Tywanna Swain_Evidence-Based Medicine Policy Analysis
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Evidence-Based Policy Medicine Analysis
Tywanna Swain
The University of Arizona Global Campus
MHA 620: Health Policy Analyses
Andrea Curry
February 06, 2024
Evidence-Based Policy Medicine Analysis
Evidence-based medicine (EBM) is an idea that has grown in popularity in recent years and is seen to represent the expertise that healthcare professionals need to have. Different titles for the phrase have been adopted, including evidence-based practice and, more recently, translational medicine (McLaughlin & McLaughlin, 2014, para. 233). Dave Sackett and his McGill University clinical epidemiology colleagues are credited with coining the phrase, which they first published in a Canadian publication in 1980 (McLaughlin & McLaughlin, 2014, p. 233). Improving medical outcomes using the best available evidence is the aim of evidence-
based medicine (Tenny & Varacallo, 2023). Several necessary parties participate in the process, each with a specialized responsibility in hopes of producing a successful outcome.
Process of Evidence-Based Analysis
Evaluating and making decisions based on the best available evidence is a systematic process known as "evidence-based analysis" (Burns et al., 2012).
A straightforward inquiry must typically be formulated, pertinent information must be found, the evidence must be critically evaluated, the findings must be synthesized, and the conclusions must be applied to the particular
situation (Kang, 2016, para. 1). Assuring that trustworthy and legitimate data support choices and actions is the aim of this approach, which eventually produces better and more efficient results (Kang, 2016, para. 1). This is similar to the methods applied in continuous quality improvement. The foundation of evidence-based medicine is ongoing organizational, professional, and/or personal learning (McLaughlin & McLaughlin, 2014, p. 236). Naturally, the
provider's involvement is crucial, but individuals with chronic illnesses can also excel at it in their area of interest (McLaughlin & McLaughlin, 2014, p. 236).
Major Players and their Roles in EBM Policy
There are many critical players involved in the evidence-based medicine policy process. First and foremost, the policymaker is the one who creates laws, regulations, and programs that control a particular population (Fedorowicz & Aron, 2021). Decisions made by policymakers are
influenced and limited by various factors, and they obtain their information from several sources.
Advocates are the next important group (Fedorowicz & Aron, 2021). They acquire and synthesize data and evidence on a particular topic to influence public opinion and persuade politicians in ways that further particular agendas (Fedorowicz & Aron, 2021). They also represent a particular cause or goal. Another essential participant is the research scientist, the primary source of evidence related to policy (Fedorowicz & Aron, 2021). Next are funders of research and practitioners who bring their agendas, perspectives, and expertise to EBM (Fedorowicz & Aron, 2021). Another essential component in evidence-based policymaking is the
government. Since many federal programs rely on state support and action, strong connections between the federal government and the states are often necessary for evidence-based policymaking to be effective. State organizations are crucial to producing and applying evidence as they run programs, execute policies, and gather data (Kelly et al., 2017, p. 681).
Levels of Evidence Evidence-based medicine (EBM) is the process of locating evidence and applying it to clinical decision-making, as the term implies. The evidence is categorized hierarchically, which is a fundamental component of EBM. The degrees of evidence are the names given to this system. (Burns et al., 2012, p.305). The levels of evidence are primarily itemized in a pyramid format. The fewest studies with the highest reliability are represented at the top of the pyramid (McLaughlin & McLaughlin, 2014, p. 237). At the bottom are the least reliable ones, the
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anecdotes, personal opinions (expert or otherwise), and case reports, which are greatest in number, and the pyramid may have anywhere from 4 to 10 levels" (McLaughlin & McLaughlin, 2014, p. 237). These pyramids defy logic since randomized controlled studies, also known as the "gold standard," are in the middle while expert opinions are at or near the bottom (McLaughlin &
McLaughlin, 2014, p. 237). Studies that are systematic and incorporate data from several studies rank highest. A small number of studies syntheses would come next, then meta-analyses incorporating several studies (McLaughlin & McLaughlin, 2014, p. 237). Next, are controlled trials that are randomized. Case-control studies will likely come next, then cohort studies after that. Each level represents a distinct level of rigor and reliability in the evidence (McLaughlin & McLaughlin, 2014, p. 237). Constraints on ACA Case Analysis
The ACA recognized the advancement of evidence-based medicine and created the Patient-Centered Outcomes Research Institute in collaboration with the Centers for Medicare and
Medicaid Services, as stated in the "Constraints of the ACA on Evidence-Based Medicine" case (McLaughlin & McLaughlin, 2014, p. 248). They also limited how the Institute's research could be used, which caused concern with federal lawmakers (McLaughlin & McLaughlin, 2014, p. 248). Specific rules by Medicare were offered, and the ACA added constraints on how evidence should be used and outlined several provisions on who should utilize the evidence (McLaughlin & McLaughlin, 2014, p. 248).
Conclusion Evidence-based medicine (EBM) is a methodical approach that assesses the best available data to inform decisions. Policymakers, advocates, research scientists, funders,
practitioners, and the government are just some essential parties involved. A key component of EBM is the hierarchy of evidence levels, where the most trustworthy research is placed higher. EBM promotes making healthcare decisions based on the best available scientific data in conjunction with practitioner judgment and patient preferences. By encouraging the use of the best interventions and well-informed decision-making, EMB seeks to raise the standard of healthcare.
References
Bernstein, J. (2004). Evidence-Based Medicine. JAAOS - Journal of the American Academy of Orthopaedic Surgeons
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(2), 80. https://journals.lww.com/jaaos/abstract/2004/03000/evidence_based_medicine.3.aspx
Burns, P. B., Chung, K. C., & Rohrich, R. J. (2012). The Levels of Evidence and Their Role in evidence-based Medicine. Plastic and Reconstructive Surgery
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(1), 305–310. https://doi.org/10.1097/PRS.0b013e318219c171
Fedorowicz, M., & Aron, L. (2021). Improving Evidence-Based Policymaking: A Review
. https://www.urban.org/sites/default/files/publication/104159/improving-evidence-based-
policymaking.pdf
Kang, H. (2016). How to understand and conduct evidence-based medicine. Korean Journal of Anesthesiology
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(5), 435. https://doi.org/10.4097/kjae.2016.69.5.435
Kelly, M. P., Atkins, L., Littleford, C., Leng, G., & Michie, S. (2017). Evidence-based medicine meets democracy: the role of evidence-based public health guidelines in local government. Journal of Public Health
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(4), 678–684. https://doi.org/10.1093/pubmed/fdx002
McLaughlin, C. P., & McLaughlin, C. D. (2014).
Health policy analysis: An interdisciplinary approach
(2nd ed.). Jones & Bartlett Learning.
Tenny, S., & Varacallo, M. (2023). Evidence Based Medicine
. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470182/#:~:text=The%20goal%20of
%20evidence%2Dbased
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