management. The term was originally used to describe an approach to teaching the practice of medicine and improving decisions by individual physicians about individual patients.
A medical guideline is a document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of healthcare. Such documents have been in use for thousands of years during the entire history of medicine. However, in contrast to previous approaches, which were often based on tradition or authority, modern medical guidelines are based on an examination of current evidence within the paradigm of evidence-based medicine. They usually include summarized consensus statements on best practice in healthcare. A healthcare provider is obliged to know the medical guidelines of their profession, and has to decide whether to follow the recommendations of a guideline for an individual treatment.
The McMaster Faculty of Health Sciences is one of six faculties at McMaster University in Hamilton, Ontario, Canada. The faculty was established in 1974 to oversee the School of Nursing, the School of Medicine, and Graduate programs in health sciences. Today, the Faculty of Health Sciences oversees 5,000 students, 770 full-time faculty, more than 1,800 part-time faculty, and 28 Canada Research Chairs. The faculty is well known for running the most competitive medical and undergraduate program in Canada. The MD program at McMaster University Medical School receives 5000 applications for 203 positions. The BHSc program at McMaster University receives over 5100 applications for 210 positions annually and was ranked the most competitive undergraduate program in Canada by Yahoo Finance in 2016. The faculty was ranked 25th in the world in the 2015 Times Higher Education World Rankings in the Clinical, Pre-Clinical and Health category.
A hierarchy of evidence, comprising levels of evidence (LOEs), that is, evidence levels (ELs), is a heuristic used to rank the relative strength of results obtained from experimental research, especially medical research. There is broad agreement on the relative strength of large-scale, epidemiological studies. More than 80 different hierarchies have been proposed for assessing medical evidence. The design of the study and the endpoints measured affect the strength of the evidence. In clinical research, the best evidence for treatment efficacy is mainly from meta-analyses of randomized controlled trials (RCTs). Systematic reviews of completed, high-quality randomized controlled trials – such as those published by the Cochrane Collaboration – rank the same as systematic review of completed high-quality observational studies in regard to the study of side effects. Evidence hierarchies are often applied in evidence-based practices and are integral to evidence-based medicine (EBM).
David Lawrence Sackett was an American-Canadian physician and a pioneer in evidence-based medicine. He is known as one of the fathers of Evidence-Based Medicine. He founded the first department of clinical epidemiology in Canada at McMaster University, and the Oxford Centre for Evidence-Based Medicine. He is well known for his textbooks Clinical Epidemiology and Evidence-Based Medicine.
Victor Montori is a professor of medicine at the Mayo Clinic in Rochester, Minnesota, USA. He was born and raised in Lima, Peru. He completed medical school at Universidad Peruana Cayetano Heredia in Peru, before joining the Internal Medicine Residency Program at the Mayo Clinic. He was named Chief Resident of the Department of Internal Medicine from 1999 to 2000.
The Users’ Guides to the Medical Literature is a series of articles originally published in the Journal of the American Medical Association, later rewritten and compiled in a textbook, now in its third edition. The guides provide practical, clinician-friendly advice on all aspects of evidence-based medicine.
David M. Eddy is an American physician, mathematician, and healthcare analyst who has done seminal work in mathematical modeling of diseases, clinical practice guidelines, and evidence-based medicine. Four highlights of his career have been summarized by the Institute of Medicine of the National Academy of Sciences: "more than 25 years ago, Eddy wrote the seminal paper on the role of guidelines in medical decision-making, the first Markov model applied to clinical problems, and the original criteria for coverage decisions; he was the first to use and publish the term 'evidence-based'."
Canadian Society for Clinical Investigation (CSCI) was founded in 1951. The original purpose was to provide people with a forum to exchange scientific information. CSCI's current Mission is "To promote clinical and basic research in the field of human health throughout Canada, to lobby for adequate research funding at the federal, regional and local levels, and to support Canadian researchers in their endeavours and at all stages of their careers."
The Michael G. DeGroote School of Medicine, known as the McMaster University School of Medicine prior to 2004, is the medical school of McMaster University in Hamilton, Ontario, Canada. It is operated by the McMaster Faculty of Health Sciences. It is one of two medical programs in Canada, along with the University of Calgary, that operates on an accelerated 3-year MD program, instead of the traditional 4-year MD program.
The National & Gulf Center for Evidence Based Health Practice has been established with the initiative of Bandar Al Knawy, Chief Executive Officer of National Guard Health Affairs, and with the support of former chief executive, Abdullah bin Abdulaziz Al Rabiah in March 2004. The center is recognized by the Cooperation Council for the Arab States of the Gulf Ministers of Health as a reference to evidence-based medicine (EBM) in Saudi Arabia and the Cooperation Council for the Arab States of the Gulf (GCC). The center is an affiliated center to Evidence Based Clinical Practice Group in McMaster University, Canada. This group is led by Gordon Guyatt. It is also a collaborating centre to The Joanna Briggs Institute for Evidence Based Health care, in the University of Adelaide, Australia. The center works in contact, coordination and collaboration with the National EBM committee, GCC Ministers of Health Executive Office, Arabian Gulf University EBM Center, Bahrain, University of Sharjah EBM center, United Arab Emirates, and Sultan Qaboos University EBM Center, Oman.
The GRADE approach is a method of assessing the certainty in evidence and the strength of recommendations in health care. It provides a structured and transparent evaluation of the importance of outcomes of alternative management strategies, acknowledgment of patients and the public values and preferences, and comprehensive criteria for downgrading and upgrading certainty in evidence. It has important implications for those summarizing evidence for systematic reviews, health technology assessments, and clinical practice guidelines as well as other decision makers.
Holger Jens Schünemann is a physician and professor of Preventive Medicine and Public Health and professor emeritus of medicine and Clinical epidemiology. Since 1 December 2023 he is Director of the Clinical Epidemiology and Research Center (CERC) at Humanitas University. From 1 February 2009 to 30 June 2019 he was the chair of the Department of Health Research Methods, Evidence, and Impact at McMaster University in Hamilton, Canada, where he now works as full professor.
Alejandro R. Jadad Bechara is a Canadian-Colombian physician whose work focuses on improving health for all, and transforming healthcare, through creative human-machine collaboration powered by scientific evidence and collaboration across traditional boundaries. He is also known as the researcher responsible for the development of the Jadad Scale, the first validated tool to assess the methodological quality of clinical trials. He also co-created the methodology behind 'Computational Management', a systematic approach to facilitate task automation for the integration of artificial intelligence into existing workflows.
Stanley Paul Kutcher is a Canadian Senator and Professor Emeritus of Psychiatry at Dalhousie University. He was appointed to the Senate of Canada on 12 December 2018.
Robert Brian Haynes OC is a Canadian physician, clinical epidemiologist, researcher and an academic. He is professor emeritus at McMaster University and one of the founders of evidence-based medicine.
Peter Tugwell is a Canadian physician and Professor in the Department of Medicine and School of Epidemiology and Public Health at the University of Ottawa. He is known for promoting clinical epidemiology and championing for health equity worldwide. In 2013 he was named Officer of the Order of Canada for his efforts as "tireless contributor to global health".
Philip James Devereaux is a Canadian cardiologist, clinical epidemiologist, and perioperative care physician. Devereaux conducts clinical research within cardiac and perioperative fields, with a focus on vascular surgical complications.
Kaveh G. Shojania is a Canadian doctor, academic and an author. He is the vice chair of quality & innovation in the department of medicine at the University of Toronto as well as staff physician at the Sunnybrook Health Sciences Centre.
Benjamin Djulbegovic is an American physician-scientist whose academic and research focus revolves around optimizing clinical research and the practice of medicine by comprehending the nature of medical evidence and decision-making. In his work, he has integrated concepts from evidence-based medicine (EBM), predictive analytics, health outcomes research, and the decision sciences.
