Success factors for evidence-based healthcare practice adoption

Background: Evidence-based health policies are widely acknowledged as being essential for attaining ongoing improvements in health outcomes. This study represents a theoretical model to test and identify to identify the key drivers for adopting evidence-based healthcare practice (EBHP). Objectives: The goal of this study was to investigate the critical success factors for the adoption of evidence-based healthcare at a South African public hospital. Methods: Medical healthcare professionals were surveyed using a questionnaire developed by the researcher. The results were analysed with SPSS 23 and AMOS. A hypothetical model based on updated (D&M) IS Success Model, Technology, Organization and Environment framework (TOE) as well as Technology Acceptance Model (TAM) was developed and analysed using structural equation modelling (SEM). Results: The findings of this study indicate that EHR is crucial and the main construct influencing the adoption of EBHP. The findings of this study indicated a positive relationship between the construct electronic health records (EHR) with medical error reduction (MER), information quality (IQ) and knowledge quality (KQ), all showed a strong positive correlation towards the adoption of EBHP. Conclusions: Better coordination of patient care (BCP) typically results in lower health care costs. The results also show that using EBHP improves the accuracy of disease diagnosis and treatment, which lowers the burden of disease. Contribution: The developed framework will help healthcare systems that are strapped for money, particularly in developing countries.

Systematic reviews on interventions for COVID-19 have rarely graded the certainty of the evidence

ABSTRACT BACKGROUND: Numerous systematic reviews on coronavirus disease-19 (COVID-19) treatment have been developed to provide syntheses of the large volume of primary studies. However, the methodological quality of most of these reviews is questionable and the results provided may therefore present bias. OBJECTIVE: To investigate how many systematic reviews on the therapeutic or preventive options for COVID-19 assessed the certainty of the evidence through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. METHODS: We conducted a sensitive search in MEDLINE (via PubMed) and included all systematic reviews that assessed any intervention for COVID-19. The systematic reviews included were examined to identify any planned and/or actual assessment using the GRADE approach (or absence thereof) regarding the certainty of the evidence. RESULTS: We included 177 systematic reviews and found that only 37 (21%; 37/177) assessed and reported the certainty of the evidence using the GRADE approach. This number reduced to 27 (16.2%; 27/167) when Cochrane reviews (n = 10), in which an evaluation using GRADE is mandatory, were excluded. CONCLUSION: Most of the systematic reviews on interventions relating to COVID-19 omitted assessment of the certainty of the evidence. This is a critical methodological omission that must not be overlooked in further research, so as to improve the impact and usefulness of syntheses relating to COVID-19.

Scoping review: a relevant methodological approach for knowledge synthesis in Brazil's health literature / Revisão de escopo: uma abordagem metodológica relevante para a síntese de evidências da literatura em saúde no Brasil

A methodologically robust approach to synthesize relevant knowledge in health literature is the scoping review, which is used to answer broader questions (e.g., "What is known about this concept?") and can be used to map evidence for research and practice decision-making. This paper discussed the importance of scoping reviews as a methodological approach for knowledge synthesis in Brazil's health literature. Definitions and methodological steps were discussed. We examined 45 scoping reviews that were published in Brazil's journals or available as thesis or dissertations to dis-cuss their content and methodological characteristics. Recommendations for authors were presented in order to improve the planning, executing and reporting of further scoping reviews in Brazil. This will help Brazilian researchers and health professionals to understand when and how scoping reviews can be helpful for knowledge synthesis on health topics, including for physical activity and health research area

Uma abordagem metodologicamente robusta para sintetizar a literatura relevante em saúde é a revisão de escopo, a qual é utilizada para responder questões abrangentes (por exemplo, "O que se conhece sobre um de-terminado conceito em saúde?") e pode ser utilizada para mapear evidências para a tomada de decisão prática e em pesquisa. Este artigo discutiu a importância de revisões de escopo como uma abordagem metodológica para síntese de conhecimento da literatura em saúde no Brasil. As definições e as etapas metodológicas foram discutidas. Um sumário das 45 revisões de escopo que foram publicadas em periódicos brasileiros ou como tese/dissertação foi apresentado para discutir seu conteúdo e suas características metodológicas. Recomendações para os autores foram apresentadas para melhorar o planejamento, execução e descrição de revisões de escopo a serem realizadas no Brasil. Este estudo pode ajudar pesquisadores e profissionais de saúde brasileiros a compreender quando e como revisões de escopo podem ser úteis na síntese de evidências, incluindo para o campo de pesquisas em atividade física e saúde

Roles of Health Technology Assessment for Better Health and Universal Health Coverage in Korea / 보건행정학회지

Health technology assessment (HTA) is defined as multidisciplinary policy analysis to look into the medical, economic, social, and ethical implications of the development, distribution, and use of health technology. Following the recent changes in the social environment, there are increasing needs to improve Korea's healthcare environment by, inter alia, assessing health technologies in an organized, timely manner in accordance with the government's strategies to ensure that citizens' medical expenses are kept at a stable level. Dedicated to HTA and research, the National Evidence-based Healthcare Collaborating Agency (NECA) analyzes and provides grounds on the clinical safety, efficacy, and economic feasibility of health technologies. HTA offers the most suitable grounds for decision making not only by healthcare professionals but also by policy makers and citizens as seen in a case in 2009 where research revealed that glucosamine lacked preventive and treatment effects for osteoarthritis and glucosamine was subsequently excluded from the National Health Insurance's benefit list to stop the insurance scheme from suffering financial losses and citizens from paying unnecessary medical expenses. For the development of HTA in Korea, the NECA will continue exerting itself to accomplish its mission of providing policy support by health technology reassessment, promoting the establishment and use of big data and HTA platforms for public interest, and developing a new value-based HTA system.

Evidence-based practice

Evidence-based practice (EBP) has seen tremendous growth in recent years. EBP provides an opportunity for clinicians and healthcare professionals to provide the best treatment possible based on the best available evidence, which will in turn result in better patient outcomes. The Joanna Briggs Institute’s (JBI) approach to evidence-based healthcare provides a better understanding of the role that evidence plays in clinical practice with a central focus on the effectiveness, meaningfulness, appropriateness and feasibility of health practices and delivery methods.

EVIDENCE: CREATE, COMMUNICATE AND UTILIZE / 体力科学

EBM is the integration of best research evidence with clinical expertise and patient values. EBM has been extending to “evidence-based healthcare/practice” with wider perspectives. When considering healthcare-related evidence, it is useful to distinguish three aspects. Namely, they are “create”, “communicate”and “utilize”. At first, “clinical questions” are generated in real clinical settings. To create clinical evidence, “clinical questions” need to be refined as “research questions”. Concerning the aspect of communication, there are lots of proposals and statements to improve the reporting of research findings. The Uniform Requirements for Manuscripts Submitted to Biomedical Journals proposed by the International Committee of Medical Journal Editors has been evolved since 1979 and has become the global standard for scientific authors and editors. Concerning the aspect of “utilize”, there are two problems, that is, overuse and underuse of evidence. The former is related with the problem of evidence-practice gap. Appropriate use of clinical practice guidelines are expected to reduce these gaps. The latter is linked with the confusion that evidence equals EBM. Evidence is merely evidence even if the level is high in scientific and general meaning. When clinicians make individual decisions, they are required to do them comprehensively balancing the three factors such as evidence, value and resource.

Evidence-Based Healthcare: Seeking for the Broken Virtuous Circle

Several hot issues boiled our healthcare system in these years: off-label drug use, DUR, reuse of single-use devices (SUD), and conflicts in adopting new health technologies. Perhaps, most of conflicts among the stakeholders and policy makers of healthcare system can be explained by lack of communications and unsatisfactory efforts to understand each other. Evidence-based healthcare might be a solution, a common language to talk each other. Hence, it is worthwhile to assemble a strategic approach of evidence generation and synthesis of evidence. Furthermore, the introduction of conditional coverage decision in the national health insurance system is necessary to deal with uncertainty. To summarize, proper synthesis of evidence and a prudent use of it along with social values in decision making process is an answer to the conflicts. Now is the time to advance to a virtuous cycle of evidence-based healthcare.