2.1 Evidence-based Practice

Question 1

What is evidence-based practice?

Answer 1

The integration of individual clinical expertise with the best-available external clinical evidence from systematic research.

Question 2

Where does the external clinical evidence come from in evidence-based practice?

Answer 2

Meta-analysis and systematic reviews

Question 3

Why are systematic reviews important?

Answer 3

Help to address clinical uncertainty 
Highlight gaps in research 
Highlight poor quality research 
Offer up-to-date conclusions
Reduce delays between research and implementation

Question 4

What is meant by a ‘practical criticism’ of evidence-based practice?

Answer 4

Criticism around the possibility of evidence-based practice

Question 5

Give some examples of practical criticisms of evidence-based practice?

Answer 5

Volume of research too large to analyse
Challenging and expensive to conclude findings
RCTs not always feasible
Choice of outcomes is often very biomedical as opposed to focusing on QoL

Question 6

What is meant by a ‘philosophical criticism’ of evidence-based practice?

Answer 6

Criticism around the desirability of evidence-based practice

Question 7

Give some examples of philosophical criticisms of evidence-based practice?

Answer 7

Does not align with doctor’s method of reasoning
A treatment for the majority may not work for an individual
May undermine trust in the doctor-patient relationship
May cause unreflective rule followers

Question 8

Give reasons why it may be hard to implement evidence-based medicine into clinical settings

Answer 8

Need to change habits
Doctor’s responsibility to keep up to date
Patient’s rights and opinions
May lack financial and human resources
Managers may lack the ability to make a change