Is Our Clinical Decision Making Based on the Best Research Evidence?



Kachuie MA¹ ; Sadeghizadeh A¹ ; Khalighinejad N¹ ; Mozafarpour S¹ ; Kabiri P^{2, 3} ; Changiz T³ ; Aminpour F^{3, 4} Show Affiliations
Source: Journal of Isfahan Medical School Published:2011

Abstract

Introduction: Evidence based practice is an approach to clinical practice which emphasizes the use of best clinical researches as a component of clinical decision making. The aim of this study was to determine the percentage of current clinical decision making and disease management which is based and supported by high-level evidence in an educational hospital located in Isfahan, Iran. Methods: A cross-sectional study was carried on 103 patients who were admitted during one month to seven Internal medicine wards in Alzahra hospital. For each patient, the primary diagnosis and primary treatment were recorded. Evidence based resources were then searched for randomized controlled trials (RCT's), systematic reviews and clinical practice guidelines to find the best research evidence that the treatments were effective. The main outcome measure was the level of evidence which supports the primary intervention for the primary diagnosis of each patient. Finding: Level I evidence (at least one randomized trial) supported the primary intervention used in 68.9% of internal admissions and level II evidence (convincing non-experimental evidence) supported the primary intervention in 31.1% of admissions. None of patients received intervention with level III supporting evidence. Conclusion: Most patients had received high level supported interventions. It seems that we should repeat this study in other wards. Also it may be recommended to design some educational evidence based practice for non academic physicians.