In his seminal article Evidence-based Medicine, David Sackett states that good doctors combine their expertise with evidence to arrive at the best clinical decisions. Sackett writes, “Without clinical expertise, practices risk becoming tyrannized by external evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. Without current best external evidence, practice risks becoming rapidly out of date, to the detriment of patients.”
Optometrists, in addition to clinical expertise and strong didactic and theoretical knowledge, should be able to find, evaluate, and use high-quality evidence in order to most effectively care for their patients. This guide is a good starting place if you wish to use evidence-based practice in your own patient care.
There are five cyclical steps to evidence-based practice (aka the “5 As”):
- ASK a clinical question relating to your patient’s needs.
- ACQUIRE evidence to answer your question.
- APPRAISE the evidence to ensure it is high-quality and free from bias.
- APPLY the evidence in patient care, taking your patient’s preferences into account.
- ASSESS the outcome and determine if any changes need to be made.
…and repeat as necessary!
