Evidence-Based Clinical Practice 2.0: An Updated Primer for Urologists

Introduction: The practice of evidence-based medicine is important in optimizing patient care by ensuring that clinical decisions are made by considering the best available evidence that is tailored to each patient. We provide an update and guide in the practice of evidence-based urology. Methods: We review the principles of evidence-based medicine and provide a guide to implementing them in day-to-day clinical practice. We use examples from the urological literature to explore the core concepts in practicing evidence-based urology. Results: The practice of evidence-based urology is best captured in the 6 steps of assess, ask, acquire, appraise, apply and assess. This first involves identifying a knowledge gap, framing a clinical question and then obtaining the relevant literature. Once the literature is acquired, a key step is to judge its reliability in regard to several domains. We provide a detailed guide to evaluating the risk of bias in published articles using real-life examples. It is then important to consider each patient's values and preferences in applying the evidence to make a clinical decision. Finally, we reassess our own performance in the practice of evidence-based medicine to ensure professional development as we strive to improve patient outcomes. Conclusions: Implementing the principles of evidence-based medicine should be a routine part of every urologist's daily practice. Therefore, clinicians should review and remain up-to-date with the methods of evidence-based urology to ensure patient care is optimized.