Page 16 - Athletic Health Handbook
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SPORTS MEDICINE
CONCEPTS

EVIDENCE-BASED MEDICINE:
A PRIMER

RICK W. WRIGHT, MD EVIDENCE-BASED MEDICINE (EBM) AS A
Department of Orthopaedic Surgery CONCEPT HAS BECOME INCREASINGLY
Washington University School of Medicine IMPORTANT in the practice of clinical medicine. EBM as defined
at Barnes-Jewish Hospital
St. Louis, Missouri by Sacket and others involves the use of the best available evidence in
combination with a physician’s personal experience and expertise and an
individual patient’s needs and expectations.1 Its role has been downplayed
or minimized by clinicians unfamiliar with its basic tenets.

What EBM does not state is that a double blinded randomized
controlled trial (RCT) is required for clinical decision making. What it
does advise is the use of the best “available” evidence—sometimes a RCT,
but frequently in sports medicine with less common injuries or diagnoses,
a retrospective case series. This is then combined with a physician’s personal
experience and expertise. If clinical trials have demonstrated an arthroscopic
procedure is equivalent to an open procedure, but the physician has never
performed it arthroscopically, then his patient is probably best served by
an open procedure until the physician gains additional training or expertise

EVIDENCE-BASED MEDICINE: A PRIMER 16
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