The EBM Medical Literature Search

Applying your appraised articles to your PICO question will take a combination of your EBM skills to ensure you have found the best clinical evidence available at the time of your initial search, used your clinical expertise in evaluating the available information, and have taken into consideration your patient's values and expertise. 

Evaluating your decision requires determining the culmination of the search and its effectiveness on your clinical or research question. 

You have successfully determined the articles you have found are quality sources that aid you in answering your PICO question. Now it is time to use your expertise in applying to your patient. 

Some questions to keep in mind: 

• Does the patient present any beliefs and/or values that prevent the intervention from being applicable? 
• Is the intervention obtainable? Affordable to the patient? 
• Does the use of the intervention outweigh the act of "doing nothing?" 

 This is when you ask "How has my decision impacted the end result?"

•  Was your search process adequate?
  • Could you go back and run a second search with additional known details?
  • Could your strategy be improved? 
• Did you analyze or appraise sources adequately?
  • Should you go back to reevaluate any? 
• Did you fully take into account your patient's input?
  • Did your decision align with their expectations regarding quality of life (i.e. patient-centered outcomes) or the medical expectations (i.e. clinical outcomes)?  

Well, if you determine your PICO question is not fully answered or you have gained new information (e.g. a new drug came on the market; you discover your patient desires a holistic approach you are unfamiliar with; your research demographic had to be adjusted), then you would cycle back to ASK or ACQUIRE with your new goals in mind.

If you are satisfied and wish to write up a case study or literature review, now is the time to proceed onwards.