Session 2 - Evidence-based parctice

Question 1

What is evidence-based practice?

Answer 1

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

Question 2

Why is evidence-based practice important?

Answer 2

• Ineffective/inappropriate interventions waste money and resources
• Variations on treatment when decided solely by clinician creates inequity
• Without evidence new intervention could be harmful
• EBM results in the most effective interventions being used which is fair to all

Question 3

What is the alternative to evidence based practice?

Answer 3

-Practice based on professional opinion, clinical fashion, historical president and social culture

Question 4

Why is it good to use systematic reviews in EBM?

Answer 4

• Primary literature can be biased
• Quality of review can be poor
• address clinical uncertainti and quality control by surverying all the literature
• Highlights gaps in research

Question 5

Describe some practical criticisms of EBM

Answer 5

• Impossible task to create and maintain systematic reviews across all specialities
• Challanging and expensive to disseminate and implement findings
• RCTs not always ethical
• Limits interventions trialled to biomedical ones

Question 6

Describe some philosophical criticisms of evidence based medicine

Answer 6

• Population-level outcomes do not always work for individuals
• Potential for EBM to crease unreflective rule followers out of clinicians with the potential to undermine the dr-pt relationship

Question 7

Describe some problems of implementing EBM in pratice

Answer 7

• Ineffective dissemination can leave some doctors unaware
• Doctors may choose not to follow EBM out of habit/judgement
• Some organisations cannot support innovation

Question 8

State how some NHS policies encourage EBP

Answer 8

-Clinical governance and quality care commission leagally olblige NHS organisations to follow NICE guidance within 3 months of issue