This work was completed while the author was employed in the Department of Bioethics, National Institutes of Health. The views expressed are those of the author and do not represent the positions or policies of the National Institutes of Health or the Department of Health and Human Services. Steve Pearson and Marion Danis provided constructive feedback on earlier versions of this paper.
Evidence-based medicine beyond the bedside: keeping an eye on context
Article first published online: 31 OCT 2008
© 2008 Blackwell Publishing Ltd. No claim to original US government works
Journal of Evaluation in Clinical Practice
Special Issue: Evidence Based Medicine
Volume 14, Issue 5, pages 721–725, October 2008
How to Cite
Tilburt, J. C. (2008), Evidence-based medicine beyond the bedside: keeping an eye on context. Journal of Evaluation in Clinical Practice, 14: 721–725. doi: 10.1111/j.1365-2753.2008.00948.x
- Issue published online: 31 OCT 2008
- Article first published online: 31 OCT 2008
- Accepted for publication: 17 September 2007
- decision making;
- evidence-based medicine;
- health policy;
Rationale Evidence-based medicine is being applied to decisions in a range of contexts beyond one-to-one patient care. Yet considerable disagreement persists regarding the defining components of evidence-based decision-making, particularly in institutional and public health contexts.
Aims and Objectives This article reviews the key elements of evidence-based decision-making for clinical medicine, and adapts those key elements and argues for their broad applicability to a variety of decision-making contexts including institutional, public health, and self-care decision-making contexts.
Methods Conceptual Analysis.
Results Evidence based decision-making involves research evidence, “social and institutional circumstances”, and “values” of stakeholders. Furthermore, evidence-based decision-making includes “judgment” exercised by experts to appropriately weigh and integrate the various decision-making elements.
Conclusion Asking critical questions about the purposes and context of a specific decision, basic principles of evidence-based reasoning can be appropriately applied beyond the bedside.