Evidence Based Practice (EBP) - From Research to Implementation

The goal of Evidence Based Practice (EBP) is the integration of: (a) development expertise/expert opinion, (b) external scientific evidence, and (c) client/stakeholder/practitioner perspectives (often in consensus conferences or expert meetings) to provide high-quality services reflecting the interests, values, needs, and choices of the communities we serve.  Because EBP is client/stakeholder centered, a development practitioner's task is to interpret best current evidence from systematic review or research in relation to a specific setting, including that population's preferences, environment, culture, and values regarding development and well-being. Ultimately, EBP provides optimal development service to that population in a particular setting. Because EBP is a continuing process, it is a dynamic integration of ever-evolving development expertise and external evidence in day-to-day practice.

EBP which GIDE and its partners use to improve lives, is increasingly shaping inclusive development as the preferred approach for professionals rendering services in social and economic development to underserved or vulnerable populations.  There is a growing consensus that EBP should involve the integration of the best and most current research evidence with social and economic expertise and relevant stakeholder perspectives in the pursuit of making the best possible decisions for a particular intervention.  

A review of several studies focused on a research question that tries to identify, appraise, select and synthesize all high quality research evidence relevant to that question is "a systematic review (SR)".  The purpose of a SR is to sum up the best available research evidence from multiple studies on a specific research question. This is done by synthesizing the results of several studies, critically appraising the evidence and producing a synthesis of the best available evidence.  Thus, systematic reviews (SRs) help us determine what we know, they are also powerful tools for documenting knowledge gaps in the literature but SR is not the literature review we know.  Unlike the traditional literature review,  SRs use an objective and transparent approach for research synthesis, with the aim of minimizing bias.  SRs are used to inform practice guidelines and public and private sector policy decisions in inclusive green growth as is now commonly used in health policy decisions as an alternative to expert opinion or consensus conferences.

Why do SRs need multiple studies rather than a single study to generate a credible evidence?  Single studies can be comparable to single respondents in a survey.  Just as one would not base any conclusion on the data from one survey interviewee, the same applies to a systematic review of literature.

SRs often, but not always, use statistical techniques (meta-analysis) to combine results of the eligible studies, or at least use scoring of the levels of evidence depending on the methodology used.  While many SRs are based on an explicit quantitative statistical analysis of available data, there are also qualitative reviews (narrative synthesis)  which adhere to the standards for gathering, analyzing and reporting evidence. Both quantitative and qualitative reviews adhere to a strict predefined methodology governing factors such as inclusion/exclusion criteria and search strategies, allowing for the reproducibility of findings.

For practitioners in socioeconomic development seeking to implement EBP, the following process is followed: (1) define a well-built question, (2) select evidence sources, (3) implement a search strategy, (4) appraise and synthesize the evidence, (5) disseminate and apply the evidence.  At the end of this process, practitioners and relevant stakeholders have a means to influence the direction of future research. 

A  more detailed process of a systematic review that GIDE uses is presented in the figure below.

Systematic Review Protocol.png