The health sciences literature contains the most current and detailed accounts of the testing of various phenomena and innovations related to health promotion and disease control. It also contains the best information available for the management of many healthcare problems. It is voluminous, however, and is often neither well written nor organised for easy clinical application. As a result, its use for solving clinical problems is challenging for even the most persistent and knowledgeable clinicians. Most clinicians indicate that they feel overwhelmed by the literature and don't attempt to use it for solving clinical problems.¹ EBM notebook

Clinicians can use the clinical literature to support clinical decisions in 2 complementary ways: for regular surveillance and for problem oriented searches. Both methods require an appreciation of the many purposes of the clinical literature. They also require a basic understanding of the strengths and weaknesses of studies for providing information that is valid and clinically applicable for questions related to the cause, course, diagnosis, and treatment or prevention of health problems.

In general, the peer reviewed journal literature serves science rather than clinical practice, with its prime function being to facilitate communication from scientist to scientist.² Most of the investigations reported in journals are non-definitive tests of hypotheses and innovations, only a small portion of which may eventually survive testing well enough to warrant routine clinical application.

Reports of definitive studies (scientist-to-clinician communication) are not frequently seen. This situation is cause for both celebration and dismay: celebration because clinicians need to review only a small portion of the literature, and dismay because journals scatter definitive studies among many preliminary investigations. The reader must know and apply critical appraisal skills …