Source: Source: SUNY Downstate Medical Center. Medical Research Library of Brooklyn. Evidence Based Medicine Course. A Guide to Research Methods: The Evidence Pyramid: http://servers.medlib.hscbklyn.edu/ebm/2100.htm]

Podiatrists are inundated every day with information about foot and ankle conditions.  Textbooks, colleagues, journal articles, CME programs, drug and manufacture representatives, it is difficult to keep up and make sense of such a large amount of information. Often this information may be confusing and contradictory. 

Expert-based medicine relies on anecdotal information from leaders in the profession, pathophysiologic mechanisms of disease, case reports and case series.  Evidence-based medicine in contrast emphasizes clinical expertise, patient values, and the reliance on the results of rigorous clinical trials when making decisions about patients.   

Evidence-based medicine practitioners advocate that clinically relevant information be categorized from least biased to most biased. The specific type of study varies with the topic of interest.  For example, systematic reviews, meta-analysis and randomized controlled trials are considered level one evidence for therapeutic interventions. Anecdotal information is considered by exponents of evidenced- based medicine as the least valid and most biased; as a result, it is considered level five evidence. It is important for foot specialists to distinguish between studies which generate a hypothesis (case reports) and those which test a hypothesis (randomized trials).

Like most surgical specialties, only a small percentage of publications about foot and ankle conditions could be considered level one evidence.  Of those publications which might be considered level one evidence few stand up to a rigorous evaluation for internal validity.  Therefore, only a few publications should have a significant impact on podiatric patient care.

Evidence-based Podiatric Medicine is a web site which provides practicing podiatrists with a summary and analysis of recent evidence involving foot and ankle disorders. In addition, the site will also provide resources for the self-directed learner to understand and apply evidence-based medicine principles in clinical practice.