Evidence-Based Practice, Ethics and EHDI Program Quality
نویسنده
چکیده
Evidence-based practice (EBP) has evolved over the last decade into what might be considered a mantra of the new millennium. Early on in this evolution, Yale University’s Alvan Feinstein, who was a founding father of modern clinical epidemiology, noted that the evidence-based approach to clinical care ‘ . . . has acquired the kind of sanctity often accorded to motherhood, home and the flag . . . ’ (Feinstein and Horwitz 1997). The pervasiveness of the evidencebased approach, and the reverence accorded to it by many, have increased in recent years. Mantras and their related totems often evoke a broad range of response, from uncritical enthusiasm through to uncritical aversion. Evidence-based practice is no exception, with its share of devotees and detractors. As history often teaches us, there may prevail eventually a balanced viewpoint that is less doctrinaire, which recognizes the strengths and limitations of the new approach, and which places them more or less in proper perspective. One purpose of this article is to acquaint the reader with some tools, strengths and limitations of the evidence-based approach, at least from my own perspective. This will be done with special reference to the context of EHDI programs. This article is intended to complement, and in some areas to amplify, that by Judy Gravel in this volume. Unfortunately, this subject requires a discussion of ideas, not data, so I apologize to the reader for the wad of text and lack of nice figures. There have been many attempts to define evidence-based practice or, more specifically,
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