An approach to evidence-based clinical decision making during the COVID-19 pandemic

Abstract

The COVID-19 pandemic presents us with a difficult context for clinical decision making. In this scenario, this article aims to explain some fundamental concepts about evidence-based decision making. For this purpose, we will first discuss when to carry out an evidence-based decision-making process. Then certain previous concepts will be clarified (decision-making based on pathophysiological plausibility, observations made during clinical practice, indirect clinical evidence, and direct clinical evidence; as well as the influence of the pharmaceutical industry). Next, the following steps are presented to make evidence-based decisions: Ask a question, search for studies that answer that question, critically read these studies, understand the logic of decision-making, prepare to make the decision, bake a balance (between benefits, harms and costs), carry out a shared decision-making process, and reevaluate the evidence.