Dylan Collins, DPhil Student
So, you’ve heard of evidence-based medicine, but you’re busy seeing patients and not sure where to start. You don’t have to take fancy classes, listen to podcasts, or read any textbooks to start practicing evidence-based medicine (but if you want to, you can find them all here).
Here are five things you can do right now to jumpstart your evidence-based practice:
1. Stop taking information from for-profit companies
Stop seeing pharmaceutical representatives. Don’t take their pamphlets, don’t use their pens.
If a study or one of its authors was funded by a for-profit company look for a different study. The vested interests of funders and authors tend to influence the results of research.
2. Know what the All Trials Campaign is, and why it matters
Only half of clinical trial results are published. How can we make evidence-based decisions about clinical care if the results of half of all clinical trials are withheld?
3. Know the PICO framework, inside and out
PICO, which stands for Population, Intervention, Comparison Intervention, and Outcome, is a framework for structuring research questions. You should be able to translate your clinical question (e.g. will low-dose aspirin help my patient?) into an answerable research question (e.g. does 80 mg of aspirin daily, relative to no aspirin, reduce the risk of heart attack in diabetic women over the age of 50?). Practice by reading research papers and describing their research question in a PICO framework. Get really good at it. Learn how here.
4. Keep a journal of clinical questions
Keep track of your clinical questions by writing them down all in one place. Use a notebook, your phone, or a computer. Try recording them in the PICO format, or translating them into the PICO structure later.
5. Schedule time in your diary to read one research paper
If you do not schedule it, it won’t happen. To use evidence in practice, you need time to find and critically appraise research findings. Take it one research paper at a time. At first, schedule 30 minutes to thoroughly read a paper. You’ll get faster as you practice.
You can use your journal of clinical questions to search for a research paper on a topic relevant to your practice. Alternatively, try following some researchers on twitter to help find interesting and up-to-date research to read. I’ve assembled a twitter list of people and organisations to get you started.
I’ve implemented tip five by scheduling 30 minutes every Monday morning (with digital reminders!) to read a new paper. If you’re short on time, try scheduling one lunch break each week where you can eat and read. This week I read Audit: how to do it in practice¸ which is a great introductory article for clinicians looking to conduct an audit of their practice. For my doctoral research, I’m conducting a clinical audit of refugee health care in Jordan. This article was particularly helpful for me to understand the organisational structures that lead to successful service improvement, and I will use this knowledge when engaging with stakeholders and sharing the findings of the audit.
Try these five steps and let me know how it goes. When you’re ready, we offer everything from short courses in evidence-based medicine, to an MSc and DPhil in evidence-based health care.