Best available evidence
Clinical expertise
Pt values & preferences
Clinical CONTEXT
Evidence-based medicine, coined in 1992 by Gordon Guyatt of McMaster University, has also be called 'enlightened skepticism.' Listen to these inspirational stories of EBM: the past, present and future: An oral history.
https://files.jamanetwork.com/sdebm/
Granular components of EBM:
Scientific skepticism
Critical analysis of literature
Constant reappraisal of the evidence/literature
Combined with:
Clinical experience --> clinical expertise via deliberate practice (planning, performing, reflecting)
Patient values and preferences
Clinical context of a given patient, physicians & system at a given moment in time
Beware of clinical inertia and evidence-based exit block where clinical practice has failed to become fully aligned with strong evidence supporting a change in diagnosis or therapy.
-Goldberger LA and Goldberger ZD. Becoming a Consummate Clinician: What Every Student, House Officer, and Hospital Practitioner Needs to Know. Wiley-Blackwell: 2012.