Foreword

The evidence-based approach to health care is assuming a greater role in informing patient care worldwide. This approach arises from a convergence of factors, including the easy availability of evidence-based resources that synthesize the evidence, as exemplified by the Cochrane database, the desire of practitioners to attain best practices in the face of an almost overwhelming volume of new biomedical information, and the realization that, in an environment of limited health care resources, the best evidence of effectiveness should be central to the determination of which specific treatments warrant full investment. On the most immediate level, best evidence should inform the rational care of individual patients by the practitioner. On a broader level, best evidence should also influence specific decisions by society on the provision of specific health care services. In each case, evidence forms one of the two main components of a medical decision, as described by David Eddy.