Ratner Nan Bernstein
Department of Hearing and Speech Sciences, 0100 Lefrak Hall, The University of Maryland, College Park, MD 20742, USA.
Lang Speech Hear Serv Sch. 2006 Oct;37(4):257-67. doi: 10.1044/0161-1461(2006/029).
The purpose of this article is to consider some of the ramifications that arise when a discipline newly endorses evidence-based practice (EBP) as a primary guiding principle. Although EBP may appear straightforward, events experienced by peer disciplines that have preceded us in the implementation of EBP raise questions about defining acceptable forms of evidence for treatment effectiveness and efficacy, the potential roles of nonspecific or common factors, therapist quality in achieving therapy outcomes, and eventual applications of EBP that may overly confine which treatments are considered acceptable and reimbursable.
Through narrative review of the literature, the article examines valuable as well as controversial features of EBP in addition to obstacles that may impede the transition of evidence (research findings) to clinical practice.
EBP is a valuable construct in ensuring quality of care. However, bridging between research evidence and clinical practice may require us to confront potentially difficult issues and establish thoughtful dialogue about best practices in fostering EBP itself.
本文旨在探讨当一门学科新近将循证实践(EBP)作为主要指导原则时所产生的一些影响。尽管循证实践看似简单直接,但在我们之前实施循证实践的同行学科所经历的事件,引发了关于确定治疗有效性和疗效的可接受证据形式、非特异性或共同因素的潜在作用、治疗师在实现治疗结果方面的素质,以及循证实践的最终应用可能过度限制哪些治疗被视为可接受和可报销的问题。
通过对文献的叙述性综述,本文除了探讨可能阻碍证据(研究结果)向临床实践转化的障碍外,还研究了循证实践的有价值和有争议的特征。
循证实践在确保医疗质量方面是一个有价值的概念。然而,在研究证据和临床实践之间架起桥梁可能要求我们面对潜在的难题,并就促进循证实践本身的最佳实践建立深入的对话。