The authors of the Second edition of this book set out a classification of ten main areas (Table 1.2 Page 19) as central to the practice of EBM:

1. "Clinical findings - history and physical examination
2. Aetiology - causes of disease including iatrogenic forms
3. Clinical manifestations - how often and when a disease causes clinical manifestations
4. Differential diagnosis - possible causes (likely, serious and responsive to treatment)
5. Diagnostic tests - selection and interpretation of tests to confirm or exclude a diagnosis
6. Prognosis - likely clinical course and possible complications
7. Therapy - appropriate treatments
8. Prevention - risk factors and screening
9. Patient experience and meaning - empathy with the patient's situation
10. Self-improvement."

" Evidence based medicine seeks to empower clinicians so that they can develop independent views regarding medical claims and controversies. Although many helped to lay the foundations of evidence based medicine,1 Archie Cochrane's insistence that clinical disciplines summarise evidence concerning their practices, Alvan Feinstein's role in defining the principles of quantitative clinical reasoning, and David Sackett's innovation in teaching critical appraisal all proved seminal. The term evidence based medicine,2 and the first comprehensive description of its tenets, appeared little more than a decade ago. In its original formulation, this discipline reduced the emphasis on unsystematic clinical experience and pathophysiological rationale, and promoted the examination of evidence from clinical research. Evidence based medicine therefore required new skills including efficient literature searching and the application of formal rules of evidence in evaluating the clinical literature....

Evidence based medicine's biggest future challenge is one of knowledge translation, ensuring that clinicians base their day-to-day decision making on the right principles and on current best evidence. All too often clinicians are unaware of the available evidence or fail to apply it. Because clinicians' values often differ from those of patients, even those who are aware of the evidence risk making the wrong recommendations if they do not involve patients in the decision making process. "

" While evidence-based medicine has increasingly broad-based support in health care, it remains difficult to get physicians to actually practice it. Across most domains in medicine, practice has lagged behind knowledge by at least several years. The authors believe that the key tools for closing this gap will be information systems that provide decision support to users at the time they make decisions, which should result in improved quality of care. Furthermore, providers make many errors, and clinical decision support can be useful for finding and preventing such errors. Over the last eight years the authors have implemented and studied the impact of decision support across a broad array of domains and have found a number of common elements important to success. The goal of this report is to discuss these lessons learned in the interest of informing the efforts of others working to make the practice of evidence-based medicine a reality. "