What is Evidence based healthcare?

Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.

Individual clinical expertise means the proficiency and judgment that individual clinicians acquire through clinical experience and clinical practice. Increased expertise is reflected in many ways, but especially in more effective and efficient diagnosis and in the more thoughtful identification and compassionate use of individual patients’ predicaments, rights, and preferences in making clinical decisions about their care.

Components of EBP

• Set of rules and institutional arrangements designed to encourage transparent and balanced use of evidence in public policy making.
• Controlled trials and observational studies.
• Broad range of theoretical and empirical evidence about human behavior.
• stakeholder opinions and other sources of intelligence
• Potential to facilitate open democracy and to improve policy outcomes.

Types of evidence for evidence-based policy:

1. Quantitative Evidence

Quantitative evidence for policymaking (i.e., data in numerical quantities) can take many forms, ranging from scientific information in peer-reviewed journals, to data from public health surveillance systems, to evaluations of individual programs or policies.

2. Qualitative Evidence

Qualitative evidence involves non numerical observations, collected by methods such as participant observation, group interviews, or focus groups. Qualitative evidence can make use of the narrative form as a powerful means of influencing policy deliberations, setting priorities, and proposing policy solutions by telling persuasive stories that have an emotional hook and intuitive appeal.

EBP in health care will be very suitable for India due to following:

There is immense need of focus on identifying the specific policy elements that are likely to be effective. Both quantitative and qualitative data can be used by policymakers to determine the appropriate policy intervention for diverse sections of the society.

The increasing load of life style diseases needs preventive care for large sections of the society. The evidence based health care policy can manage this challenge to considerable extent.

The insurance policies can be better implemented through scientific approach of healthcare management.

EPB is highly democratic in nature and thus goes parallel with the welfare philosophy of the state.

Medical device standards are just about evolving in India. Mechanisms of evaluation and evidence are based on standards borrowed from the drug industry. Such policy can be helpful in affordable availability if healthcare facilities.

Documenting the effects of implemented policies (policy outcome) is equally important in supporting evidence-based policy. Policy evaluations are critical to the understanding of the impact of policies on community- and individual-level behavior changes.

Making public policy is a continuous or recursive process that relies heavily upon scientific evidence and other influences scientific evidence that examines the impact of public policies on systems and individual-level behavior change is one possible source of feedback.

Conclusion:

India would do well to adopt a comprehensive health technology assessment that is a multidisciplinary process that handles and analyses information on medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner. It would be a better approach to informed decision making on funding decisions leading to efficient access and use of technology.