Evidence-based programs become more often required and necessary in almost all areas of activity. The field of healthcare and mental health is most in need of such programs, since the introduction of new treatment methods requires accuracy and a high probability of their effectiveness because their main aim is people’s health and well-being. However, despite the development and prevalence of evidence-based programs, there are still shortcomings in their details and policies that need to be improved.
Scholars, researchers, and policymakers offer a variety of definitions for evidence-based programs; however, they all have the same meaning. For example, the definitions of the American Psychological Association (APA) and The Oregon Addictions and Mental Health Division (AMH) are essentially the same. Both organizations define evidence-based programs as practices that combine the best scientific evidence with clinical practice, patient values, and cultural competence (“Policy Statement,” 2005; The Oregon Addictions and Mental Health Division, 2007). Consequently, evidence-based programs are new approaches to treating and diagnosing patients or organizing the work of institutions and facilities, which are aimed at obtaining positive outcomes sand have scientific evidence of their effectiveness.
However, evidence-based programs differ in their purpose, audience, duration, and quality, which should be considered in the process of choosing. The first most important feature of the program is the quality and relevance of the evidence it uses. For example, AMH (2007) identifies three levels of evidence that meet the criteria for determining it as valid. Such levels include studies conducted in a controlled and routine care setting, controlled or routine care setting, and those that are difficult to study in a controlled environment. In other words, a study should have pieces of evidence based on empirical research but not just assumptions and clinical experience. At the same time, research should be transparent, standardized, have meaningful results, comply with a fidelity scale and replication principle, and be published in a peer-review journal (AMH, 2007). Meeting these elements or criteria usually demonstrates that the evidence-based program is reliable and valid.
In addition, it is also necessary to assess the capabilities and goals of the institution to chose an effective and appropriate program. For this reason, program duration and cost, characteristics of the researched group, and patient values are also criteria of selection. For example, if a program has any ethical aspects that are not in line with hospital policy, it can be rejected by the facility.
However, these criteria also cannot be universal and have some drawbacks. Tanenbaum (2005), in her article, speaks of several policy contradictions for the use of evidence-based practices in the field of mental health. For example, the author says that the criteria for defining research or programs as evidence-based are imperfect because they rely more on technical aspects (Tanenbaum, 2005). Thus, some mental health programs that do not meet these criteria but focus on relationships can be effective but not funded.
In addition, the issue of evaluating effectiveness is also controversial, since a reduction of symptoms, treatment of a disease, or elimination of its cause can be equally effective from different points of view (Tanenbaum, 2005). Thus, the author shows that the policy of defining evidence-based practices and programs has shortcomings that need to be improved.
In my opinion, the advantages of evidence-based programs outweigh their disadvantages. Inaccurate policies in relation to various medical fields can partly hinder the determination of the most effective programs. In some cases, this disadvantage leads to loss of funds or positive results; however, such inaccuracies are unlikely to produce negative effects. In other words, even if an effective program was not used due to non-compliance with criteria, the patient’s health outcomes remain the same. However, the requirement to provide evidence ensures that practices that are harmful or completely ineffective for patients. At the same time, since the evidence must be transparent and confirmed by other researchers, this approach leads to a significant decrease in the chances of wasting money on ineffective programs.
Therefore, the practice and the requirements for evidence-based programs demonstrate that they can be effective tools for improving health care systems and patient outcomes. Consequently, this approach should be applied and extended to various fields of medicine. However, as healthcare areas use different treatment approaches, the criteria of research and evidence quality must also be refined. As Tanenbaum (2005) points out, many aspects of evidence-based practices have imprecision and controversy due to specific approaches to treating mental problems, so policymakers should take these details into account. In this way, the accuracy of the definition and selection of evidence-based programs will increase and facilitate adequate funding.
In conclusion, evidence-based programs are promising practices for improving patient outcomes, although they have their drawbacks. The main disadvantage is the lack of sensitivity to the peculiarities of different medicine areas, which create inaccurate or unrealistic criteria that make it possible to define programs as evidence-based. However, the current requirements for programs can eliminate the least effective or false ones, which reduces health care costs. Consequently, the adjustment of the policy of evidence-based practices assessment for different areas of medicine contributes to the improvement of the healthcare system.
References
Policy statement on evidence-based practice in psychology. (2005). Web.
Tanenbaum, S. J. (2005). Evidence-based practice as mental health policy: Three controversies and a caveat. Health Affairs, 24(1), 163–173. Web.
The Oregon Addictions and Mental Health Division (AMH). (2007). Operational definition for evidence-based practices. Oregon Health Authority. Web.