Evidence-Based Practice

Evidence-Based Practice

Evidence-based practice (EBP) developed gradually rather than from a single event. Starting in the 1980s, the British government emphasized using accurate and varied evidence to inform public policy. In the US, a prominent milestone was the Evidence-Based Medicine Working Group’s 1992 release of Evidence-Based Medicine: A New Approach to Teaching the Practice of Medicine. It described an approach that ‘deemphasizes intuition, unsystematic clinical experience and pathophysiological rationale as sufficient grounds for clinical decision making and [instead] stresses the examination of evidence from clinical research’. The aim was to combine individual clinical expertise with the best available external research evidence. EBP also spread to management and psychology, as illustrated by the 2005 Academy of Management presidential address and the American Psychological Association’s Presidential Task Force on Evidence-Based Practice in 2006.4

Reviewing and Combining Research

Research must be assessed before it can guide a decision. Two tools help with this: systematic reviews (SR) and meta-analyses (MA). A systematic review collects and evaluates studies that address a specified question. A meta-analysis uses statistical methods to combine results from studies. A systematic review need not include a meta-analysis.

Reviews take time and resources. Shared efforts can spread that work: the Cochrane collection described here drew on contributors from more than 100 countries. But a large collaboration does not remove every source of bias. Even with steps to reduce reviewer bias,5 researchers still exercise judgment when defining the question, finding studies, extracting data, assessing quality and combining results. Statistical pooling also requires attention to differences among studies; a single estimate can conceal differences that matter to the decision.

Applying Evidence in Management

Management faces a persistent gap between academic research and practice. Researchers may study questions that do not match managers’ immediate concerns, while practitioners may overlook useful findings. Limiting evidence to academic studies can therefore leave important parts of a management problem unexplored.

Sharing knowledge presents another difficulty. Physicians treating similar conditions can benefit from a common research base. Managers may also benefit from shared knowledge, but competition can discourage organizations from sharing information that gives them an advantage. Time matters too: a review that takes months or years may arrive after a manager must act.

Researchers themselves have criticized the coherence and practical relevance of management research. Studies of goal setting, for example, have reported both improved and reduced performance from challenging goals. Such differences require attention to the circumstances of each study rather than a search for a rule that applies everywhere. The author also describes concerns about fragmented research, limited accumulation of replicable findings and attempts to find universal answers to problems that depend heavily on context.

These limitations do not make research useless. Human reasoning is constrained by mental skills, habits and reflexes. Relevant research can help a manager understand a problem, challenge a habitual interpretation and compare possible actions. The task is to assess the quality and applicability of the evidence, combine it with professional experience and make a judgment appropriate to the decision. An impressive story about an intuitive leader is not, by itself, evidence that the same approach will work elsewhere.