[Evidence based medicine: An example in the pediatric setting]

OBJECTIVE: This paper reviews the main steps to incorporate into clinical practice the concepts of evidence-based medicine, which is a strategy to help clinicians take more suitable decisions when confronted with clinical problems. METHOD: Search in Medline database of articles related with evidence-based medicine, review of a number of clinical epidemiology textbooks and selected articles. RESULTS: Evidence-based medicine recognizes two main sources of information for clinical decision making: 1) the individual patient; and 2) clinical epidemiological research. Trough evidencebased medicine the experience accumulated by a trained clinician should be integrated with the best external evidence obtained from systematic research. The appraisal of external evidence requires new knowledge and skills for the practicing clinician. These skills aim at enabling the clinician to make independent critical judgement of the quality of information that will translate into medical actions for his/her patients. Evidence-based medicine provides the tools to 1) keep up with an ever growing burden of health information; 2) efficiently select best available information; 3) critically appraise selected information; 4) synthesize selected information; and 5) integrate selected information into clinical experience in the management of diagnosed health problems. CONCLUSIONS: Evidence-based medicine could be seen as a way to bridge knowledge, skills, and attitudes acquired from clinical experience with the ability to evaluate the best available external evidence generated by scientific research.