Nabil Gaghan

Physicians must use their clinical skills and prior experience to rapidly identify each patient’s unique clinical situation, applying the evidence tailored to the individual’s risks versus benefits of potential interventions. Ultimately, the normative goal of EBM is to support the patient by contextualizing the evidence with their preferences, concerns, and expectations. This results in a process of shared decision making, in which the patient’s values, circumstances, and setting dictate the best care.

The widespread use of EBM in many healthcare disciplinesb  reflects its broad impact. EBM is also an important tool for social justice. If applied appropriately, it has the potential to be a great equalizer – striving for equitable care for patients in disparate parts of the world. Furthermore, EBM plays a prominent role in policy making; politicians are increasingly speaking to their use of research evidence to inform their decision making as a declaration of legitimacy.[3][4]

Its history has been artfully described in ‘an oral history of EBM’, presented by Dr. Richard Smith, which includes discussions with the founders of EBM – including Drs David Sackett, Brian Haynes, and Gordon Guyatt.[5] Interested readers can also reference the James Lind Library, which outlines many seminal moments in EBM history.[6] The bottom line of these articles is that EBM is not a new concept but rather it reflects the work of countless people who have improved the process of generating clinical evidence over several decades, and that it continues to evolve.

Developing the skills to practice EBM requires access to evidence, opportunities to practice, and time. We hope this portal will be a starting point. You might choose to use this resource to become a more savvy consumer of the literature or to become the next person to advance this collective wisdom. Much work remains: finding novel ways to integrate evidence into personal health records for use at the bedside and in the patient’s home, improving strategies for risk communication, and finding ways to learn and practice medicine in the face of uncertainty are ripe for efforts.[7] We hope you’ll join this ongoing conversation.

Reena Pattani MD MPH FRCPC Assistant Professor, Division of General Internal Medicine Department of Medicine St. Michael’s Hospital University of Toronto

Sharon E. Straus MD MSc FRCPC Professor, Division of Geriatric Medicine Department of Medicine St. Michael’s Hospital University of Toronto

Acknowledgements: SES is funded by a Tier 1 Canada Research Chair.

a The term EBM is used interchangeably with evidence-based practice or evidence-based health care. b Occupational therapy, physiotherapy, nursing, dentistry, and complementary medicine, to name a few.

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The truth is that before Columbus came to America, men had already been there for thousands of years. The Last Glacial Maximum is considered to be when humanity arrived in America.

They crossed through a bridge that was submerged in the ocean. We are talking about 16,000 years in the past.

A recent finding suggests that man's arrival in America may have been long ago.

It is about the discovery of a group of footprints that have been in the park for thousands of years.

This area is a desert of white sand and sparse vegetation, but thousands of years ago it was a swamp in New Mexico. It is the oldest record of human presence in the world.

The Vikings are thought to be the true discoverers of America. A group of explorers from the Nordic countries, led by the leader, may have been ahead of Columbus by 500 years.

Various historical data and documents suggest that a Nordic navigator set sail with 89 men and women in the year 1000 and settled in the New World. For a long time, it was thought that this group of explorers had settled in Rhode Island in the United States.

In 1960, a place called L'Anse Aux Meadows was discovered on the northern tip of the island of Newfoundland, in the current province of Newfoundland and Labrador in Canada, which was considered an indigenous camp.

The design of some of the mounds at L'Anse AuxMeadows was very similar to the Viking settlements in Iceland and Greenland.

Columbus thought he was in the East Indies when he arrived in the Americas in 1492. He and his men landed on the island of Guanahan, which he christened San Salvador, later arriving in the territories of Santo Domingo and Cuba.

The purpose of his trip was to find new trade routes to India.

There was a strong interest in achieving a territorial and religious expansion by Spain for commercial and economic purposes.

The Genoese navigator is not considered the man who discovered America, but rather the one who allowed the world to look at this part of the world. He began the colonial period that ended with towns and entire civilizations by Spanish conquerors in this way.

Columbus Day and Hispanic Heritage, Columbus Day or National Holiday Day are some of the different names for Columbus Day in Mexico and other parts of America. Seeing it from a different perspective makes it difficult to study the facts rigorously.

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