scholarly journals Exploring the Use of Evidence From the Development and Evaluation of an Electronic Health (eHealth) Trial: Case Study

10.2196/17718 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e17718
Author(s):  
Monika Jurkeviciute ◽  
Henrik Eriksson
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Patient Preferences ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Professional Experience ◽  
Evidence Based ◽  
Policy Decisions ◽  
Professional Experiences

Background Evidence-based practice refers to building clinical decisions on credible research evidence, professional experience, and patient preferences. However, there is a growing concern that evidence in the context of electronic health (eHealth) is not sufficiently used when forming policies and practice of health care. In this context, using evaluation and research evidence in clinical or policy decisions dominates the discourse. However, the use of additional types of evidence, such as professional experience, is underexplored. Moreover, there might be other ways of using evidence than in clinical or policy decisions. Objective This study aimed to analyze how different types of evidence (such as evaluation outcomes [including patient preferences], professional experiences, and existing scientific evidence from other research) obtained within the development and evaluation of an eHealth trial are used by diverse stakeholders. An additional aim was to identify barriers to the use of evidence and ways to support its use. Methods This study was built on a case of an eHealth trial funded by the European Union. The project included 4 care centers, 2 research and development companies that provided the web-based physical exercise program and an activity monitoring device, and 2 science institutions. The qualitative data collection included 9 semistructured interviews conducted 8 months after the evaluation was concluded. The data analysis concerned (1) activities and decisions that were made based on evidence after the project ended, (2) evidence used for those activities and decisions, (3) in what way the evidence was used, and (4) barriers to the use of evidence. Results Evidence generated from eHealth trials can be used by various stakeholders for decisions regarding clinical integration of eHealth solutions, policy making, scientific publishing, research funding applications, eHealth technology, and teaching. Evaluation evidence has less value than professional experiences to local decision making regarding eHealth integration into clinical practice. Professional experiences constitute the evidence that is valuable to the highest variety of activities and decisions in relation to eHealth trials. When using existing scientific evidence related to eHealth trials, it is important to consider contextual relevance, such as location or disease. To support the use of evidence, it is suggested to create possibilities for health care professionals to gain experience, assess a few rather than a large number of variables, and design for shorter iterative cycles of evaluation. Conclusions Initiatives to support and standardize evidence-based practice in the context of eHealth should consider the complexities in how the evidence is used in order to achieve better uptake of evidence in practice. However, one should be aware that the assumption of fact-based decision making in organizations is misleading. In order to create better chances that the evidence produced would be used, this should be addressed through the design of eHealth trials.

scholarly journals Exploring the Use of Evidence From the Development and Evaluation of an Electronic Health (eHealth) Trial: Case Study (Preprint)

2020 ◽  
Author(s):  
Monika Jurkeviciute ◽  
Henrik Eriksson
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Patient Preferences ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Professional Experience ◽  
Evidence Based ◽  
Policy Decisions ◽  
Professional Experiences

BACKGROUND Evidence-based practice refers to building clinical decisions on credible research evidence, professional experience, and patient preferences. However, there is a growing concern that evidence in the context of electronic health (eHealth) is not sufficiently used when forming policies and practice of health care. In this context, using evaluation and research evidence in clinical or policy decisions dominates the discourse. However, the use of additional types of evidence, such as professional experience, is underexplored. Moreover, there might be other ways of using evidence than in clinical or policy decisions. OBJECTIVE This study aimed to analyze how different types of evidence (such as evaluation outcomes [including patient preferences], professional experiences, and existing scientific evidence from other research) obtained within the development and evaluation of an eHealth trial are used by diverse stakeholders. An additional aim was to identify barriers to the use of evidence and ways to support its use. METHODS This study was built on a case of an eHealth trial funded by the European Union. The project included 4 care centers, 2 research and development companies that provided the web-based physical exercise program and an activity monitoring device, and 2 science institutions. The qualitative data collection included 9 semistructured interviews conducted 8 months after the evaluation was concluded. The data analysis concerned (1) activities and decisions that were made based on evidence after the project ended, (2) evidence used for those activities and decisions, (3) in what way the evidence was used, and (4) barriers to the use of evidence. RESULTS Evidence generated from eHealth trials can be used by various stakeholders for decisions regarding clinical integration of eHealth solutions, policy making, scientific publishing, research funding applications, eHealth technology, and teaching. Evaluation evidence has less value than professional experiences to local decision making regarding eHealth integration into clinical practice. Professional experiences constitute the evidence that is valuable to the highest variety of activities and decisions in relation to eHealth trials. When using existing scientific evidence related to eHealth trials, it is important to consider contextual relevance, such as location or disease. To support the use of evidence, it is suggested to create possibilities for health care professionals to gain experience, assess a few rather than a large number of variables, and design for shorter iterative cycles of evaluation. CONCLUSIONS Initiatives to support and standardize evidence-based practice in the context of eHealth should consider the complexities in how the evidence is used in order to achieve better uptake of evidence in practice. However, one should be aware that the assumption of fact-based decision making in organizations is misleading. In order to create better chances that the evidence produced would be used, this should be addressed through the design of eHealth trials.

scholarly journals The PICO strategy for the research question construction and evidence search

2007 ◽  
Vol 15 (3) ◽  
pp. 508-511 ◽  
Author(s):  
Cristina Mamédio da Costa Santos ◽  
Cibele Andrucioli de Mattos Pimenta ◽  
Moacyr Roberto Cuce Nobre
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Research Question ◽  
Clinical Decision ◽  
Evidence Based ◽  
Review Of The Literature

Evidence based practice is the use of the best scientific evidence to support the clinical decision making. The identification of the best evidence requires the construction of an appropriate research question and review of the literature. This article describes the use of the PICO strategy for the construction of the research question and bibliographical search.

scholarly journals Safe and effective praxis without scientific evidence: is it possible?

2020 ◽  
Vol 19 (3) ◽  
pp. 178
Author(s):  
Jefferson Petto ◽  
Igor Macedo De Oliveira ◽  
Alice Miranda De Oliveira ◽  
Marvyn De Santana Do Sacramento
Keyword(s):  
Decision Making ◽  
Health Professionals ◽  
Scientific Literature ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
Science And Technology ◽  
Evidence Based ◽  
Scientific Thought ◽  
Daily Lives

The earliest accounts of scientific thought date back to thousands of years BC, where problems in the daily lives of our predecessors led to the search for effective and replicable forms of resolution. Nowadays, in the advent of science and technology, health professionals' decision making has been organized based on the analysis of the diverse evidence available in the scientific literature. This process has been identified Evidence Based Practice (EBP)...

scholarly journals Evidence-Based Practice and Chiropractic Care

2012 ◽  
Vol 18 (1) ◽  
pp. 75-79 ◽  
Author(s):  
Ron LeFebvre ◽  
David Peterson ◽  
Mitchell Haas
Keyword(s):  
Health Care ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Chiropractic Care ◽  
Therapeutic Interventions ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Chiropractic Education ◽  
Growing Body

Evidence-based practice has had a growing impact on chiropractic education and the delivery of chiropractic care. For evidence-based practice to penetrate and transform a profession, the penetration must occur at 2 levels. One level is the degree to which individual practitioners possess the willingness and basic skills to search and assess the literature. Chiropractic education received a significant boost in this realm in 2005 when the National Center for Complementary and Alternative Medicine awarded 4 chiropractic institutions R25 education grants to strengthen their research/evidence-based practice curricula. The second level relates to whether the therapeutic interventions commonly employed by a particular health care discipline are supported by clinical research. A growing body of randomized controlled trials provides evidence of the effectiveness and safety of manual therapies.

Clinical Effectiveness: Systematic Reviews and Evidence-Based Practice in Occupational Therapy

1997 ◽  
Vol 60 (11) ◽  
pp. 479-483 ◽  
Author(s):  
Katrina Bannigan
Keyword(s):  
Health Care ◽  
Occupational Therapy ◽  
Systematic Reviews ◽  
Health Care Professionals ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Occupational Therapists ◽  
Evidence Based ◽  
Sources Of Information ◽  
High Quality

Evidence-based health care can be defined as an approach to health care that involves finding and using up-to-date research into the effectiveness of health care interventions to inform decision making (Entwistle et al, 1996). For many occupational therapists, the practicalities of keeping up to date with the best research evidence is difficult; however, through the National Health Service Centre for Reviews and Dissemination (NHS CRD), the NHS Research and Development (R&D) Programme is aiming to improve the availability of high quality research evidence to all health care professionals. The NHS CRD carries out and commissions systematic reviews. Systematic reviews are a means of pulling together large quantities of research information and are considered to be one of the most reliable sources of information about effectiveness (Chalmers and Altman, 1995). The NHS CRD also disseminates the findings of systematic reviews, one method of which is through the Database of Abstracts of Reviews of Effectiveness (DARE). The relevance of systematic reviews to the clinical practice of occupational therapists is explored in this paper using two examples: a poor quality and a high quality systematic review identified from the abstracting process for DARE. Both reviews are directly relevant to occupational therapy, being about sensory integration and falls in the elderly respectively. The implications of these reviews for evidence-based practice in occupational therapy are discussed.

scholarly journals Strategies to Promote Evidence-Based Practice in Pediatric Physical Therapy: A Formative Evaluation Pilot Project

2009 ◽  
Vol 89 (9) ◽  
pp. 918-933 ◽  
Author(s):  
Joe Schreiber ◽  
Perri Stern ◽  
Gregory Marchetti ◽  
Ingrid Provident
Keyword(s):  
Decision Making ◽  
Formative Evaluation ◽  
Research Evidence ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Physical Therapists ◽  
Pilot Project ◽  
Clinical Decision ◽  
Evidence Based ◽  
Practice Behaviors

BackgroundThe physical therapy profession has been perceived as one that bases its practice largely on anecdotal evidence and that uses treatment techniques for which there is little scientific support. Physical therapists have been urged to increase evidence-based practice behaviors as a means to address this perception and to enhance the translation of knowledge from research evidence into clinical practice. However, little attention has been paid to the best ways in which to support clinicians’ efforts toward improving evidence-based practice.ObjectivesThe purpose of this study was to identify, implement, and evaluate the effectiveness of strategies aimed at enhancing the ability of 5 pediatric physical therapists to integrate scientific research evidence into clinical decision making.DesignThis study was a formative evaluation pilot project.MethodsThe participants in this study collaborated with the first author to identify and implement strategies and outcomes aimed at enhancing their ability to use research evidence during clinical decision making. Outcome data were analyzed with qualitative methods.ResultsThe participants were able to implement several, but not all, of the strategies and made modest self-reported improvements in evidence-based practice behaviors, such as reading journal articles and completing database searches. They identified several barriers, including a lack of time, other influences on clinical decision making, and a lack of incentives for evidence-based practice activities.ConclusionsThe pediatric physical therapists who took part in this project had positive attitudes toward evidence-based practice and made modest improvements in this area. It is critical for the profession to continue to investigate optimal strategies to aid practicing clinicians in applying research evidence to clinical decision making.

Navigating the Evidence-Based Practice Maze

2012 ◽  
Vol 48 (3) ◽  
pp. 159-166 ◽  
Author(s):  
Valerie L. Mazzotti ◽  
Dawn R. Rowe ◽  
David W. Test
Keyword(s):  
Decision Making ◽  
Students With Disabilities ◽  
Secondary Students ◽  
Teaching Practices ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Statewide Testing ◽  
Education Movement

Factors such as the standards-based education movement, mandated participation in statewide testing, and inclusion have forced an increased focus on improving outcomes for students with disabilities. There are many determinants of postschool success for students with disabilities; however, teachers primarily have control over only one, teaching practices and programs. As a result, it is important that teachers choose and implement practices that have proven successful for secondary students with disabilities. This article guides teachers through the process of navigating the evidence-based practice maze to identify evidence-based practices and programs for secondary students with disabilities. Particularly, it addresses the need to (a) follow a research-based framework (i.e., Kohler’s Taxonomy), (b) use practices with the best available research evidence to support effectiveness, and (c) use data-based decision making to guide use of evidence-based practices.

scholarly journals Professionalism and Evidence-Based Mental Health Care: The Roadblocks and New Ways

2019 ◽  
Vol 11 (11) ◽  
pp. 33
Author(s):  
Oyeyemi Olajumoke Oyelade ◽  
Agathe Uwintonze ◽  
Munirat Olayinka Adebiyi
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Nursing Care ◽  
Evidence Based Practice ◽  
Scientific Evidence ◽  
World Health Organisation ◽  
World Health ◽  
Evidence Based ◽  
Evidence Based Care

BACKGROUND: Knowledge acquisition and knowledge update through research remains an important factor to ensure quality and cost-effective care, which is the hallmark of professionalism and evidence-based care. Knowledge is vital in nursing due to the centrality of nursing to health care. More importantly is mental health because mental health is primary to general health, just as nursing is the heartbeat of health care. This makes the issue of mental health care, a necessary service that cannot be overemphasised. The World Health Organisation declares mental health as the essential form of health that needs to be acquired without which all others form of health may not be achieved. Further to this, the global emphasis on care and recovery of lost mental health is on the increase. This, therefore, makes evidence-based mental health care, a necessity and not a choice. AIM: To discuss evidence-based nursing, the benefits, challenges and opportunities. METHODOLOGY: This article adopts the traditional review method to assess the concept of discussion on mental health care, evidence-based practice and professionalism. FINDINGS: The term evidence-based care Is gaining recognition in a variety of professions and organisations. The use of evidence in nursing care is influenced by policies, knowledge of time management, availability of human resources, practice autonomy and attitude of professionals. However, the use of evidence-based practice is not debatable. CONCLUSION: The use of scientific evidence for validating nursing care is germane. This article exposed the barriers to evidence-based mental health nursing and the way forward. 

scholarly journals Proposal of a Holistic Model to Support Local-Level Evidence-Based Practice

2010 ◽  
Vol 10 ◽  
pp. 1520-1529
Author(s):  
Said Shahtahmasebi ◽  
Luis Villa ◽  
Helen Nielsen ◽  
Hilary Graham-Smith
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Evidence Based Practice ◽  
Local Level ◽  
Policy Formation ◽  
Decision Makers ◽  
Evidence Based ◽  
Holistic Model ◽  
Local Evidence ◽  
External Evidence

In response to a central drive for evidence-based practice, there have been many research support schemes, setups, and other practices concentrating on facilitating access to external research, such as the Centre for Evidence Based Healthcare Aotearoa, the Cochrane Collaboration, and the York Centre for Reviews and Dissemination. Very little attention has been paid to supporting internal research in terms of local evidence and internal research capabilities. The whole evidence-based practice movement has alienated internal decision makers and, thus, very little progress has been made in the context of evidence informing local policy formation. Health and social policies are made centrally based on dubious claims and often evidence is sought after implementation. For example, on record, most health care practitioners appear to agree with the causal link between depression and mental illness (sometimes qualified with other social factors) with suicide; off the record, even some psychiatrists doubt that such a link is applicable to the population as a whole. Therefore, be it through misplaced loyalty or a lack of support for internal researchers/decision makers, local evidence informing local decision making may have been ignored in favour of external evidence. In this paper, we present a practical holistic model to support local evidence-based decision making. This approach is more relevant in light of a new approach to primary health care of “local knowledge” complementing external evidence. One possible outcome would be to network with other regional programmes around the world to share information and identify “best” practices, such as the “Stop Youth Suicide Campaign”(www.stopyouthsuicide.com).

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