What Hierarchy Of Evidence Is Used When Making Decisions About Clinical Interventions?

Qualifications for best available research, consist of medical (health science) research, which reigns supreme because it most likely will yield accurate, unbiased and information, with multiple practice questions for specific patients and or patient groups. The research is large and effective in relation to prevalence, treatment, assessment, disorders and patient populations. The evidence should yield systematic

Evaluating EvidenceBefore research should be used in practice, it must be evaluated. There are many complexities and nuances in evaluating the research evidence for clinical practice. Evaluation of research behind evidence-based medicine requires critical thinking

validated through research (Monti & Tingen, 1999). This author believes that the basis of a good practice is through the use of evidence based findings. If the procedure or care plan is supported by research, and the findings are reproducible, then this author is more likely to implement it into his practice.

Evidence-based practice is an approach used by health care professionals to continually use current best evidence-based research to make ethical and reliable decisions regarding patient care. “Research to promote evidence-based practice is becoming more and more a part of the regular work of health care leaders” (Grand Canyon University, 2015, p. 1). However, it is important to determine the difference between solid research and flawed research that provides unreliable inferences. Evidence-based research includes focusing on a clinical question; and includes the review and incorporation of several studies to strengthen the results of the new study (Grand Canyon University, 2015). Roddy et al. and Ganz et al. articles will be assessed to determine if the recommended changes were backed by solid research that warrants changes in a hospital.

Evidence-Based Practice (EBP) was initially a movement in medicine, dating back to early 20th century (Spring, 2007). It was described as a careful decision making process about the care of individual patients using best available evidence by Sackett, Rosenberg, Gary, Haynes, and Richardson (1996). Greenhalgh (2010) gave a similar definition but with more emphasis on the mathematical assessment of the potential benefit and harm. By now, EBP has been widely adopted by many health disciplines, including psychology. In 2005, the American

Evidence based practice is the incorporation of individual clinical expertise with best research evidence and patient values and expectations. Health care decision of individual patients should be based on best available research evidence. A health decision made from a sound research evidence has the potential to ensure best practice and reduce variations in health care delivery. In health science, an ever increasing plethora of studies being published and is challenging for clinicians to keep up with the literature. Integrating research into practice is time consuming and need methods for easy access to such evidences for busy clinicians. Indeed, clinical decision should be based on the latest research evidence. Systematic reviews and meta-analyses summarize the research evidence, which is generally the best form of evidence, thereby making the available evidence more accessible to decision makers and are positioned

The evidence hierarchy is a ranking that distinguish the types of research evidence based on the strength of the evidence itself (Polit & Beck, 2012). It is mostly applicable to the research questions regarding the effects of clinical interventions. The evidence that are ranked based on the evidence that uses appropriate research methods, rigorously reviewed with minimized biases and has great clinical implications. The strongest evidence based on the evidence hierarchy is systematic reviews, which draws conclusions from many randomized controlled trails (Polit & Beck, 2012).

There are many versions of the hierarchical evidence levels. When deciding on basing clinical interventions on evidence, there are two specific models to look at. They both describe levels of evidence and are depicted as pyramids. The first is the 6S model, with the “more patient-specific” information listed at the top of the pyramid (Houser, 2015). The top of the pyramid has the least amount of information as compared to the base, it is more relevant, but it yields the least amount of information (2015). Conversely, the more abundant information found at the bottom is less relevant to the specific intervention in question (2015). Also, the searches conducted at the more basic levels typically take less time to yield results due to the broader relationship to the intervention in question (2015). The 6S model of hierarchical pyramid of evidence are listed as follows from highest to lowest:

It would seem a foregone conclusion that effective clinical practice is based on the best possible, rigorously tested evidence because the public assumes it, patients expect it and practitioners profess to value it. Yet the emphasis on evidence as a basis of clinical practice reached the forefront of health care only in the last two decades. The past decade has seen unprecedented advances in information technology, making research and other types of evidence widely available to healthcare practitioners. Technology has supported the rapid communication of best practice and afforded consumers open access to healthcare information as well. As a result, Evidence Based Practice (EBP) is quickly becoming the norm for effective clinical practice.

The study was a systematic review of scientific papers selected by a search of the SciELO, Cochrane, MEDLINE, and LILACS-BIREME databases. Among the 2169 articles found, 12 studies proved relevant to the issue and presented an evidence strength rating of B. No publications rated evidence strength A. Seven of the studies analyzed were prospective cohorts and 5 were cross-sectional studies.

Evidence-based practice is defined as the “integration of best current evidence with clinical expertise and patient or family preferences and values for the delivery of optimal health care” (Quality and Safety Education for Nurses, 2012). It is “the use of research in clinical decision making” (Brower, 2017).With the tremendous changes in the healthcare landscape, many processes have to be evaluated for its relevance, reliability,

You are absolutely right that the evidence has to match the reality, to be useful in clinical setting. Since health care professionals want to ensure an effective and compassionate care which meets their patients’ needs, the validity of the evidence is important, therefore a sound research evidence which tells us what does and does not work, and with whom and where it works best, is very important while incorporating the evidence from research, clinical expertise, and patient preferences into decisions about the health care of individual patients (Mulhall, 1998). Health care professionals can make use of Cochrane Reviews for the authoritative, relevant, and reliable evidence of researches (Cochrane, 2016)

“Evidence-based practice (EBP) is an approach to health care wherein health professionals use the best evidence possible, i.e., the most appropriate information available, to make clinical decisions for individual patients” (McKibbon, 1998). It is patient/family centered and involves complex and contentious decision making that is based on evidence available as well as the patient situations, characteristics and preferences. The evidence found does not make the decision, but helps support the patient care process. Health care is ever changing and involves multiple different aspects that evidence based practice gives the health care providers the formalization of the care process. There are

The lesson and case studies presented for evaluation was a great learning exercise. A better understanding of how to interpret data was gained. Also, weighing the clinical significance versus the statistical significance to show relevance is invaluable. All research is not quality research and one must be equipped to recognize bias, threats to validity and proper population representation. Moreover, critiquing the credibility of a study is essential to the health care advances.

Evidence Based Practice hierarchies rank research articles based on their quality and accuracy. The evidence hierarchy allows you to choose from the best research evidence from top to bottom based on the significance of the research article. Meta Analysis is on top of the hierarchy followed by random controlled trials, quantitative evaluation & design, pretest-posttest design, posttest only design, qualitative case design, and clinical wisdom (E. Weiss, personal communications, September 9, 2016). Systematic reviews and meta-analysis are on the top of the hierarchy and were conducted on the study from Grenard et al. (2011). However, the research designs by Bayliss and Holttum, (2015), a qualitative (quasi-experimental) design was listed on the bottom of the hierarchical triangle, meaning the articles evidence are low in strength. In addition, the single case study by Cromarty, Jonsson, Moorhead, & Freeston, (2011), was also listed on the bottom of the hierarchal triangle, which is also ranked low in strength. The social worker also encountered rigorous studies that