[Neuropediatrician and evidence-based medicine]

Practicing evidence-based medicine (EBM) in neuropediatrics requires clinical expertise, but also expertise in retrieving, interpreting, and applying the results of scientific studies to patients. EBM aims for the ideal that healthcare professionals should make 'conscientious, explicit, and judicious use of current best evidence' in their everyday practice in five steps: ask, access, appraise, apply and audit. Some neuropediatricians are 'producers' of EMB, but all are 'consumers', because EBM may be a help to obtain information in medicine 'just in time and just in case'. It's important to know and use the '5S' pyramid of knowledge for evidence based health care decisions: studies, syntheses, synopses, summaries and systems. EBM categorizes different types of scientific publications in levels of evidence and grade of recommendations, and ranks them according to the strength of their freedom from the various biases that beset medical research. It is recognized that EBM have limitations and disadvantages and that they are problems to generate, access and implement evidence.

It's important that neuropediatricians know the main tools in EBM and then make an appropriate a evidence-based decision-making in clinical practice. EBM is one of on-going 'revolutions' in biomedical knowledge, closely related with other four revolutions in the field of health sciences: knowledge revolution, web revolution, open access revolution and librarian revolution.