1. Developing an Evidence Base for Medicine in Africa Gil C Grimes, MD Department of Family Medicine Scott and White September 2007

2. Roadmap Define Evidence Based Medicine Describe the evolution in the US and at Scott and White How to make it work in Ghana Steps you can take

3. Definition Simply put it is the integration of research evidence with clinical expertise and patient values. Allow us to do more good than harm Patients want to know the following Will it make my life better Will it make me live longer

4. What EBM is not Cookbook medicine The perfect answer A way for the government to save money A substitute for thinking

5. Where did it come from? Began with Archie Cochrane and Effectiveness and Efficiency: Random Reflections on Health Services Grew with work done at McMasters University in Canada by Sackett and Guyatt defining methodologies to determine the best evidence

6. My experience A lonely clinic in Utah The culture of Scott and White Revolution from the ground up Acceptance and integration

7. How can it work in Ghana? Clinical Databases Access to Publications Commitment to Learning

8. Clinical Databases Evidence Based Databases that provide access to vast array of literature Inforetriever DynaMed Cochrane Clinical Evidence

9. Access to Publications HINARI WIDERnet and eGranary PubMed FreeMedicalJournals.com

10. Commitment to Learning Continuing Education Lifelong Learning Reviewing what is common Continuing Curiosity Question your practice often

11. Results to expect Doing what we know works Avoiding things that do not work Including patient in process Improving the care of our nation