Evidence-Based Medicine and the Necessity of Science

Posted by Winifred S. Hayes, RN, PhD, ANP, Founder and CEO on February 1, 2017

healthcare reform_1200.jpgThere’s no disputing that the current state of healthcare is in flux. Regardless of public opinion and political leanings about the topic, the manner in which clinicians and health systems deliver care is changing, and more disruption to long-accepted paradigms is on the horizon. Though the move away from fee-for-service medicine has been in existence for some time, the adoption of an evidence-based approach in the provider market has been uneven at best. Perhaps now more than ever, a refocusing is required on just what evidence-based medicine (EBM) is, and why the application of the scientific method to healthcare delivery is essential to achieving the crucial Triple Aim.

“Evidence-based medicine is an approach to the delivery of patient care that emphasizes the use of well-designed, well-conducted research that provides high-quality evidence.”

A phrase coined by Dr. David Sackett in the 1980s based on his vision to improve healthcare through research, the definition of evidence-based medicine has seen a number of iterations. The most commonly accepted description of EBM is an approach to the delivery of patient care that emphasizes the use of well-designed, well-conducted research that provides high-quality evidence; that is evidence from:

  • Meta-analysis: Synthesis of the results of numerous studies designed to address a specific question; can be used to identify a common effect when it is consistent from study to study as well as to identify reasons for variations across studies.
  • Systematic reviews: A summarization and critical appraisal of randomized controlled trials about treatment effects, benefits, or other questions.
  • Randomized controlled trials: Subjects are allocated at random to an experimental or control group.

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best practice_1200.jpgTraditionally, care decisions for both individuals and specific populations were grounded largely in opinions about the best treatment options, based either on the clinician’s training or on anecdotal experience. Research references impacted opinion, but not necessarily in a comprehensive or systematic way. But as healthcare costs continued to rise and patient outcomes suffered, it became obvious that clinical expertise and beliefs alone were insufficient to provide safe, efficient, and cost-effective care. To attain these results, a scientific methodology is needed in order to effectively apply evidence to patient care.

“Physicians have expressed their understanding of the need for evidence; they also report a significant amount of fatigue and burnout associated with adding yet another step.”

physician burnout_1200.jpgBut to do so requires time, resources, and the scientific expertise necessary to critically appraise the body of available evidence. These are in short supply for busy physicians, as well as supply chain and value-analysis professionals. They are tasked with improving patient outcomes while adhering to financial goals, both set by the health system, and based on the Value-Based Purchasing initiative set forth by the Centers for Medicare & Medicaid Services (CMS). It bears mentioning that while physicians have expressed their understanding of the need for evidence, they also report a significant amount of fatigue and burnout associated with adding yet another step to their data entry, which many feel creates an additional barrier between them and their patients.

Hayes recognizes the ever-increasing need for evidence-based practice while being sensitive to the level of provider fatigue associated with implementing it. For more than 25 years, Hayes has championed the application of science to the delivery of patient care. As the drive toward value-based care continues, Hayes will remain a source of fiercely unbiased evidence evaluation. Our expert analysts perform the necessary critical appraisals of the evidence surrounding health technologies, and they do so with scientific rigor, and without the influence of product manufacturer bias. In addition, our client services include support from our analysts under the guidance of our Medical Director to implement your clinical initiatives.

Evidence keeps science in healthcare. Let Hayes show you how. Schedule a demo today.

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Topics: Hospitals, Hayes Blog, Healthcare Evidence, Health Technology Assessments,, Medicare

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