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)
A meta-analysis and a systematic review are both methods used to synthesize research findings, but they differ in their scope and methodology.
Systematic Review:
Meta-Analysis:
In summary, a systematic review can exist without a meta-analysis, but a meta-analysis is always part of a systematic review if the data allows for quantitative synthesis.
Here are the basic types of scientific articles commonly used in evidence-based practice:
Original Research Article (Empirical Study):
Systematic Review:
Meta-Analysis:
Clinical Practice Guidelines:
Case Report/Case Series:
Cohort Studies:
Randomized Controlled Trial (RCT):
These types of articles form the backbone of evidence-based practice, helping to inform clinical decisions and policy-making with the best available scientific evidence.
As the impacts of climate change and the transgression of other planetary boundaries on human health become evident, so is the impact of healthcare on climate change and environmental degradation. This interplay between human health and the environmental impact of healthcare increasingly emerges as a critical concern. Healthcare delivery, while aimed at preserving human health, paradoxically contributes to environmental pollution and greenhouse gas emissions, either directly from healthcare facilities or indirectly from the supply chain of healthcare goods and services.
While striving to adhere to the principle of ‘first, do no harm’, healthcare is an important contributor to climate change, environmental degradation, biodiversity loss, and resource depletion.
Cardiovascular disease (CVD) continues to exert a heavy burden in most countries in the world, with high blood pressure continuing to be one of the most important drivers of this burden. The urgency to tackle CVD has never been clearer.
WHO launched a global effort (the Global Hearts Initiative) with five technical packages aimed at targeting major drivers of the CVD burden, including actions on tobacco (MPOWER), physical activity (ACTIVE), some aspects of diet such as reducing salt (SHAKE) and trans fats intake (REPLACE) and HEARTS. HEARTS is a set of activities to improve cardiovascular risk management in primary care, with a focus on high blood pressure.
The HEARTS technical package is an institutionalised model of care and a set of guidelines for cardiovascular risk management, focusing on hypertension control and secondary prevention in primary healthcare. HEARTS is structured around six pillars, focusing...
Shared decision-making in medicine is widely viewed as a collaboration between the patient and the clinician. For example, Montori et al state, ‘The patient and clinician must collaborate to arrive at a useful formulation of the problem’.