Evidence Based Practice Flashcards
What is the argument for using evidence based practice?
Health service delivery should be based on the best possible evidence- not tradition or gut feeling
Using the best evidence of effectiveness and cost effectiveness
What is a defination for evidence based practice?
Evidence based medicine involves the intergraiton of indivdual clinical expertise with the best available expert clinical evidence from systematic reasearch
Why are systematic reviews useful for clinicans?
Apprasing and intergrating findings allows for qaulity control and increased certainity, they are authoritive and generalisable and up to date information, save clincians from having to locate the studies and may reduce the delay between discorvy and implementation
What are some of the practical criticims of evidence based practice?
May be impossible to create and maintain systematic reviews across all specialities.
May be challenging and expensive to disseminate and implement findings,
RCTS are the gold standard but may not be approate or necssary
Choice of outcomes biomedical which may limit the treatment options provided
Requires good faith on the part of pharmtectical companies
What are some of the philosophical criticisms of evidence based practice?
Does not align with most doctors mode of reasoning
Aggregate population based outcomes does not mean it will work for a paitent
Potential to make unrelfective rule followers out of clinicans
Might be understood as a means of legitmising rationing which could damage the doctor-patient relationship
Proffersional responsibility/ accountability
What are some of the problems with getting evidence into practice?
Evidence exists but doctors don’t know- dissemination ineffective
Doctors know but don’t use it - habit, organisational cultures, professional judgement
Organisational systems cannot support innovation
Commissioning decisions reflect different priories
Resources not available to implement change
