This document discusses evidence-based back pain management. It introduces evidence-based medicine (EBM) and the 5 A's process of EBM: Ask, Acquire, Appraise, Apply, Act. It emphasizes asking answerable clinical questions using the PICO format. It recommends searching for evidence through clinical summaries, synopses, systematic reviews, and primary studies. It highlights using keywords and MeSH headings to effectively search databases like PubMed and appraising the quality and applicability of evidence. The goal of EBM is to integrate the best research evidence with clinical expertise, patient values and circumstances.

1. Evidence-Based Back Pain Management Sohail Bajammal, MBChB, MSc, FRCS(C), PhD(c) Assistant Professor of Orthopaedics May 30, 2010

3. Double blind in orthopaedics?

5. I will tell you NOTHING about back pain management

6. I will show you how YOU can FIND EVERYTHING about back pain management

8. GCC EBHC

9. National & Gulf Center for EBHP

11. What is EBM? Haynes et al. BMJ 2002;324:1350 Clinical Circumstances Research Evidence Patients’ Preferences Clinical Expertise

12. 5As of EBM

19. What’s wrong with googling?

21. So what to do?

22. 5S Hierarchy of Evidence Haynes RB. Evid Based Med 2006;11:162-164 RCTs, Cohort, Case control, Case series Expert Opinion: Classical Textbooks

24. Pyramid of Evidence http://library.downstate.edu/EBM2/2100.htm

27. MeSH (Medical Subject Headings)

29. It is a “strategy” Acute Low Back Pain OR "Low Back Pain"[Mesh] AND Low Back Ache Low Backache OR OR AND Treatment Management Therapy OR OR OR Surgery

30. PubMed Tutorials

35. Critical Appraisal

38. It’s time consuming

39. Secondary Sources Systematic Reviews

42. PubMed

44. Cochrane Library

49. Appraisal

51. So what’s next? Critically-Appraised Journal Articles & Abstracts Evidence-Based Guidelines & Textbooks

56. http://clinicalevidence.bmj.com/

57. http://www.guideline.gov/

65. All what we’ve talked about Research Evidence

66. To practice EBM, we need all the four Clinical Circumstances Research Evidence Patients’ Preferences Clinical Expertise

68. http://www.andrews-clinic-natural-therapies.co.uk/documents/54.html

69. Resources

70. http://eapps.ngha.med.sa/ebm/

71. http://ebmjeddah.info/

72. Information Overflow

73. MDLinx.com

74. http://plus.mcmaster.ca/EvidenceUpdates/