Evidence-Based Practice is not...
There may be misunderstandings about what Evidence-based practice (EBP) aims to achieve. It is helpful to also consider what EBP is not.
EBP is not:
- Focussed only on randomised controlled trials
- EBP uses ‘best available’ evidence, because ‘best possible’ may be unavailable or not appropriate. When quality evidence is sparse or not available, clinicians need to use the evidence available, even if it is limited.
- Focused on statistics
- EBP focuses on acquiring and applying the best available evidence from multiple sources. Although a high level understanding of key statistical terms is important in interpreting study results, EBP is not about doing statistics.
- A search for cost effectiveness
- The focus is on effectiveness, not cost (although often choosing evidence-based practices will reduce cost in the long term through avoiding potential harm).
- ‘Cookbook medicine’
- EBP is intended to provide a choice of effective options to suit different needs, not just one option. Evidence is not a directive but provides clinicians with information on probabilities, indications, and tentative conclusions. The purpose is to reduce inappropriate variation in practice and take into consideration the patient’s values, preferences, and circumstances.
- Intended to restrict the autonomy of clinicians
- Clinician expertise is essential in appropriately interpreting and applying sources of evidence. Clinicians remain responsible for choices in clinical care, having integrated the patient’s wishes with the best available evidence.