EBN.org
Evidence-Based
Nutrition
Definition of EBP
Evidence-Based Practice (EBP) posits that health care providers, health service workers and policymakers use the best available evidence, ideally from up-to-date, high-quality systematic reviews or guidelines (if available), together with clinical or real-world experience, to help patients or members of the public prevent, resolve, or cope with problems related to their health, according to their values and preferences.
Core competencies in EBP (treatment, prevention)
According to the Journal of the American Medical Association (JAMA) Users’ Guides to the Medical Literature, EBP is based on five core competencies:
(i) Formulating a structured clinical or public health question ​
P | I | C | O | T4 |
|---|---|---|---|---|
Population Patient Problem | Intervention or exposure | Comparator | Outcome(s) | Time point for outcome Type of study (Experimental, observational) |
Who are the patients? | What do we do to them? | What do we compare the intervention with? | What happens? | Type of question (Treatment, prevention, prognosis, diagnosis) |
What is the problem? | What are they exposed to? | What is the outcome? | Trade-offs (Alternative treatments, benefits, harms) |
(ii) Finding the best available research evidence (un-appraised & pre-appraised evidence)
(iii) Assessing the methodological quality of the available evidence (e.g. cohort and randomized studies)
(iv) Assessing the study results (i.e. magnitude [size] of effects and precision of effects) for all desirable (benefits) and undesirable (harms) outcomes
(v) Applying results based on the generalizability of the evidence to one’s patient (clinical) or target population (public health).
​Applicability includes the patient or population health-related values and preferences based on the best available evidence for potential benefits, harms and the burdens of an intervention.
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*Values refer to a patients or populations values or attitudes toward different health outcomes (e.g., mortality, heart attack, lipid profile)
**Preferences refer to preferential choices after the best available, (i.e. magnitude of effect, certainty of evidence for valued outcomes of benefit and potential harm) is shared with patients
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For further reading, please see philosophy of evidence-based principles and practice in nutrition, and evidence-based practice competencies among nutrition students and professionals.