MHA 620 Assignment (Wk 3)
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Evidence-Based Medicine Policy Analysis
Amber Cuyler
The University of Arizona Global Campus
MHA 620 Health Policy Analyses
Catherine Kisavi-Atatah
12/11/2023
Explain the process of evidence-based analysis.
Daily there are obstacles that arise in healthcare. It is important that these issues are dealt with practically. That is why we have the practice of evidence-based medicine. In a 1996 article, they presented a revised definition, stating that evidence-based medicine is “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research” (Sackett et al., 1996). (
McLaughlin, C. P., &
McLaughlin, C. D. (2014). As we know, any major change in healthcare affects the public, whether it be a change in an individual patient health plan, or a health policy that is going to be implemented by the public, these solutions to health concerns should be adequately accessed. This is what starts the process of evidence-based analysis. During this analysis process a health decision is broken down and thoroughly to ensure that decision made is the most effective in the given situation. There are several important steps that should be taken. First the problem needs to
be identified. Once the problem is identified the research can begin, next is accessing the level of
the evidence and its validity, and selecting the best available answer for implementation, then trying the approach in one’s clinical practice. Once clinical testing has been completed, and the researchers have concluded the positive aspects of testing, then adapting this knowledge to the needs of the specific patient, or public can be done. (McLaughlin, C. P., & McLaughlin, C. D. (2014) The most important aspect to all evidence-based analysis is making sure research is thoroughly done and that the research is focused on medical concern.
Highlight the major players and their roles in EBM policy (i.e., government, providers,
patients, etc.)
When you focus on the major players in any EBM policy you have to determine what is the focus. For example, if a healthcare official is working on devising a health plan, where the physician uses a different health approach that is not commonly used in the medical field, then the major player in the EBM policy would be the provider and the patient. The goal with EBM is
to critically assess possible adverse reactions to any medical treatment used in the public. That is why patients are one of the most important players in EBM. When a public health policy is trying to be implemented, such as a vaccine or new medicine, that is going to be consumed by the public, it must be tested, not only for safety, but to also make sure it’s practical to address the health need. For example, during the COVID pandemic, because it was such a new disease, there
was no vaccine. After conducting research gathering evidence on the disease they were able to address the health problem, which was COVID, and begin constructing the vaccine, which they had to test, to decide which treatment would be the most effective. In this instance the major players in the EBM policy would be the government and healthcare providers. These are the individuals who would have the knowledge to enforce all healthcare policies. Explain the EBM “Levels of Evidence” as defined in your course text.
For an “evidence-based” decision to be made you must conduct research to gather information. This could be as simple as googling a concern. The methods used to obtain this information are put into various categories or “levels” As stated in our text, “Anyone who goes on an Internet search engine looking for images related to “levels of evidence” will be deluged with graphical representations, mostly pyramidal, expressing pretty much the same rankings. The top of the pyramid represents the most reliable studies, which are the fewest in number. At the bottom are the least reliable ones, the anecdotes, personal opinions (expert or otherwise), and case reports,
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which are greatest in number.” ((
McLaughlin, C. P., & McLaughlin, C. D. (2014) There could be
anywhere from 4 to 10 various levels. All information collected is used by the designated individual who is analyzing the specific health policy.
Review the case “Constraints of the ACA on Evidence-Based Medicine.”
The ACA was the catalyst for making evidence-based medicine more prominent. As stated in our
required text, “The ACA expanded the emphasis on developing evidence-based medicine in the 2009 stimulus act and established the Patient-Centered Outcomes Research Institute (PCORI) within the Centers for Medicare & Medicaid Services.” ((
McLaughlin, C. P., & McLaughlin, C. D. (2014) Although this new legislative in a way expanded the focus on evidence-based medicine the legislation still put limits on the research that could be used. This is where you start to see the constraints of the ACA. As the ACA established the Patient-Centered Outcomes Research Institute, the research that they acquired had stipulations. For example, as noted in our required text, “Pearson and Bach (2010) noted: Under current law and because of years of precedent, Medicare generally covers any treatment that is deemed “reasonable and necessary,” regardless of the evidence on the treatment’s comparative effectiveness or its cost in relation to other treatments. “As you can see, these researchers could have introduced new healthcare innovative treatment, but if the ACA deemed it “unnecessary” they could negate all the research that was used. Provide a written analysis of the case “Constraints of the ACA on Evidence-Based
Medicine” in Chapter 9 of your textbook. (Utilize the “Levels of Evidence and Grades of
Recommendations” as defined by the University of Minnesota) Clearinghouse.
In the section “Constraints of the ACA on Evidence-Based Medicine” in our required text it details the impact of the ACA legislation on health research for organizations such as the Department of Health and Human Services. As the ACA was implemented, they listed these specific “constraints”. For example, as stated in the ACA legislation, “SEC. 1182 o42 U.S.C. 1320e–1. (a) The Secretary may only use evidence and findings from research conducted under section 1181 to make a determination regarding coverage under title XVIII (Medicare) if such use is through an iterative and transparent process which includes public comment and considers the effect on subpopulations.” (
McLaughlin, C. P., & McLaughlin, C. D. (2014) This shows that when dealing with various health concerns, the government can determine the viability of any research being conducted to address health concerns. Determining viability of the information is what affects the level of evidence and grades of recommendation. Summarize the policy of EBM in your conclusion.
Evidence-Based Medicine is a very important asset in implementing healthcare policies. As various policies are being devised to innovate healthcare, these changes must be carefully assessed. With the process of EBM these health changes are being reviewed so that healthcare organizations and healthcare officials can properly deliver health treatments to the public. Although there are several major players in the EBM process, these individuals work together to establish health policies that are effective for the public. With the research being the foundation of any decision it is important that there is a process to ensure health organization, and health officials are using accurate information to ensure the health and safety of everyone.
References:
McLaughlin, C. P., & McLaughlin, C. D. (2014).
Health policy analysis: An interdisciplinary approach
(2nd ed.).
Jones & Bartlett Learning.
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