Medical care organizations, due to increased staff workload in performing the duties, need to correct required resources to use advanced tools in order to convert data and information to high quality knowledge through automating the processes of treatment. A medical therapeutic process often comprises data collection (observation), diagnosis, and therapeutic plan [14]. It starts with the patient history, demographic data and proceeds with diagnostic procedures that are selected based on available information. The role of (electronic) medical records, as IT, is to assist healthcare personnel in making informed decisions. Consequently, the system should present relevant information at the time of data acquisition and at the time of order entry [15]. In any medical discipline, the diagnosis is made by taking some of the data and converting this data into information by a physician or other medical practitioners. Based on the diagnosis, appropriate treatment, which may take months or even years, is selected for most diseases like high blood pressure or cancer [16]. Each pass of this cycle aims at decreasing uncertainty about the patient's disease or the actual state of the disease process [15]. Thus, an important question that should be answered is how relevant data can be determined. The available information only comprises primary assumptions for decision-making. There are numerous medical software programs on the Internet installed on computers. Clinical reference applications that provide guidelines and information can be accessed via the Internet. Availability of clinical data at the point of care provides access to complete and accurate clinical information for the care provider. Dosage and computational formulas, which were previously available only through printed material but are now accessible through handheld computers, can help to reduce medical errors and update old data [17]. They may offer solutions to administrative and information management that are more realistic than those offered by desktop computers or traditional Electronic Medical Record (EMR). There are different tools for providing computer-based medical guidelines such as proformalisation, which is a process of capturing clinical expertise in a form that can be directly applied by one agent (such as a computer) on behalf of another (such as an expert clinician or an authoritative organization). CAPSULE is an example of proformalised expertise [18]. IT is a decision support system designed to advise on the prescription of medications for common conditions in general practice [19]. Asbru is another tool which places a particular emphasis on an expressive representation for time-oriented actions and world states [20]. Quaglini describes a methodology for representing clinical practice guidelines and facilitating their introduction into the medical routine [21].

This section consists of two parts; part one examines the problems of traditional ways and explains benefits of EBM as a new solution. The second part is practical work conducted in a university hospital.

There is no doubt that both physicians and patients benefit from strategies that improve diagnosis, clinical judgment, and decision making [22]. EBM is the conscientious, explicit, and judicious use of current best evidence in making clinical decisions about patient care [23]. EBM is being applied to decisions in a range of contexts beyond one-to-one patient care [24]. In the present era of technology, medical procedures and treatments are not acceptable only based on specialists' old information [25]. Hillman [26] stated that medical procedures essentially based on old data, uncontrolled studies, expert opinions and financial constraints may increase the possibility of inappropriate actions. Medical knowledge limited to medical reference books is rapidly changing [27]. On the other hand, there is a large gap between the information contained in published medical guidelines and the knowledge required to perform remedial action. An appropriate way to fill this gap is through the application of IT and focusing on medical informatics research. Physicians usually do not have enough time to do all the above-mentioned activities [26]. Covell et al. [19] showed that only 30% of the physicians' information needs were met during patient visit and that this percentage could usually be achieved through asking questions from colleagues. They also mentioned that lack of necessary knowledge and up-to-date recourses needed by professional, time shortage for the retrieval of information from texts, and old printed material were among the reasons why physicians were not willing to use traditional resources [19]. Sackett et al. [28] reported that 52% of the information searches to answer clinical questions resulted in effective management decisions, 25% led to new treatments or diagnoses and 23% led to correction of previous treatment programs. Crowley demonstrated [18] that 53% of clinical questions led to management decisions and 47% led to changes in medications, diagnostic tests and information modification given to patients [29]. Many efforts have been made to establish standards for modeling of diagnostic and therapeutic guidelines [30]. Medical guidelines with direct medical knowledge at the point of care with an evidence-based nature and access to updated information help to improve the quality of treatment and treatment outcomes, reduce unwanted errors and decrease economic costs [31]. Greenes and Lorenzi [32], Stead et al. [33], and Shiffman et al. [34], in separate researches, studied the effective ways of applying medical guidelines in clinical settings and stated that the guidelines provided features for timely and rapid access to information, through which physicians would be able to respond and make decisions quickly using appropriate and accurate information in real time [25]. Several official websites such as www.guideline.gov have been created in order to share medical knowledge among physicians. Many of these websites can create texts in HTML or text format and provide useful links [3]. The most important step in EBM is to collect the best available evidence (primary and secondary papers registered in databases) to answer a clinical question. It has been determined that practitioners who have established their actions based on scientific evidence could make better decisions, perform high quality of care, and reduce costs and hospital stays [35].

To sum up, EBM is a tool for proper and efficient incorporation of the results of research in decision-making. Accessing and retrieving valid and reliable evidence is possible through the knowledge of proper electronic databases and systematic and purposeful search strategies. Lack of knowledge about the best available evidence is one of the main causes of application of various and controversial medical treatments [22].