Users' Guides to the Medical Literature
Evidence-Based Medicine Working Group
"Can it work?"
Are there pathophysiologic differences in the illness under study that may lead to a diminished treatment response?
Are there patient differences that may diminish the treatment response?
Social and Economic:
"Will it work?"
Are there important differences in patient compliance that may diminish the treatment response?
Are there important differences in provider compliance that may diminish the treatment response?
"Should it work?"
Do my patients have co-morbid conditions that significantly alter the potential benefits and risks of treatment?
Are there important differences in untreated patients' risk of adverse outcomes that might alter the efficiency of treatment?
JAMA, 1998; 279: 545-549
Extent to which conclusions derived from a trial can be used beyond the setting of the trial and the particular people enrolled in it.
To arrive at a conclusion. The act of taking information from published experience and individualizing to specific patients.
Strength of Inference:
How dogmatic a clinician feels about applying published experience to individual patients: Significantly influenced by the hierarchy of the validity of available evidence.