Evidence-based medicine as a tool for clinical decision-making in Puerto Rico

Evidence-based medicine (EBM) is defined as "the process of systematically finding, appraising and using contemporaneous research findings as the basis for clinical decisions". Although EBM has been extensively described across the Americas and Europe, no study has looked at the practice of EBM in Puerto Rico. A cross-sectional analysis based on a 23-item questionnaire was employed. We showed that there is a high use (88%) and familiarity (93%) with EBM, and that physicians keep a positive attitude towards EBM (80%) in Puerto Rico. There is an over-representation of academicians (58.9% vs. 34.6%, p = 0.02) and an under-representation of solo office practitioners (10.5% vs. 26.9%, p = 0.03) among EBM users. Additionally, patient workload (48%), time constraints (36%), and limited access to the Internet (28%) were the most frequently cited obstacles to the practice of EBM in Puerto Rico. Taken together, these results help create a cross-sectional profile of EBM practice among Puerto Rican physicians.