Evidence-based Decision-making: From 1 Different Sources
In a policy context, evidence-based decision-making is the application of the best available scientific evidence to policy decisions about specific treatments or care, as well as changes in the delivery system.
The process of systematically identifying, appraising and using the best available research ?ndings, integrated with clinical expertise, as the basis for clinical decisions about individual patients. The aim is to encourage clinicians, health-service managers and consumers of health care to make decisions, taking account of the best available evidence, on the likely consequences of alternative decisions and actions. Evidence-based medicine has been developing internationally for the past 25 years, but since around 1990 its development has accelerated. The International COCHRANE COLLABORATION ?nds and reviews relevant research. Several other centres have been set up to look at the clinical application of research results, including the Centre for Evidence-Based Medicine in Oxford.... evidence-based medicine
Evidence derived from descriptions of cases or events rather than systematically collected data that can be submitted to statistical tests.... anecdotal evidence
The blend of health and social services provided to an individual or family in his/her place of residence for the purpose of promoting, maintaining or restoring health or minimizing the effects of illness and disability. These services are usually designed to help older people remain independent and in their own homes. They can include senior centres, transportation, delivered meals or congregate meals sites, visiting nurses or home health aides, adult day care and homemaker services.... community-based care / community-based services / programmes
An approach to decision-making that involves modelling the sequences or pathways of multiple possible strategies (e.g. of diagnosis and treatment for a particular clinical problem) to determine which is optimal. It is based upon available estimates (drawn from the literature or from experts) of the probabilities that certain events and outcomes will occur and the values of the outcomes that would result from each strategy.... decision analysis
See “decision analysis”.... decision support system
See EVIDENCE-BASED MEDICINE.... evidence
The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individuals. This approach must balance the best external evidence with the desires of the individual and the clinical expertise of health care providers.... evidence-based care
See “community-based care”.... home and community-based services; home and community care programme
Planning processes which involve the allocation of resources on the basis of community need.... needs-based planning
Health services targeted at populations with specific diseases or disorders.... population-based services
see HEMS.... helicopter-based emergency medical services
(LBC) a technique used for analysing *cervical smears taken for *cervical screening. The specimen is collected using a brush or spatula and then mixed with a liquid preservative fluid. In the laboratory, this fluid is spun and filtered to remove blood and other extraneous material, leaving a thin layer of cells that is spread on a microscope slide and examined. LBC yields specimens that are easier to screen and give more accurate results than those obtained by the traditional Pap test.... liquid-based cytology
(surrogate decision) a decision made with or on behalf of a person who lacks full legal capacity to *consent to or refuse medical treatment. See best interests; Gillick competence; parental responsibility; power of attorney; substituted judgment.... proxy decision
see proxy decision.... surrogate decision
(in England and Wales under the Mental Capacity Act 2005) a legally recognized decision or statement by an adult with *capacity identifying any specific or general treatment the patient does not want in the event that he or she loses capacity. An advance directive or decision (formerly often called a living will) should be informed, made voluntarily, and must be valid and applicable to the medical situation that arises; at the extreme it can constitute an advance refusal of potentially life-saving treatment. It cannot, however, be used to demand future treatment and does not apply as long as the person retains capacity. An advance statement is a more general and less legally binding expression of the person’s values and views on the sort of treatment he or she may or may not wish to undergo. Directives and statements can raise ethical questions: for example, should life-saving treatment refused in advance nevertheless be given if it could restore the patient to a quality of life with which he or she was content before losing capacity.... advance directive, decision, or statement
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