The model that best supports evidence-based medicine (EBM) for defining and measuring quality outcomes is the Structure-Process-Outcome (SPO) model, also known as the Donabedian model. Here’s why:

• Focus on Healthcare: The SPO model was specifically designed for use in healthcare settings. It considers three key aspects: the structure (resources and capabilities), processes (how care is delivered), and outcomes (patient health impact). This aligns with EBM’s emphasis on applying research findings to improve patient care.
• Integration with Research: EBM relies on strong research evidence. The SPO model facilitates the design of research within healthcare by providing a framework for identifying relevant measures across structure, process, and outcome.
• Comprehensiveness: Unlike some general quality management models, the SPO model provides a more comprehensive picture of quality. It goes beyond simply measuring processes (following guidelines) to assess the resources available (structure) and the ultimate impact on patients (outcomes).

While other models may have a role, the SPO model’s focus on healthcare, alignment with EBM principles, and emphasis on evidence-based measurement make it the strongest choice for defining and measuring quality outcomes in an evidence-based medicine framework.