Evidence-Based Decisions in Healthcare

 

 

 

 

 

 

 

 

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During the previous decade, a significant shift has been observed in the way health care workers use evidence gathered from scientific research in clinical practice. Globally, evidence-based health care concept has recently been incorporated in the language of health services’ researchers, policymakers, managers and clinicians. The idea of evidence-based health care has been incorporated in to the health care system. However, its uptake is uneven in the clinical practice. The adoption and diffusion of evidence-based health care ideas in the 1990s prove their relevance and power to the existing challenges and problems in the health care systems in several nations. It is worth noting that the concept is also used in fields such as education, criminal justice and social care.

Cochrane evaluates the impacts of health care treatments in offering significant information, and the risks and benefits of the interventions (Gotham, 2006, 606).Individual patients can be guided by Cochrane Reviews in making decisions that are well-informed concerning their health care. Patients differ in their preferences, circumstances and values, and therefore, varying treatment choices are made and are all founded on similar evidence. This paper aims at exploring the methods of enquiry used to make evidence-based decisions in health care, and their application to clinical practice.

Methods of inquiry/methodologies

Clinical experiences are reported by experts as extremely low quality evidence, similar to observational studies and case reports. According to Larrabee (2003, 12) vast randomized controlled trials that are well-conducted offer high quality evidence, especially if used for informing systematic reviews.

Systematic reviews are founded on clinical studies with a careful participant selection. Consequently, more complicated combinations of social aspects and clinical problems are ignored. The Cochrane Collaboration aims at ensuring qualitative studies can inform and add to knowledge received from randomized controlled studies. Outcomes are measured using numerical terms and therefore termed quantitative studies.  Lifestyle changes and quality of life are some of the qualitative measures, and are obtained using detailed questionnaires. In addition, narrative interviews can be used, where respondents talk of their experiences. Semi-structured prompts and questions explore the information and issues needed for a study.

GRADE (Grading of Recommendations Assessment, Development and Evaluation) is a system used to develop recommendations from evidence (clinical trials). The term health technology can be applied in numerous health care systems such as a procedure, drug, piece of equipment or device, or a diagnostic test.Pearson, Field and Jordan(2007)argue that health technology assessment focuses on the extensive health system; if the health care system can afford the demonstrated effectiveness of the interventions in changing health impacts. In addition, the intervention should be required and the health system able to finance the service.

Health care users require the tools for assessing arguments against and for decisions concerning their health care. The necessity for better or new treatment is best known by the sick and their caregivers. Therefore, their views need to be included in decisions about health care.

Application to clinical practice

Guidelines are formulated to provide patients and practitioners with information concerning the most suitable interventions and treatments in clinical situations. This is based on research studies as much as possible. Clinical guidelines focus on defining clinical pathways, and are significant in ensuring the right and timely treatment for various patients (Rosswurm and Larrabee, 1999, 319).

Systematic reviews are significant evidence sources for informing clinical practice guidelines. Since clinical trials are unavailable to answer questions that emerge during clinical practice guidelines’ development, the guidelines and recommendations may not be founded on strong evidence always.

 

 

References

Gotham, H. J. (2006) Advancing the Implementation of Evidence-Based Practices into Clinical Practice: How Do We Get There From Here? Professional Psychology: Research and Practice.Vol. 37, iss. 6), 606-608.

 

Larrabee, J.H. (2003) Advancing Quality Improvement through Using the Best Evidence to Change Practice. Journal of Nursing Care Quality. Vol.19, iss. 1, 10-13.

 

Pearson, A., Field, J., and Jordan, Z. (2007)Evidence-Based Clinical Practice in Nursing and Health Care: Assimilating Research, Experience and Expertise. Blackwell Publishing.

 

Rosswurm, M. A. and Larrabee, J. H. (1999) A model for Change to Evidence-Based Practice. The Journal of Nursing Scholarship. Vol. 31, iss. 4, 317-322.