The Need for Evidence-based Practice

Proponents of EBP argue the need for EBP with four main points. These are: ‘the research-practice gap, poor quality of most research, information overload and practice which is not evidence-based’ (Trinder 2000, p.3-4).

During the last century there has been an exponential growth of research and knowledge (Humphreys, McCutcheon 1994, p.18). The growth of health care information has been particularly rapid in diagnostic and therapeutic technologies, with the sheer volume of medical papers published doubling every 10 to 15 years (Hook 1999, p.3) and electronic access to full text articles and journals available since 1998 (Delamothe and Smith 1998, p.1109-10). Although, with all this research it was still argued that many medically based practitioners have a research-practice gap, which basically means that there is a limited extent to which they utilize and draw upon research finding to determine or guide their actions. Ultimately, they rely on indicators such as ‘prior knowledge, prejudice, outcomes of previous cases, fads or fashions, and advice from senior colleagues’ (Trinder 2000, p.4). With this expansion of information, our knowledge should be greater and our practice should be more effective. Unfortunately this is too often not the case (Walker, Grimshaw , Johnston, Pitts, Steen , Eccles 2003, p.19). This recognised gap between best evidence and practice is one of the driving forces behind the development of EBP.

Furthermore, it can be seen that many of those who do utilise research findings note that most research is methodically weak and of a generally poor quality. For example, the studies have not utilised the ‘gold standard of research, such as a well conducted randomized controlled trial (RCT)’(Trinder 2000, p. 4).

Those who do find research papers often discover information overload, which relates to the sheer amount of research papers available. According to Hook the volume of medical papers published doubles every 10 to 15 years (1999, p.3). Therefore the task of distinguishing between rigorous and useful research and poor or unreliable research has become a much more difficult task for clinicians and practitioners (Trinder 2000, p. 4).

Lastly, it can be seen that many practitioners are utilising techniques that are not based on evidence. The consequences of these previous factors result in the continual utilisation of medical interventions that have ‘been shown to be ineffective, harmful, slow or limited adoption of interventions which have been proven to be effective or more effective, and there continue to be variances in practice’ (Trinder 2000, p.4).