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Evidence-based Decision Making: Introduction and Formulating Good Clinical Questions

Course Number: 311

The Need for EBDM

An evidence-based approach emerged in response to the need for improving the quality of health care, keeping up with the evidence as it changes with new research, and demonstrating the best use of limited resources. Forces driving the need to improve the quality of care include:

  1. variations in practice,

  2. slow translation and assimilation of the scientific evidence into practice,

  3. managing the information overload, and

  4. changing educational competencies that require students to have the skills for lifelong learning.

Table 1. The Need For EBDM.

Forces Driving the Need for EBDMProblemResult of using EBDM
Variations in Practice6,7Translation of research for use in practice is not fully applied so that patients receive the best possible care.Enhances consistency of practice.

Increases standards of practice and practice guidelines based on scientific evidence.
Slow Translation and Assimilation of Research into Practice8Patients do not receive the best possible care as soon as it is available and ineffective care is not discontinued.Allows clinicians to stay current in order to close the gap between what is known and what is practiced.
Managing the Information Overload9Ability to keep up with the increasing publication of clinical research studies in multiple journals and databases. Also, quick access to health information, new products and procedures is now available, however not all sources are accurate and can be misleading or not appropriate.Access to computers and online databases, i.e., PubMed, allow clinicians to quickly find research evidence to accurately answer questions and provide patient-centered care that is based on an evaluation of the most recent scientific findings.
Changing Educational RequirementsADA Accreditation Standards10 and ADEA Competencies for the New Dentist11 and for Dental Hygienists12 have been updated and now require programs to integrate an evidence-based approach in clinical decision making. This is a change rather than a problem.Greater emphasis is placed on the importance of comprehensive patient-centered care and the need for adding evidence-based decision-making to the traditional experienced-based decision-making approach.
©2010 Forrest and Miller, National Center for Dental Hygiene Research & Practice