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1 Evidence-Based Medicine Policy Analysis Tangela Peele The University of Arizona Global Campus MHA 620: Health Policy Analyses Dr. Pamela Brown May 15, 2023

2 Evidence-Based Medicine Policy Analysis Evidence-based medicine (EBM) has become increasingly important in healthcare settings. EBM utilizes empirical research and firsthand practice to improve patient care (Dizon, 2019). EBM aims to provide patients with the most effective and efficient care possible. In this essay, we will discuss the process of evidence-based analysis, the major players and their roles in EBM policy, the levels of evidence, and a case study on the constraints of the Affordable Care Act (ACA) on evidence-based medicine. It involves thoroughly analyzing the available research evidence to determine the effectiveness and safety of healthcare interventions. EBM is an indispensable tool in modern healthcare, and healthcare providers, policymakers, and patients widely use it. EBM Background The process of evidence-based analysis involves several key steps that must be followed to ensure that the analysis is rigorous and dependable. These steps include formulating a well- defined clinical question, searching for relevant research evidence, critically appraising the quality of the evidence, synthesizing the results, and applying the findings to clinical practice (Dizon, 2019). The process is iterative, meaning it may need to be repeated as new evidence becomes available or as clinical circumstances change. The significant players in EBM policy include the government, providers, patients, and researchers. The government plays a significant role in EBM policy by funding research and setting regulations that ensure the safety and effectiveness of healthcare practices (Dizon, 2019). Healthcare providers, including physicians, nurses, and other clinical professionals, are responsible for implementing EBM in their clinical practice and staying current with the latest research evidence (Dizon, 2019). Patients also play a crucial role in EBM by participating in research studies and making informed decisions about

3 their healthcare are responsible for conducting studies and disseminating their findings to inform EBM policy. Levels of Evidence The EBM "Levels of Evidence" categorize research studies based on their quality and validity. The EBM "Levels of Evidence," as defined in the course text, are a system for categorizing research evidence based on the strength of its design and the degree of confidence that can be placed in its findings. There are several levels of evidence, ranging from level 1 (high-quality evidence from systematic reviews of randomized controlled trials) to as many as ten levels (low-quality evidence from expert opinion or case reports) (McLaughlin & McLaughlin, 2014). Level 1 evidence is considered the highest quality, consisting of well- designed randomized controlled trials (RCTs) (Stevens & Kim, 2019). Level 2 evidence includes non-randomized studies with a control group, while Level 3 evidence consists of non- randomized studies without a control group (Stevens & Kim, 2019). Level 4 evidence includes case series and case reports, considered the lowest quality evidence, and level 5 evidence from methodical reviews of descriptive and qualitative studies (meta-synthesis) (Stevens & Kim, 2019). The levels of evidence are used to guide clinical decision-making and to determine the strength of recommendations made in clinical guidelines. Constraints of the ACA The case "Constraints of the ACA on Evidence-Based Medicine" explores the impact of the ACA on EBM policy. The ACA aimed to increase access to healthcare and reduce costs, but it also imposed constraints on EBM practices (Virgin, 2017). The case "Constraints of the ACA on Evidence-Based Medicine," which was presented in Chapter 9 of the textbook, raises several issues regarding the application of evidence-based medicine (EBM) in the United States

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