The principles of evidence-based medicine (EBM) are well described and the integration of these principles into practice is an important part of the daily work of clinicians. However, three conditions need to be satisfied before EBM will work in practice. This chapter explores some of the obstacles to these conditions, and offers some strategies and practical suggestions to help learn and teach evidence-based anaesthesia. A systematic review and a study using a validated questionnaire have demonstrated significant increases in knowledge and skills of participants in EBM courses. It is important to regard the process of EBM as an integral part of clinical practice and education, rather than it being an "optional extra". The process of implementing evidence-based practice can be made easier by using sources of pre-appraised evidence that present summaries of critically appraised evidence, systematic reviews and other collations of information.

This chapter focuses on the critical appraisal of randomised controlled trials of treatment or preventive interventions and the presentation of study details from these in systematic reviews. Critical appraisal of study reports for systematic reviews is generally a two-stage process. Firstly there is "study selection" where potentially eligible studies are checked to see if they meet the pre-specified inclusion criteria of the review. Then there is "quality assessment" of and data collection from the studies that meet the inclusion criteria. The format and content of text and tables presenting the details of studies included in literature reviews and other work depend on the aims, destination and readership of the intended report. The critical appraisal of studies and the succinct presentation of study details are essential components of evidence-based anaesthesia. Both assist the interpretation of the evidence from studies in terms of its validity and, if valid, its applicability.