What is evidence based-medicine?
The most popular definition of evidence-based medicine (EBM) states that it is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best external clinical evidence from systematic research.” What that mouthful means is that while no patient is identical, we can identify general best practices in the treatment or curing of certain illnesses. Unsurprisingly then, one of the key components of the EBM approach is the use of clinical practice guidelines. There is also a heavy emphasis on expanding the evidence base, particularly through randomized control trials to produce more
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A visit to your doctor may certainly seem like an evidence-based medicine: certain symptoms and tests yield a diagnosis, and that diagnosis in combination with your individual history leads to a treatment plan. Yet there is still room for wild amounts of variation—the reliance on the individual experience of healthcare providers means that a cluster of symptoms may signal a different diagnosis to different doctors, and due in part to the fee-for-service model in American medicine, doctors may be rewarded for ordering tests that are redundant or unnecessary. Even in the presence of strong evidence, compliance with guidelines isn’t all that high: four years after the National Heart, Lung, and Blood Institute issued guidelines for the treatment of asthma in 1991, only 45.5% of those surveyed were aware of the guidelines, and only 24% had gone so far as to read …show more content…
In a 1999 study of the same asthma guidelines mentioned above, a hospital committee educated the staff, eliminated barriers in following the guidelines and tested the treatment plan for six-months, only to manage a 68% adherence rate from hospital staff. Much of the resistance to EBM guidelines comes from healthcare providers themselves, who have a decent argument: the visibility of research and guidelines can be murky given the number of organizations and journals that contribute (it’s been estimated that a general practitioner would have to read 19 journal articles a day, each day of the year to stay current with every advance in treatment). Many physicians also see EBM as the promotion of “cookbook medicine,” a threat from academics and legislators toward the craft of their profession, although proponents of EBM say this could never happen, due to the complexity of modern medicine and the needs of individual patients. Studies have shown that consumers can be hesitant to support EBM as well, mistaking evidence-based to mean medical tests from the provider, or assuming that more (and more expensive) care is
Evidence Based Practice (EBP) is useful to practice because it aids practitioners development and widens their knowledge and insight, therefore enhancing the experience of the practitioner. This ensures that the best quality of care is given to the patient (Duncan, 2006).
EBP is a method of finding evidence and using it in practice: as Blaney (1986) states, it is used to assess health, plan, implement, and evaluate individualized care (p.182). Finotto et al. (2013) breaks EBP down into steps as follows: Formulate a research question; find the most relevant evidence; appraise evidence; integrate evidence with clinical experience and patient values to make practical decisions; and evaluate the outcome (p.460). Carrazzone (2009) and Moch et al. (2010) argue that didactic components with EBP integrated into the education are believed to be beneficial to studen...
With the high degree of variations in health care, patients can be under or over treated or even treated with the wrong treatment for their illness. These unwarranted care techniques can be categorized into three different situations. The first category of unwarranted care is the use of evidence or lack thereof, based on other medical care. The way to explain this category is that a care plan for a patient is proven effective without any proof as to why. The example given by Kongstvedt (2007) is the use of beta blockers post heart attack. Beta blockers prove to be effective in nearly one h...
Evidence-Based Practice is a methodology, framework, gathering of ideas or concepts, adopted principles and strategies supported by research (Fixsen et al.,
Asthma is also a serious public health issue because it imposes huge impact not only population but also health care systems. According to recent statistics, each year, 5000 deaths, half million hospitalizations, and two million emergency visits are solely explained by asthma [1]. It is also leading cause of absence from school and work. Economic impact is enormous, too. 11 billion dollars of cost was due to only medications of asthma in 1994 [2], which was later increased up to 14 billion dollars in 2002 [3], and still increasing. Unfortunately, this financial burden of asthma falls disproportionately to some vulnerable subgroups: minorities, and children.
Evidence based practice is the basis for needed change in practice and function. It is a sound method for scientific, fact-based change. Changes which have no evidence to support them are fragile, unscientific, and subjective. These changes don’t effect real change over time, as they aren’t able to be proven to a more general population.
Evidence-based practice is important to consider when researching for interventions, further knowledge, or help to guide a new idea in the health professions. Evidence-based practice is comprised of three significant concepts: respect and awareness for the targeted population’s values, previous clinical practice or experience with that population, and systematic research to establish a better understanding of what is already known about the study’s focus. These concepts are all taken into consideration when designing and conducting a study because it provides a more valid and credible source for others.
Evidence Based Practice emerged in the late 20th century, becoming widespread in the 21st century. According to Research and Practice: The Role of Evidence-Based Program Practices in the Youth Mentoring Field ( 2009) “The concept of Evidence Based Practice (EBP) actually has its roots in the medical field, where the work of Archie Cochrane (1972) and others examined the key role that the substantial body of medical research and literature could play in how doctors make decisions in patient care” (para 6); Thus, a doctor’s decision would be an “educated” decision, based on evidence gathered (patient symptoms), history of cases they have overseen, or research of previous case diagnosed by another doctor, with a related case. Evidence Based Practices are defined as “ integration of: (a) clinical expertise/expert opinion, (b) external scientific evidence, and (c) client/patient/caregiver perspectives to provide high-quality services reflecting the interests, values, needs, and choices of the individuals we serve” (“Evidence Based Practice (EBP),” 1997-2014); often described as the “Best Practices”. The evidence itself is not the basis of decisions made, but it does help support the process of care given to our clients.
In social work evidence based practice is considered to be a decision making process and practitioners rely on the evidence when working with clients. According to Aveyard and Sharp (2013), evidence based practice is not easy to put into practice and there are many barriers to evidence based practice such as lack of time, lack of awareness of research, lack of support and cooperation, and lack of authority and inadequate facilities (p. 145). Although there are challenges to implementing evidence base practice this is still a doable task in the field of social work. Therefore, practitioners need to explore the motivation, knowledge and skills needed by the individual, the organizational motivation, learning
“At its core evidence based ‘anything’ is concerned with using valid and relevant information in decision making” “high quality research is the most important source of valid information”. Psychological Association (2006, p. 273) defines EBP as "the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences. " When caring for patients it is fundamentally important to have a good selection of up to date evidence Based Practice clinical articles to support research strategies, this allows professionals to assemble the most recent and accurate information known which enables them to make decisions tailored to the individual’s plan of care. It is essential to have clinical expertise and have the involvement of the individual patient, they must have full engagement and incorporation in order to have the accurate evaluation.... ... middle of paper ...
The idea behind conforming to evidenced based practices is that research is the most likely tool to improve patient
Clinical Practice Guidelines (CPGs) are very crucial in the evaluation of the practice to be absorbed and implemented by an organization. Often, clinical practice guidelines are defined as the statements that recommend intentions to optimize patient care that is informed by a systematic review of evidence, outcome and findings and an assessment of advantages and benefits and the disadvantages and challenges of alternative care options. Clinical practice guidelines play a very important role in providing medical practitioners with explicit and extrinsic evidence and findings while at the same time recommending how to manage health conditions and reduce the utilization and implementation of unnecessary, ineffective or harmful interventions.
Evidence-based medicine (EBM) has been described as “the conscientious, explicit, and judicious use of current best evidence in making decision about the care of individual patients” . Evidence-Based Practice is a thoughtful integration of the best available evidence, coupled with clinical expertise. It enables one to address healthcare questions with an evaluative and qualitative approach. It is about applying the best available research evidence in provision of health, behavior and education services to enhance outcomes. Evidence-Based practice is about performing the best possible practice in order to provide the best possible care .
Walshe,K. & Rundall,T. 2001, Evidence based management:From theory to practice in health care ,Milbank Quarterly, Vol.79, PP.429-457
Richardson, W., Sackett, D., Rosenberg, W., & Haynes, R. (1997). Evidence-based medicine: how to practice and teach EBM. London (UK): Churchill Livingstone.