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Evidence Based Practice: Evidence Based Practice

Evidence Based Practice Stages and Pyramid

 

WHAT IS EVIDENCE BASED PRACTICE?

The most common definition of EBP is taken from Dr. David Sackett, a pioneer in evidence-based practice. EBP 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 available external clinical evidence from systematicresearch." (Sackett D, 1996)

EBP is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician's cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal and unique concerns, expectations, and values. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology. (Sackett D, 2002)

 

 

British Medical Journal- Recent Issues

  • Insights on the German College of General Practitioners and Family Physicians (DEGAM) guideline addressing medical overuseThis link opens in a new windowNov 22, 2024

    Overdiagnosis is a common phenomenon. It is defined as the identification of an abnormality that would not have harmed the patient if it had not been detected. However, once detected, the knowledge of such an abnormality alone has the potential to harm the patient, both psychologically and physically.1 Next to problems for individuals, ‘too much medicine’ also contributes to problems in our healthcare systems: continuously rising healthcare costs, a shortage of healthcare workers, increasing burnout rates among them and increasing greenhouse gas emissions by the healthcare sector.2 Due to limited human, financial and environmental capacities, solutions must be found to better allocate the available resources. The international Preventing Overdiagnosis Conference (PODC) has been dedicated to this topic for 10 years now.3 In August 2023, the conference was held in Copenhagen. The aim of the PODC is the international scientific exchange on the topic...

  • Reporting health and medical researchThis link opens in a new windowNov 22, 2024

    The use of the best available evidence to inform patient care in evidence-based medicine is reliant on the accurate, complete and transparent reporting of health and medical research. Without a complete and transparent account of what was done and what was found during a research study, findings cannot be fully understood, replicated, assessed for validity and applicability, and used to inform clinical and policy decisions.

    For over 50 years, problems of incomplete and poor reporting of research have been widely documented across health and medical research.1–3 Unusable research reports contribute to avoidable research waste4 through the inability to appraise and synthesise research and can detrimentally impact patient care through incorrect implementation of research findings.5 Because of this, complete and transparent reporting of research is a researcher’s moral and ethical responsibility to maximise the usefulness and positive impact of their...

  • Guidelines for the development and validation of patient-reported outcome measures: a scoping reviewThis link opens in a new windowNov 22, 2024
    Objective

    The objectives of this scoping review were to provide an overview of existing guidelines for the development and validation of patient-reported outcome measures (PROMs), review them for comprehensiveness and clarity and provide recommendations for their use based on the goals of the instrument developers.

    Design

    Scoping review.

    Methods

    A literature search was performed in PubMed, Scopus, PsycInfo and Google Scholar up to 2 June 2023 to identify guidelines for the development and validation of PROMs. Screening of records and reports as well as data extraction were performed by two reviewers. To assess the comprehensiveness of the included guidelines, a mapping synthesis was performed and steps to develop and validate a measurement instrument outlined in the included guidelines were mapped to an a priori framework including 20 steps, which was based on the guideline by de Vet et al.

    Results

    A total of 40 guidelines were included. Statistical advice (at least partially) was provided in 98% of the guidelines (39/40) and 88% (35/40) of the guidelines included examples for steps required to develop and validate PROMs. However, 78% (31/40) of the guidelines were not comprehensive and two essential steps in PROM development (‘consideration and elaboration of the measurement model’ and ‘responsiveness’) were not included in 80% and 72% of the guidelines, respectively. Three guidelines included all 20 steps and six included almost all steps (≥90% of steps) for developing and validating a PROM.

    Discussion

    Most guidelines on PROM development and validation do not appear to be comprehensive, and some crucial steps are missing in most guidelines. Nevertheless, for some purposes of PROMs, many guidelines provide helpful advice and support.

    Conclusion

    At least 15 guidelines may be recommended, including three comprehensive guidelines that can be recommended for the development and validation of PROMs for most purposes (eg, to discriminate between subjects with a particular condition and subjects without that condition, to evaluate the effects of treatments (between a pre and post time-points) or to evaluate a status quo).

Evidence Based Practice Resources

Books about EBP

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