Evidence-based veterinary medicine (EVM)
The definition of evidence-based veterinary medicine (EVM) used by the CEVM is:
Evidence-based veterinary medicine is the use of best relevant evidence in conjunction with clinical expertise to make the best possible decision about a veterinary patient.
The circumstances of each patient, and the circumstances and values of the owner/carer, must also be considered when making an evidence-based decision.
[Adapted from: Straus SE, Richardson WS, Glasziou P, Haynes RB (2005). Evidence-based Medicine: How to Practice and Teach EBM, 3rd ed. Churchill Livingstone.]
The basis of EVM is good clinicians using good science to make good decisions about their patients to benefit their health and welfare. To be able to do this the veterinary profession needs high quality, relevant science made readily available to them in clinical practice.
There are five steps to Evidence-based Veterinary Medicine, the "Five As":
1. Ask - This step is about identifying the right questions the veterinary surgeons need answers to.
2. Acquire - This step is about obtaining evidence on the subject of interest. This involves systematic searching for existing literature, and where there is no evidence, undertaking new studies to answer question of interest.
3. Appraise - This step involves appraising the literature for quality and sources of bias that may affect the believability of the results.
4. Apply - This step involves applying the evidence to practice, where appropriate.
5. Audit - This step is all about assessing whether the application of the new evidence has affected the outcome of interest.
For EVM to work and be useful it needs to start (Ask) and finish (Apply and Audit) in practice.
[Adapted from: Heneghan C, Badenoch D (2006). Evidence-based Medicine Toolkit, 2nd ed. Blackwell Publishing.]