Evidence-Based Medicine Course

Introduction

Evidence-Based Medicine is the science of rigorously critiquing the medical literature and judiciously applying the results to the care of individual patients. EBM was developed in the 1980s at McMaster University in Canada as a clinical learning strategy. Practicing evidence-based medicine requires some familiarity of basic epidemiology, statistics, clinical research, and outcomes research. A course in the application of evidence-based medicine is provided for the Baylor College of Medicine critical care fellows with the goal of improving fellows’ skills in interpreting and applying the medical literature interpretation.

Format

EBM seminars are conducted monthly with the initial lectures designed to provide background knowledge of the history and practice of EBM and basic knowledge of statistics and study design. Subsequent lectures cover basic epidemiology and literature search skills with active participation by the fellows. The last half of the series utilizes participant’s active application of these skills as fellows appraise and critique selected articles from the medical literature. The EBM appraisal formats used by the PedsCCM Evidence-Based Medicine Journal Club is used to critique all articles reviewed by the critical care section. The following types of studies are appraised on a yearly basis: randomized control trials, diagnosis, prognosis, harm, meta-analysis, and economic studies. While one fellow is assigned the responsibility of overseeing each monthly session, all participants are encouraged to read the material provided in advance of the lecture and perform individual appraisals of the articles in order to participate in discussions. 

Pediatric critical care fellows have an outstanding record of submitting their EBM appraisals to the PedsCCM Evidence-Based Medicine Journal Club at http://pedsccm.org/EBJournal_Club_intro.php  for electronic publication. Several reviews from former and current BCM fellows are currently available at the electronic journal club.

Yearly curriculum

• Introduction to EBM
• Statistics 101
• Advanced statistics
• Study design
• Literature search strategies
• How to review a therapy article
• How to review a prognosis article
• How to review a diagnosis article
• How to review a harm article
• How to review an economic article
• How to review a meta-analysis