Proper handwashing helps
prevent the transmission of
germs and infections. This
discovery began long ago
and included the discovery
Dr. Ignaz P. Semmelweis - 1860
Dr. Ignaz Semmelweis, aged 42 in 1860
a copperplate engraving by Jenő Dopy.
A Hungarian physician, Dr. Ignaz Philipp Semmelweis described as the "savior of mothers", who discovered by 1847 that the incidence of puerperal fever could be drastically cut by the use of hand disinfection (by means of handwashing with chlorinated lime solution) in obstetrical clinics. Puerperal fever (or childbed fever) was common in mid-19th-century hospitals and often fatal, with mortality at 10%–35%.
Source: Wyklicky H, Skopec M. Ignaz Philipp Semmelweis, the prophet of bacteriology. Infection Control : IC, 1983 Sep-Oct;4(5):367-70.
What is Evidence-Based Practice?
“EBP is the integration of the best research evidence with clinical expertise and patient values.”
Bandolier describes critical appraisal as
"The process of assessing and interpreting evidence by systematically considering its validity, results and relevance."
A longer essay on critical appraisal is available from the Bandolier web site - What is critical appraisal?
Critical appraisal uses intrinsic (research design etc) not extrinsic (author, journal, institution) factors which is more commonly used in evaluating web sites.
When appraising an article, it needs to meet the following three requirements:
Another aspect to consider when appraising evidence is: "How does this inform my practice?"
There are a number of checklists / tools available on the Internet to assist you in undertaking critical appraisal of evidence. Some examples are listed below.
Therapeutics Initiative: Evidence Based Drug
The Therapeutics Initiative (TI) was established in 1994 by the Department of Pharmacology and Therapeutics in cooperation with the Department of Family Practice at The University of British Columbia with its mission to provide physicians and pharmacists with up-to-date, evidence-based, practical information on prescription drug therapy.
WHO: Essential Medicines and Pharmaceutical
WHO carries out its work in the area of medicines and essential drugs at global, regional and country level.
Evidence Based Practice Module
A module on Evidence Based Practice developed bt the Biomedical Library of the University of Minnesota.
Health Information Resources/Evidence (formerly
National Library for Health)
NHS Evidence provides free access to clinical and non-clinical information - local, regional, national and international. Information includes evidence, guidance and Government policy.
"Evidence based thinking about health care"
National Prescribing Centre (UK) - Evidence Based Therapeutics
The NPC delivers resources and activities to support and promote evidence based prescribing practice.
Agency for Healthcare Research and Quality Evidence-Based Practice
The Agency for Healthcare Research and Quality's (AHRQ) mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. Information from AHRQ's research helps people make more informed decisions and improve the quality of health care services.
National Guidelines Clearinghouse
Public resource for evidence-based clinical practice guidelines. An initiative of the Agency for Healthcare Research and Quality (AHRQ) and U.S. Department of Health and Human Services.
Physiotherapy Evidence Database. PEDro is a free database of over 16,500 randomised trials, systematic reviews and clinical practice guidelines in physiotherapy.
Search the published literature for evidence-based information.
Clinical search tool designed to allow health professionals to rapidly identify the highest quality clinical evidence for clinical practice.