Evidence-based medicine in anesthesiology.

Two decades ago, Evidence-Based Medicine (EBM) was introduced to improve the quality of medical care. Using EBM in practice can be seen as a cyclic process consisting of 5 steps. This paper explains how to apply these steps in anesthesiology. The EBM cycle involves: 1. Asking a relevant clinical question, 2. Finding evidence to answer the question, 3. Appraising the evidence, 4. Applying the findings to practice, which means integrating evidence, clinical experience and patient preferences, and 5. Reviewing these steps. Applying EMB requires effort and certain skills, for example searching for evidence and appraising the quality of the evidence. Also important is a reflective attitude towards the practitioner's own practice. This paper aims at encouraging anesthesiologists to develop such skills and to implement the steps of EBM in their daily practice.