Evidence-based cardiac practice

Increasing attention is being placed on using an evidence-based approach within health care decision making. In order to apply this approach to a particular clinical scenario, the relevant clinical evidence must be available, accessible, accepted, applied, and audited. Cardiovascular medicine is a discipline in which a large body of evidence is available. The development of the Cochrane Library, as a source of systematic reviews concerning the effects of health care, will make this evidence more accessible. However, caution is required in interpreting systematic reviews, particularly when meta-analytic techniques are used, to ensure that potential sources of bias in the identification and synthesis of the primary studies are minimised. A further challenge is to develop strategies to ensure the evidence is accepted and applied in clinical practice. Although there are no magic bullets to change behaviour of positions, there are a number of strategies which have been shown to influence change positively in clinical practice.