Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-16T15:33:03.109Z Has data issue: false hasContentIssue false
  • English
  • Français

Evidence-Based Decision-Making (Part 1): Origins and Evolution in the Health Sciences

Published online by Cambridge University Press:  28 June 2012

David A. Bradt
David A. Bradt*
Affiliation:
Center for Refugee and Disaster Response, Johns Hopkins Medical Institutions, Baltimore, Maryland USA
*
Center for Refugee and Disaster ResponseJohns Hopkins Medical InstitutionsMarburg B-187600 North Wolfe St.Baltimore, Maryland 21287-2080USA E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Evidence is defined as data on which a judgment or conclusion may be based. In the early 1990s, medical clinicians pioneered evidence-based decision-making. The discipline emerged as the use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine required the integration of individual clinical expertise with the best available, external clinical evidence from systematic research and the patient's unique values and circumstances. In this context, evidence acquired a hierarchy of strength based upon the method of data acquisition.

Subsequently, evidence-based decision-making expanded throughout the allied health field. In public health, and particularly for populations in crisis, three major data-gathering tools now dominate: (1) rapid health assessments; (2) population based surveys; and (3) disease surveillance. Unfortunately, the strength of evidence obtained by these tools is not easily measured by the grading scales of evidence-based medicine. This is complicated by the many purposes for which evidence can be applied in public health—strategic decision-making, program implementation, monitoring, and evaluation. Different applications have different requirements for strength of evidence as well as different time frames for decision-making. Given the challenges of integrating data from multiple sources that are collected by different methods, public health experts have defined best available evidence as the use of all available sources used to provide relevant inputs for decision-making.

Keywords

decision-makingdisasterevidenceevidence baseevidence-based medicinehumanitarian assistance
Type
Theoretical Discussion
Information
Prehospital and Disaster Medicine , Volume 24 , Issue 4 , August 2009 , pp. 298 - 305
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Evidence-Based Medicine Working Group: Evidenced-based medicine—A new approach to teaching the practice of medicine. JAMA 1992;268(17):2420–2425.CrossRefGoogle Scholar
2Sackett, DL, Rosenberg, WMC, Gray, JAM, Haynes, RB, Richardson, WS: Evidence based medicine: What it is and what is isn't. BMJ 1996;312:71–72.CrossRefGoogle ScholarPubMed
3Richardson, WS, Wilson, MC, Nishikawa, J, Hayward, RSA. The well-built clinical question: a key to evidence-based decisions. ACP Journal Club 1995;123:A–12.CrossRefGoogle ScholarPubMed
4Guyatt, GH, Rennie, D: Users; guides to the medical literature. JAMA 1993;270:2096–2097.CrossRefGoogle ScholarPubMed
5Oxman, AD, Sackett, DL, Guyatt, GH for the Evidence-Based Medicine Working Group: Users' guides to the medical literature. I. How to get started. JAMA 1993;270:2093–2095.CrossRefGoogle Scholar
6Guyatt, GH, Sackett, DL, Cook, DJ for the Evidence-Based Medicine Working Group: Users' guides to the medical literature. II. How to use an article about therapy or prevention. A. Are the results of the study valid? JAMA 1993,270:2598–2601.CrossRefGoogle Scholar
7Guyatt, GH, Sackett, DL, Cook, DJ for the Evidence-Based Medicine Working Group: Users' guides to the medical literature. II. How to use an article about therapy or prevention. B. What were the results and will they help me in caring for my patients? JAMA 1994;271:59–63.CrossRefGoogle ScholarPubMed
8Jaeschke, R, Guyatt, GH, Sackett, DL for the Evidence-Based Medicine Working Group: Users' guides to the medical literature. III. How to use an article about a diagnostic test. A. Are the results of the study valid? JAMA 1994;271:389–391.CrossRefGoogle Scholar
9Jaeschke, R, Guyatt, GH, Sackett, DL for the Evidence-Based Medicine Working Group: Users' guides to the medical literature. III. How to use an article about a diagnostic test. B. What are the results and will they help me in caring for my patients? JAMA 1994;271:703–707.CrossRefGoogle Scholar
10Levine, M, Walter, S, Lee, H, Haines, T, Holbrook, A, Moyer, V for the Evidence-Based Medicine Working Group: Users' guides to the medical literature. IV. How to use an article about harm. JAMA 1994;271:1615–1619.CrossRefGoogle Scholar
11Laupacis, A, Wells, G, Richardson, WS, Tugwell, P for the Evidence-Based Medicine Working Group: Users' guides to the medical literature. V. How to use an article about prognosis. JAMA 1994;272:234–237.CrossRefGoogle Scholar
12Oxman, AD, Cook, DJ, Guyatt, GH for the Evidence-Based Medicine Working Group: Users' guides to the medical literature. VI. How to use an overview. JAMA 1994;272:1367–1371.CrossRefGoogle Scholar
13Richardson, WS, Detsky, AS for the Evidence-Based Medicine Working Group: Users' guides to the medical literature. VII. How to use a clinical decision analysis. A. Are the results of the study valid? JAMA 1995;273:1292–1295.CrossRefGoogle Scholar
14Richardson, WS, Detsky, AS for the Evidence Based Medicine Working Group: Users' guides to the medical literature. VII. How to use a clinical decision analysis. B. What are the results and will they help me in caring for my patients? JAMA 1995;273:1610–1613.CrossRefGoogle Scholar
15Hayward, RS, Wilson, MC, Tunis, SR, Bass, EB, Guyatt, GH for the EvidenceBased Medicine Working Group: Users' guides to the medical literature. VIII. How to use clinical practice guidelines. A. Are the recommendations valid? JAMA 1995;274:570–574.CrossRefGoogle Scholar
16Wilson, MC, Hayward, RS,Tunis, SR, Bass, EB, Guyatt, GH for the EvidenceBased Medicine Working Group: Users' guides to the Medical Literature. VIII. How to use clinical practice guidelines. B. What are the recommendations and will they help you in caring for your patients? JAMA 1995;274:1630–1632.CrossRefGoogle Scholar
17Guyatt, GH, Sackett, DL, Sinclair, JC, Hayward, R, Cook, DJ, Cook, RJ for the Evidence-Based Medicine Working Group: Users' guides to the medical literature. IX. A method for grading health care recommendations. JAMA 1995;274:1800–1804.CrossRefGoogle Scholar
18Naylor, CD, Guyatt, GH for the Evidence-Based Medicine Working Group: Users' guides to the medical literature. X. How to use an article reporting variations in the outcomes of health services. JAMA 1996;275:554–558.CrossRefGoogle Scholar
19Naylor, CD, Guyatt, GH for the Evidence-Based Medicine Working Group: Users' guides to the medical literature. XI. How to use an article about a clinical utilization review. JAMA 1996;275:1435–1439.CrossRefGoogle Scholar
20Guyatt, GH, Naylor, CD, Juniper, E, Heyland, DK, Jaeschke, R, Cook, DJ for the Evidence-Based Medicine Working Group: Users' guides to the medical literature. XII. How to use articles about health-related quality of life. JAMA 1997;277:1232–1237.CrossRefGoogle Scholar
21Drummond, MF, Richardson, WS, O'Brien, BJ, Levine, M, Heyland, D for the Evidence-Based Medicine Working Group: Users' guides to the medical literature. XIII. How to use an article on economic analysis of clinical practice. A. Are the results of the study valid? JAMA 1997;277:1552–1557.CrossRefGoogle Scholar
22O'Brien, BJ, Heyland, D, Richardson, WS, Levine, M, Drummond, MF for the Evidence-Based Medicine Working Group: Users' guides to the medical literature. XIII. How to use an article on economic analysis of clinical practice. B. What are the results and will they help me in caring for my patients? JAMA 1997;277:1802–1806.CrossRefGoogle Scholar
23Dans, AL, Dans, LF, Guyatt, GH, Richardson, S for the Evidence-Based Medicine Working Group: Users' guides to the medical literature: XIV. How to decide on the applicability of clinical trial results to your patient. JAMA 1998;279:545–549.CrossRefGoogle Scholar
24Richardson, WS, Wilson, MC, Guyatt, GH, Cook, DJ, Nishikawa J for the Evidence-Based Medicine Working Group: Users' guides to the medical literature: XV. How to use an article about disease probability for differential diagnosis. JAMA 1999;281:1214–1219.CrossRefGoogle Scholar
25Guyatt, GH, Sinclair, J, Cook, DJ, Glasziou, P for the Evidence-Based Medicine Working Group and the Cochrane Applicability Methods Working Group: Users' guides to the medical literature: XVI. How to use a treatment recommendation. JAMA 1999;281:1836–1843.CrossRefGoogle Scholar
26Barratt, A, Irwig, L, Glasziou, P, Cumming, RG, Raffle, A, Hicks, N, Gray, JAM, Guyatt, GH for the Evidence-Based Medicine Working Group: Users' guides to the medical literature: XVII. How to use guidelines and recommendations about screening. JAMA 1999;281:2029–2034.CrossRefGoogle Scholar
27Randolph, AG, Haynes, RB, Wyatt, JC, Cook, DJ, Guyatt, GH for the Evidence-Based Medicine Working Group: Users' guides to the medical literature: XVIII. How to use an article evaluating the clinical impact of a computer-based clinical decision support system. JAMA 1999;282:67–74.CrossRefGoogle Scholar
28Bucher, HC, Guyatt, GH, Cook, DJ, Holbrook, A, McAlister, FA for the Evidence-Based Medicine Working Group: Users' guides to the medical literature: XIX. Applying clinical trial results; A. How to use an article measuring the effect of an intervention on surrogate end points. JAMA 1999;282:771–778.CrossRefGoogle Scholar
29McAlister, FA, Laupacis, A, Wells, GA, Sackett, DL for the Evidence-Based Medicine Working Group: Users' guides to the medical literature: XIX. Applying clinical trial results; B. Guidelines for determining whether a drug is exerting (more than) a class effect. JAMA 1999;282:1371–1377.CrossRefGoogle Scholar
30McAlister, FA, Straus, SE, Guyatt, GH, Haynes, RB for the Evidence-Based Medicine Working Group: Users' guides to the medical literature: XX. Integrating research evidence with the care of the individual patient. JAMA 2000;283:2829–2836.CrossRefGoogle Scholar
31Hunt, DL, Jaeschke, R, McKibbon, KA for the Evidence-Based Medicine Working Group: Users' guides to the medical literature: XXI. Using electronic health information resources in evidence-based practice. JAMA 2000;283:1875–1879.CrossRefGoogle Scholar
32McGinn, TG, Guyatt, GH, Wyer, PC, Naylor, CD, Stiell, IG, Richardson, WS for the Evidence-Based Medicine Working Group: Users' guides to the medical literature: XXII: How to use articles about clinical decision rules. JAMA 2000;284:79–84.CrossRefGoogle Scholar
33Giacomini, MD, Cook, DJ for the Evidence-Based Medicine Working Group: Users' guides to the medical literature: XXIII. Qualitative research in health care A. Are the results of the study valid? JAMA 2000;284:357–362.CrossRefGoogle Scholar
34Giacomini, MK, Cook, DJ for the Evidence-Based Medicine Working Group: Users guides to the medical literature: XXIII. Qualitative research in health care B. What are the results and how do they help me care for my patients? JAMA 2000;284:478–482.Google Scholar
35Richardson, WS, Wilson, MC, Williams, JW Jr, Moyer, VA, Naylor, CD for the Evidence-Based Medicine Working Group: Users' guides to the medical literature: XXIV. How to use an article on the clinical manifestations of disease. JAMA 2000;284:869–875.CrossRefGoogle Scholar
36Guyatt, GH, Haynes, RB, Jaeschke, RZ, Cook, DJ, Green, L, Naylor, CD, Wilson, MC, Richardson, WS for the Evidence-Based Medicine Working Group: Users' guides to the medical literature: XXV. Evidence-based medicine: Principles for applying the users' guides to patient care. JAMA 2000;284:1290–1296.CrossRefGoogle Scholar
37Strauss, SE, Richardson, WS, Glasziou, P, Haynes, RB: Evidence-Based Medicine. 3rd Edition. Edinburgh: Elsevier Churchill Livingstone, 2005.Google Scholar
38Sackett, DL, Straus, SE, Richardson, WS, Rosenberg, W, Haynes, RB: Evidence-Based Medicine. 2d Edition. Edinburgh: Churchill Livingstone, 2000.Google Scholar
39American College of Emergency Physicians. Clinical policy: Critical issues in the evaluation of adult patients presenting to the emergency department with acute blunt abdominal trauma. Ann Emerg Med 2004;43:278–290.Google Scholar
40Haynes, RB: Of studies, summaries, synopses, and systems: the 4S evolution of services for finding current best evidence. ACP J Club 2001;134:A11–13. [Editorial].CrossRefGoogle Scholar
41Bunker, JP, Frazier, HS, Mosteller, F: Improving health: measuring effects of medical care. Milbank Quarterly 1994;72:225–258.CrossRefGoogle ScholarPubMed
42US Centers for Disease Control and Prevention: Ten great public health achievements—United States, 1900–1999. MMWR 1999;48(12):241–244.Google Scholar
43Contributors to the Cochrane Collaboration and the Campbell Collaboration: Evidence from Systematic Reviews of Research Relevant to Implementing the ‘Wider Public Health’ Agenda. York, UK: NHS Centre for Reviews and Dissemination, 2001.Google Scholar
44World Bank: World Development Report: Investing in Health. New York: Oxford University Press, 1993.Google Scholar
45Laxminarayan, R, Mills, AJ, Breman, JG, et al. : Advancement of global health: Key messages from the Disease Control Priorities Project.Lancet 2006;367:1193–1208.CrossRefGoogle ScholarPubMed
46Aldis, W, Schouten E. War and public health in the Democratic Republic of the Congo. Health in Emergencies 2001;11:4–5.Google Scholar
47Connolly, MA, Gayer, M, Ryan, MJ, Spiegel, P, Salama, P, Heymann, DL: Communicable diseases in complex emergencies: Impact and challenges. Lancet 2004;364(9449):1974–1983.CrossRefGoogle ScholarPubMed
48World Health Organization: Rapid Health Assessment Protocols for Emergencies. Geneva, Switzerland: WHO, 1999.Google Scholar
49Spiegel, PS, Salama, P, Maloney, S, van der Veen, A: Quality of malnutrition assessment surveys conducted during famine in Ethiopia. JAMA 2004;292:613–618.CrossRefGoogle ScholarPubMed
50Checchi, F, Roberts, L: Interpreting and using mortality data in humanitarian emergencies—A primer for non-epidemiologists. Humanitarian Practice Network, Network Paper No 52, September 2005. Available at http://www.odihpn.org/documents/networkpaper052.pdf. Accessed June 2006.Google Scholar
51World Health Organization, Department of Communicable Disease Surveillance and Response: WHO recommended surveillance standards, 2d ed. WHO/CDS/CSR/ISR/99.2. Available at http://www.who.int/csr/resources/publications/surveillance/whocdscsrisr992.pdf. Accessed November 2007.Google Scholar
52Murray, CJL, Mathers, CD, Salomon, JA. Towards Evidence-Based Public Health. In: Murray, CJL, Evans, DB (eds). Health Systems Performance Assessment: Debates, Methods, and Empiricism. Geneva: World Health Organization, 2003.Google Scholar
53Grein, TW, Kamara, KO, Rodier, G, Plant, AJ, Bovier, P, Ryan, MJ, Ohyama, T, Heymann, DL: Rumors of disease in the global billage: Outbreak verification. Emerg Infect Dis 2000;6(2):97–102.CrossRefGoogle Scholar
54Ackoff, RL: From data to wisdom. Journal of Applied Systems Analysis 1989;16:3–9.Google Scholar
55Lynch, C: Lack of access muddies death toll in Darfur. Washington Post, February 8, 2005. Available at http://www.washingtonpost.com/wpdyn/articles/A6186-2005Feb7.html. Accessed November 2007.Google Scholar