Acting on the evidence
Being aware of the available evidence is one thing, but acting on it is another.
There are a number of well documented delays between clinical practice and the available research evidence. The most often cited examples have been in medicine but one can look at the variations in the use of topical fluorides and fissure sealants despite good evidence of their effectiveness. These delays and variations in provision and uptake of treatments have contributed to the development of the evidence-based approach.
Remember, people will judge you by your actions, not your intentions. You may have a heart of gold – but so does a hard-boiled egg.
The practitioner needs to decide whether the specific patient is similar enough to those in the research to use the findings . There may also be barriers regarding the materials or equipment required, and there may also be cost implications. There are also personal barriers such as the extent to which the results conflict with professional experience and cherished beliefs (see list of resources below).
The decision to act on evidence should be based on the evidence, the relevance to your patient, the willingness of the patient to recieve the treatment, and the practitioners ability to provide the treatment. It is therefore a carefully considered decision and not a ‘cookbook’ approach, as has been claimed by some opponents of evidence-based practice.
Resources for acting
Getting Research Findings into Practice Series from: The British Medical Journal (Now also available as a book)
- Making Better use of Research Findings
- When to Act on Evidence
- Finding Information on Clinical Effectiveness
- Barriers and Bridges to Evidence-based clinical practice
- Using research findings in clinical practice
- Decision Analysis and the implementation of research findings
- Closing the gap between research and practice
- Implementing research findings in developing countries