Skip to Main Content
Monash Health Library
Click here to chat with a librarian

Evidence-Based Practice

EBP is the process of applying up-to-date research, in conjunction with clinical expertise and patient values and choices, to ensure the best possible care. We locate the best evidence by asking a focused, clearly formulated question and using systematic and explicit methods to identify, select, and appraise research and data. 

Why is EBP important?

  • A way of keeping up with new developments
  • Assists with making informed clinical decisions based on quality evidence
  • Helps incorporate research into practice
  • Contributes to increased patient satisfaction

Key concepts of EBP

  • Evidence-based practice occurs at the intersection of evidence, clinical expertise, and patient preferences.
  • EBP optimises decision-making by ensuring all health professionals utilise evidence from well-designed and rigorously conducted research.
  • Well-designed and conducted differentiates high-quality evidence from the rest of online information, which we know is vast, problematic, and increases at an exponential rate.
  • Different types of evidence support different situations and levels of decision-making – not all research has the same value. 
  • EBP is not a Google-like experience! We use Google every day but it can be inaccurate, biased, and it will return everything, including articles published by predatory journals.
  • Results must be evaluated in a process that assesses methods, validity, and usefulness.

Recommended Resources:

The Evidence-Based Practice Process

The EBP process involves five steps, also known as the five 'A's of EBP:

  1. Ask: Asking a well-formed clinical question that can be answered using best available research evidence.
  2. Acquire: Using the PICO acronym to determine appropriate keywords to conduct the search.
  3. Appraise: Critically appraise and synthesise the evidence to ensure reliability and validity.
  4. Apply: Integrate the evidence with your clinical expertise and the patient's values, and apply to patient care.
  5. Assess: Assess the effectiveness of the intervention or decision.

Recommended resources:

Literature Searching Guide

Evidence-based pyramid

The evidence-based pyramid is divided into levels to indicate:

  • the volume of information at each level
  • that different study types have differing rigor, quality and reliability.
  • the quality of the evidence 

The quality of each individual study still needs to be critically appraised. 

Each of the five types of clinical questions are best answered by the following evidence types:

  • Therapy - determining the effect of interventions = RCT, systematic review, meta-analysis.
  • Prognosis - likely outcome for a patient population = RCT, cohort study, case-control study.
  • Harm - outcomes from an activity of exposure = RCT, cohort study, case-control study.
  • Diagnosis - accuracy of diagnostic tests = Cross-sectional analytic study, blind comparison to a gold standard.
  • Prevention - reducing chance of disease by identifying risk factors = RCT, systematic review.

Recommended resources:

Health Research Study Designs Guide

EBP Books