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Evidence-based practice targets the individual patient. Part 1: how clinicians can use study results to determine optimal individual care
  1. Dirk Bassler1,
  2. Jason W Busse2,
  3. Paul J Karanicolas3,
  4. Gordon H Guyatt2
  1. 1University Children’s Hospital, Tuebingen, Germany
  2. 2McMaster University, Faculty of Health Sciences, Hamilton, Ontario Canada
  3. 3University of Western Ontario, London, Ontario, Canada

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Despite increasing acknowledgement of its importance,1 some continue to characterise evidence-based practice (EBP) as focusing on groups of patients, and neglecting the individual.2 ,3 In this 2-part Notebook, we will describe EBP tools that address individual patient decision making. In this first part, we will focus on guides for applying research evidence and for determining benefit-to-risk ratios in individual patients.

EVIDENCE-BASED PRACTICE PROVIDES GUIDES FOR ADDRESSING THE APPLICABILITY OF RANDOMISED CONTROLLED TRIALS (RCTS) TO INDIVIDUAL PATIENTS

EBP assists clinicians pondering the generalisability of RCT results to their individual patients and their individual circumstances (table).46 That guidance directs clinicians to look for possible differences in biological factors, socioeconomic characteristics, and attitudinal or behavioural characteristics of individual patients that might modulate treatment effects.7 For instance, antibiotics for otitis media seem to be most beneficial in children younger than 2 years of age with bilateral acute otitis media, and in children with both acute otitis media and otorrhoea. …

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