The Research Process: Evidence Based Treatment

Evidence-Based Treatment (EBT) or Evidence-Based Practice (EBP) refers to the practice of incorporating study results and procedures into everyday practical application by practitioners. While study results may seem like an obvious source of knowledge for practitioners, in reality it has been a difficult procedure to transfer that knowledge from the researcher to the practitioner. Thus, EBT establishes guidelines on finding, critically analyzing, incorporating, and applying the knowledge to practice.

For an excellent description of the origins, process, and future directions of EBT (referred to as Evidence-Based Medicine here), please refer to this book chapter, located in the SAGE Reference Library database:


The EBT Process contains four steps:

1) Formulating the question
2) Searching for and acquiring evidence from literature
3) Assessing the evidence for methodological validity and analyzing the study results for statistical significance and importance
4) Applying, where appropriate, the valid study results to the patient

EBT is a patient-centered process, so your information need will begin when a patient presents physical or mental symptoms. To ensure that you, as a practitioner, are providing the best options to your patient, you will need to design a query that takes into account the particular symptoms and condition of your patient. Designing an appropriate question is critical. A well thought out question will focus your research efforts and provide clear criteria to evaluate search results. The PICO method of question formulation is most commonly used in EBT.

Patient, population, or problem
Intervention
Comparison
Outcome 

Example of a PICO formulated question:

P: In a group of otherwise healthy 10-12 year olds who are exhibiting symptoms of asthma, I: what are the effects of bronchodilators, C: versus theophylline (comparison can also be placebo), O: to control and eliminate asthma symptoms?  

Steps 3 and 4 of the EBT process will vary depending on the type of information you find in step 2. If you are working with primary studies then you will need to evaluate that study for validity and understand how the results of that study apply to your patient's particular case. If you have found meta-analyses of primary resources then much of the validation will be provided for you in the analysis.

Remember, EBT is a patient-centered process, so you must take into account other factors like patient preference and cost of treatment when determining the options for the patient. Through EBT research you may have found promising options for the patient, but your experience and judgment will be an important part of the process.