Evidence‐based practice and emergency medicine: A mismatch?

Abstract

Evidence‐based practice, also known as evidence‐based medicine, has been suggested as a more suitable basis for decision making in clinical practice than the traditional ‘expert’ based approach. Central to evidence‐based practice is the application of evidence (as found in the published literature) to an individual clinical problem. Evidence‐based practice, however, has limitations that may raise questions regarding its applicability to particular types of clinical situations, including many of the problems encountered in emergency medicine.

Clinical Measurement as a Resource for Evidence-Based Practice in Physiotherapy

“…In a well-conducted study carried out in New South Wale, United Kingdom, 60% of survey participants reported that perceived impacts on the therapeutic alliance is a barrier to applying evidence, followed by skills and environmental context and resources [36]. These reported barriers are similar to those reported from other similar studies conducted by other healthcare disciplines such as nursing [37][38][39][40][41], internal medicine [42], emergency medicine [43], and dentistry (Table 2) [44].…”

Emergency department management of hip fractures: Development of an evidence‐based clinical guideline by literature review and consensus

“…Now there is growing awareness of the need to validate clinical guidelines against the best available evidence as expert opinion does not always reflect current knowledge 1 . The applicability of evidence‐based practice to the ED context has been questioned 7 . Clinical decisions in the ED are often made under conditions of uncertainty with limited or obscure information, minimal time and little margin for error 8 .…”

“…Clinical decisions in the ED are often made under conditions of uncertainty with limited or obscure information, minimal time and little margin for error 8 . Given the physical, psychological and cognitive demands of emergency care, it is unrealistic to expect clinicians to conduct their own search for evidence, to critically appraise the literature and to reach valid conclusions on which to base their practice 7 . Evidence‐based guidelines have the ability to present the strengths, weaknesses and relevance of research findings to clinicians and distinguish care modalities that achieve positive patient outcomes while optimizing resources 2 …”