In collating the most relevant research, the quality and strength of a piece of research is key to sound EBM. In working through the process of discerning evidence and research, challenges may arise around research reliability (Wilton & Slim, 2012). The majority of guidelines draw to a consensus on using a grading system, with the aim of guiding clinicians about the strength and current recommendations of a therapeutic approach. The strength of evidence in descending order;
- placebo controlled trails
- randomised trial
- open label or placebo
- prospective or observational studies that address patient outcomes
- in the absence of clinical trials
- published opinions of experts and case series
(Guyatt,Haynes & Jaeschke 2000).
The next pillar, clinical experience and expertise, is key within the field of eating disorders. There is often much discussion on the importance for an individual to have access to experienced practitioners in the treatment of eating disorders. This is primarily due to the complex nature of the disorder, an understanding expertise in treatment is key to the recovery of an individual.
The combination of these aspects helps to provide high level patient care through a holistic and person-centred approach. The importance of working with the individual needs of a client is commonly reflected on in treatment of eating disorders literature. This overlaps with the importance of taking into consideration the experience of the patient, which in application is one of the more poorly mapped out and most challenging steps to apply (Montori, Brito & Murad, 2013). The development of patient-centred communication skills is an area that could further advance best patient care, thus additional research on this pillar could be beneficial to the treatment of eating disorders.
Guyatt, G.H, Haynes, R.B & Jaeschke, R.Z (2000) Users’ guides to the medical literature: XXV. Evidence-based medicine: principles for applying the users’ guides to patient care. JAMA 2000;284:1290Y1296. Cited in Wilton, N. K., & Slim, A. M. (2012). Application of the principles of evidence-based medicine to patient care. Southern Medical Journal, 105(3), 136–43.
Levant, R. F., Barlow, D. H., David-, K. W., Hagglund, K. J., Hollon, S. D., Johnson, J. D., … Directorate, P. (2006). Evidence-based practice in psychology. American Psychologist, 61(4), 271–285.
Montori, V,M., Brito, J.P & Murad, M.H.(2013) The optimal practice of evidence-based medicine: incorporating patient preferences in practice guidelines. JAMA
Sackett, D., Rosenberg, W., Gray, J., Haynes, R., & Richardson, W. (1996). Evidence based medicine: What it is and what it isn’t - It's about integrating individual clinical expertise and the best external evidence. British Medical Journal, 312(1), 71–72.
Wilton, N. K., & Slim, A. M. (2012). Application of the principles of evidence-based medicine to patient care. Southern Medical Journal, 105(3), 136–43.
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