Goal and Principles of EBM

Goal of EBM

EBM has one goal: to improve the health of people through decisions that will maximise their health-related quality of life and life span. The decisions may be in relation to public health, health care, clinical care, nursing care or health policy.

Principles of EBM

Two fundamental principles include:

(a) Hierarchy of evidence

It says that evidence available in any clinical decision making can be arranged in order of strength based on likelihood of freedom from error. For example, for treatment decisions, meta-analyses of well conducted large randomised trials may be the strongest evidence, followed in sequence by large multi-centric randomised trials, meta-analyses of well conducted small randomised trials, single-centre randomised trials, observational studies, clinical experience or basic science research.

(b) Insufficiency of evidence alone

The second fundamental principle of EBM is that evidence alone is never suffi cient for decision-making. It has to be integrated with clinical expertise and patients’ expectations and values. This principle gives rise to considerations of components of EBM which follows below.