Abstract

Evidence-based medicine (EBM) has been defined as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of patients.” This chapter reviews the steps of EBM in detail and discusses how to use EBM in the practice of emergency medicine with regard to diagnostic testing. EBM queries can be broken down into two categories: general medical questions and specific patient-based questions. The acronym PICO has been used to define the four elements of an answerable question regarding a diagnostic test. PICO refers to (P) patient or population, (I) investigation, (C) comparison, and (O) outcome of interest. Potential pitfalls exist in applying EBM to diagnostic testing and clinical decision rules. Case–control studies compare a group of patients who have a specific condition to another group of people who do not, and then assess the impact of a particular exposure in the two groups.

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