Importance of evidence-based medicine to clinical practice

Health professionals, researchers and health managers, as users of the health system, need increasingly clinically relevant information on which to base their own decisions. However, it is not easy or feasible to scrutinize all existing scientific evidence on the subject of interest. Reviews of the scientific literature play a central role in clinical practice. Given the limitations of narrative reviews, there is a need for systematic reviews to efficiently integrate all the information and provide a valid and reliable objective basis for rational decision making. Systematic reviews that are a synthesis and analysis of information with a practical approach are based on the best scientific evidence available; these ask clearly defined questions and use systematic and explicit methods to identify and select studies, assess them in a critical manner, extract relevant data, and analyze them. Systematic reviews, in general, and meta-analysis, in particular, have experienced in the last decade a large increase, in part due to the rise of the movement called evidence-based medicine (EBM). The biggest push in this direction has been done, without a doubt, by the Cochrane Collaboration, an independent, international and non-profit organization that aims to help people needing to take well-informed health decisions. This prepares updates and promotes access to systematic reviews of health care interventions. Particularly noteworthy has been the extension of the Cochrane Collaboration in Latin America, were it currently has a stable partnership and support in most countries.The Cochrane Library is the means chosen by the Cochrane Collaboration to transmit the results of its work and since 2002, the Biblioteca Cochrane Plus is available offering, among other materials, translations into Spanish of Cochrane reviews. Furthermore, since the end of 2008 there is a new resource, 'Excelencia Clínica',whichallowsreliably and easily finding and identifying systematic reviews over the Internet. © 2010 Universidad del Valle, Facultad de Salud.