Evidence-based medicine relies on research and evidence to implement any change in practice, which includes diagnosis, prognosis, treatment, and prevention. However, research and evidence that encompass all possible cases and scenarios is impossible, or, at least, impractically costly (Dreier & Löhler, 2016). Therefore, discovering gaps in the findings when researching literature and other types of evidence, and adjusting to compensate for them becomes a crucial part of evidence-based practice.
Gaps in research findings mean that a practice, diagnostic, or treatment method lacks sufficient evidence to verify its effectiveness. As such, the practitioner and the patient are unable to make a decision based on a full understanding of the situation. This represents a significant hindrance when proposing change based on evidence. However, in cases where the potential benefit is high, such as life-threatening conditions, even weak evidence can be used in the decision making process (Dreier & Löhler, 2016). Nonetheless, a tried method with a proven benefit should be generally preferable if one is available.
Seen from a different perspective, gaps in research can be an invitation for further research. Finding and identifying a gap is the basis of developing a new research question (Hempel, Gore, & Belsher, 2019). Furthermore, a gap in findings does not necessarily influence stakeholders’ decision making process (Hempel, Gore, & Belsher, 2019). Finally, a gap can indicate that change is needed in the area. This suggests that although gaps are inevitable, they are not always a hindrance.
Overall, gaps in evidence cannot be avoided in evidence-based practice. Depending on how they affect the decision making process, they can either hinder or present an opportunity for change. When researching evidence, one must assess each gap individually and attempt to address it with further research or personal judgment, if necessary. Ultimately, gaps in evidence are a natural and unavoidable part of research and evidence-based medicine.
References
Dreier, G., & Löhler, J. (2016). Evidence and evidence gaps — an introduction. GMS Current Topics in Otorhinolaryngology — Head and Neck Surgery; 15.
Hempel, S., Gore, K., & Belsher, B. (2019). Identifying Research Gaps and Prioritizing Psychological Health Evidence Synthesis Needs. Medical Care, 57, S259-S264.