Evidence-Based Medicine and the GRADE Approach

  • Sadeesh K. SrinathanEmail author
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)


Evidence-based medicine (EBM) is a term which entered the lexicon of medical practice in 1992. It can be defined as “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients”. In this chapter we illustrate how to practice EBM using a sequence of straight forward steps moving from phrasing a clinical question to making a judgment of the risk of bias in the evidence we encounter. We will then introduce and use the GRADE system of determining the quality of evidence to allow the surgeon a means of determining their confidence in the evidence that they use to guide their clinical practice.


EBM Evidence based medicine GRADE Bias Study design Systematic reviews Trials 


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Recommended Reading

  1. CEBM website:
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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Winnipeg Health Sciences Centre, Department of SurgeryUniversity of ManitobaWinnipegCanada

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