EBM

I have recently become a big fan of Oxford University's Center for Evidence Based Medicine, which can be found at http://cebm.net. As I'm training the new interns, I'm placing an emphasis on EBM in our clinical decision making and it is clear that we don't teach EBM enough in medical school.

Today we sat down for an hour and I handed out a bunch of different articles from "big" journals (JAMA, NEJM, Pediatrics, etc) and I had each intern tell me what their gut feeling was about the intervention being discussed. Then, I taught them how to rank the level of evidence and then apply the critical appraisal tools offered by CEBM. It was eye opening to see some of the articles included the number needed to treat, when it was say...seven, but when the NNT was 169, this statistic was nowhere to be found and had to be calculated manually. This is why it critical that we understand critical appraisal as we interpret evidence that comes across our desk each day.