scholarly journals When and why do people act on flawed science? Effects of anecdotes and prior beliefs on evidence-based decision-making

Author(s):  
Audrey L. Michal ◽  
Yiwen Zhong ◽  
Priti Shah

AbstractToday’s citizens are expected to use evidence, frequently presented in the media, to inform decisions about health, behavior, and public policy. However, science misinformation is ubiquitous in the media, making it difficult to apply research appropriately. Across two experiments, we addressed how anecdotes and prior beliefs impact readers’ ability to both identify flawed science and make appropriate decisions based on flawed science in media articles. Each article described the results of flawed research on one of four educational interventions to improve learning (Experiment 1 included articles about having a tidy classroom and exercising while learning; Experiment 2 included articles about using virtual/augmented reality and napping at school). Experiment 1 tested the impact of a single anecdote and found no significant effect on either participants’ evidence evaluations or decisions to implement the learning interventions. However, participants were more likely to adopt the more plausible intervention (tidy classroom) despite identifying that it was unsupported by the evidence, suggesting effects of prior beliefs. In Experiment 2, we tested whether this intervention effect was driven by differences in beliefs about intervention plausibility and included two additional interventions (virtual reality = high plausible, napping = low plausible). We again found that participants were more likely to implement high plausible than low plausible interventions, and that evidence quality was underweighed as a factor in these decisions. Together, these studies suggest that evidence-based decisions are more strongly determined by prior beliefs than beliefs about the quality of evidence itself.

2022 ◽  
Author(s):  
Dedi Ardinata

Evidence-based medicine (EBM), which emphasizes that medical decisions must be based on the most recent best evidence, is gaining popularity. Individual clinical expertise is combined with the best available external clinical evidence derived from systematic research in the practice of EBM. The key and core of EBM is the hierarchical system for categorizing evidence. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system divides evidence quality into four categories: high, moderate, low, and very low. GRADE is based on the lowest quality of evidence for any of the outcomes that are critical to making a decision, reducing the risk of mislabeling the overall evidence quality, when evidence for a critical outcome is lacking. This principle is also used in acupuncture as a complementary and integrative treatment modality, but incorporating scientific evidence is more difficult due to a number of factors. The goal of this chapter is to discuss how to establish a clinical evidence system for acupuncture, with a focus on the current quality of evidence for a variety of conditions or diseases.


2011 ◽  
Vol 5 (2) ◽  
pp. 514
Author(s):  
Isabelle Katherinne Fernandes Costa ◽  
Gabriela De Sousa Martins Melo ◽  
Thalyne Yuri de Araújo Farias Dias ◽  
Francis Solange Vieira Tourinho ◽  
Bertha Cruz Enders ◽  
...  

ABSTRACT Objective: to evaluate the available evidence on the impact of pain on daily life of people with venous ulcers. Method: this is a study of integrative review followed the following steps: establishing the hypothesis and objectives, establishing criteria for inclusion or exclusion of articles, defining the information to be extracted from the selected items, results analysis, discussion and presentation of results. To select the articles we used three databases, Medline, Cinahl and ISI Web of Knowledge and the sample consisted of 18 articles. Results: in the works that were analyzed showed evidence that the pain of venous ulcers influences the patient's daily life. Among people with venous ulcers, we found that the pain is a major aggravating to decreased quality of life, especially as regards the loss of mood, sleep disturbance, social isolation and loss of physical mobility. Conclusion: The pain of the wound can lead to a huge impact on the daily life of a person and, as such, the need of each patient must be acknowledged and considered in a holistic manner. Descriptors: venous ulcers; quality of life; pain; nursing.      RESUMOObjetivo: avaliar as evidências disponíveis sobre a influência da dor na vida diária da pessoa com úlcera venosa. Método: trata-se de um estudo de revisão integrativa obedeceu às seguintes etapas: estabelecimento da hipótese e objetivos; estabelecimento de critérios de inclusão e exclusão de artigos; definição das informações a serem extraídas dos artigos selecionados; análise dos resultados; discussão e apresentação dos resultados. Para a seleção dos artigos utilizou-se três bases de dados, Medline, Cinahl e Isi Web Of Knowledge e a amostra constituiu-se de 18 artigos. Resultados: nos trabalhos que foram analisados evidenciamos que a dor da úlcera venosa influencia na vida diária do paciente. Dentre as pessoas com úlcera venosa, verificamos que a dor é um dos grandes agravantes para a diminuição da qualidade de vida, principalmente no que diz respeito a perda do humor, distúrbios do sono, isolamento social e perda da mobilidade física. Conclusão: a dor da ferida pode levar a um enorme impacto na vida de uma pessoa diariamente e, como tal, a necessidade de cada paciente deve ser reconhecida e considerada de maneira holística. Descritores: úlcera venosa; qualidade de vida; dor; enfermagem.RESUMENObjetivo: evaluar la evidencia disponible sobre el impacto del dolor en la vida cotidiana de las personas con úlceras venosas. Método: se trata de un estudio de revisión integradora seguido los siguientes pasos: el establecimiento de la hipótesis y objetivos, el establecimiento de los criterios para su inclusión o exclusión de los artículos, la definición de la información que se extrae de los elementos seleccionados, la análisis de resultados, discusión y presentación de resultados. Para seleccionar los artículos que utilizaron tres bases de datos, Medline, CINAHL y el ISI Web of Knowledge y la muestra estuvo constituida por 18 artículos. Resultados: en las obras que fueron analizados mostraron evidencia de que el dolor de las úlceras venosas influye en la vida diaria del paciente. Entre las personas con úlceras venosas, se encontró que el dolor es una de las principales agravantes de disminución de la calidad de vida, especialmente en lo que respecta a la pérdida del estado de ánimo, trastornos del sueño, aislamiento social y pérdida de movilidad física. Conclusión: el dolor de la herida puede causar un gran impacto en la vida cotidiana de una persona y, como tal, la necesidad de cada paciente debe ser reconocida y considerada en forma integral. Descriptores: úlceras venosas; calidad de vida; dolor; enfermería.


2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 109-109
Author(s):  
Andrea Eisen ◽  
Jasmin Soobrian ◽  
Ashley Tyrrell ◽  
Clement Li ◽  
Derek Muradali ◽  
...  

109 Background: Disease Pathway Management (DPM) is used by Cancer Care Ontario (CCO) to set priorities for cancer control, plan cancer services, and improve the quality of care in Ontario by promoting standardization. The DPM approach applies a framework to examine the performance of the entire system from prevention to end of life care, and to identify any gaps within the system. In 2014, DPM began its breast cancer pathway initiative by mapping the patient journey, depicting evidence-based best practice along the breast cancer care continuum, identifying where further guidance is needed for clinical decision making, and identifying gaps in quality of care and performance measurement indicators. Objective: To evaluate the impact of DPM on quality assessment of breast cancer care in Ontario. Methods: DPM convened a multidisciplinary breast cancer working group (WG) of 40 experts from across Ontario. The WG held 12 meetings and used guidelines developed by CCO’s Program in Evidence Based Care (or other sources as needed) to generate pathways for the prevention, screening and diagnosis, treatment, and follow-up care for breast cancer. The pathways were used as a framework to review the existing inventory of provincial breast cancer quality indicators, and to identify areas where evidence based guidance is needed. The pathways were subjected to an extensive review process before publication. Results: The expert WG identified 28 priority areas, including opportunities to develop guidance in areas where it is lacking (e.g. role of perioperative breast MRI; indications for contralateral prophylactic mastectomy) and system barriers that may hinder optimal care (e.g. biomarker assessment). The WG also used the pathways as a framework for evaluating performance measurement indicators by mapping 48 existing quality indicators for breast cancer to the pathway. Conclusions: The CCO DPM Breast Cancer pathways facilitated a province-wide, multidisciplinary process to promote quality standards, to identify gaps and overlaps in performance and quality measurement, and to recommend additional indicators more relevant to the quality of breast cancer care in Ontario.


2018 ◽  
Vol 25 (8) ◽  
pp. 963-968 ◽  
Author(s):  
Enrico Coiera ◽  
Elske Ammenwerth ◽  
Andrew Georgiou ◽  
Farah Magrabi

Abstract Objective Many research fields, including psychology and basic medical sciences, struggle with poor reproducibility of reported studies. Biomedical and health informatics is unlikely to be immune to these challenges. This paper explores replication in informatics and the unique challenges the discipline faces. Methods Narrative review of recent literature on research replication challenges. Results While there is growing interest in re-analysis of existing data, experimental replication studies appear uncommon in informatics. Context effects are a particular challenge as they make ensuring replication fidelity difficult, and the same intervention will never quite reproduce the same result in different settings. Replication studies take many forms, trading-off testing validity of past findings against testing generalizability. Exact and partial replication designs emphasize testing validity while quasi and conceptual studies test generalizability of an underlying model or hypothesis with different methods or in a different setting. Conclusions The cost of poor replication is a weakening in the quality of published research and the evidence-based foundation of health informatics. The benefits of replication include increased rigor in research, and the development of evaluation methods that distinguish the impact of context and the nonreproducibility of research. Taking replication seriously is essential if biomedical and health informatics is to be an evidence-based discipline.


2015 ◽  
Vol 23 (2) ◽  
pp. 200-207 ◽  
Author(s):  
Maria Fernanda Manoel Imazu ◽  
Barbara Nascimento Faria ◽  
Guilherme Oliveira de Arruda ◽  
Catarina Aparecida Sales ◽  
Sonia Silva Marcon

OBJECTIVE: to compare the effectiveness of two educational interventions used by a healthcare provider in the monitoring of individuals with type 2 diabetes mellitus (T2DM), regarding knowledge of the disease, impact on quality of life and adoption of self-care actions. METHODS: comparative, longitudinal, prospective study performed with 150 subjects with type 2 diabetes, analyzed according to the type of participation in the program (individual and/or group). Participants of the individual intervention (II) received nursing consultations every six months and those of the group intervention (GI) took part in weekly meetings for three months. Data were collected through four questionnaires: Identification questionnaire, Problem Areas in Diabetes Questionnaire (PAID), Summary of Diabetes Self-Care Activities Questionnaire (SDSCA) and the Diabetes Knowledge Scale (DKN-A). Data were analyzed using the Friedman and Mann Whitney tests, considering a statistical significance of p ≤ 0.05. RESULTS: there was an increase in knowledge about the disease in the II (p<0.003) and GI (p<0.007), with reduction of the impact on the quality of life in the II (p<0.007) and improvement in self-care actions in the GI (p<0.001). CONCLUSION: in both intervention models improvements were observed in the indicators, over the six month monitoring period.


2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Yeh Chen Lee ◽  
Nazlin Jivraj ◽  
Catherine O’Brien ◽  
Tanya Chawla ◽  
Eran Shlomovitz ◽  
...  

Malignant bowel obstruction (MBO) is a major complication in women with advanced gynecologic cancers which imposes a significant burden on patients, caregivers, and healthcare systems. Symptoms of MBO are challenging to palliate and result in progressive decompensation of already vulnerable patients with limited therapeutic options and a short prognosis. However, there is a paucity of guidelines or innovative approaches to improve the care of women who develop MBO. MBO is a complex clinical situation that requires a multidisciplinary approach to ensure the appropriate treatment modality and interprofessional care to optimally manage these patients. This review summarizes the current literature on the different approaches targeting MBO management including surgical intervention, chemotherapy, total parenteral nutrition, and pharmacological treatment. In addition, the impact of MBO management on patients’ quality of life (QOL) is examined. This article focuses on the challenges in developing evidence-based treatment guidelines for MBO and barriers in clinical trial design for MBO and proposes strategies to advance the MBO management. Collaboration is essential to design studies that may improve the overall care and quality of life for these patients. Prospective data are needed to inform clinical practice, establish a new benchmark for evidence-based MBO management, and better understand the biology of MBO.


2020 ◽  
Vol 3 (2) ◽  
pp. 115-126
Author(s):  
Rizki Amalia ◽  
Moch. Hakimi ◽  
Herlin Fitriani

Evidence-based is a very effective strategy to improve the quality of midwifery services. One of the most frequently problems faced is the gap between midwifery practices that are in accordance with the procedures (based on evidence-based) with clinical care practices that occur in the clinic. The purpose of this study was to explore in-depth the obstacles to the implementation of evidence-based normal childbirth, which are the position of delivery, monitoring and documenting delivery by using partographs in the Independent Practice of Midwives of Gunungkidul District, Yogyakarta.This research was a qualitative research with a phenomenological descriptive approach. The participants of this study were midwives who had the Independent Midwife Practice (PMB) consisting of 7 informants. Participant selection in this study used a purposive sampling technique with convenience sampling and identification of obstacles used was the Consolidated Framework for Implementation Research (CFIR). Data collection used was semi-structured interviews and observations. Data analysis used was a thematic analysis.The interview and observation of delivery assistance is done at the Independent Midwife Practice Center (PMB). The position of delivery that was often used by patients was lithotomy and left slant, and the application of evidence-based monitoring and documentation using partograph was still not optimal. This was because there were several obstacles in its application, which were obstacles from patients, families, midwives, and obstacles from the organization. The impact of these obstacles was that it can reduce the quality of obstetric care in patients according to evidence-based. The evaluation of clinical practice based on evidence-based by the organization and the existence of feedback from patients to midwives are expected to improve the quality of service to patients.    


2021 ◽  
Vol 11 (4) ◽  
pp. 343
Author(s):  
Huda AbdlAziz Aldegheiry

The present research paper aims to identify the impact of sport activity on the quality of life of Saudi women (i.e., fitness and health, social aspects, psychological aspects, moral aspects, and mental aspects). It also aims to develop mechanisms to activate the sport activity to improve the quality of life of Saudi women. The sample consisted of (N= 384) Saudi women in Riyadh. The author applied a questionnaire to collect data. The results showed that sport activity has a high impact on fitness and the psychological and moral aspects and a high to moderate impact on the social and mental aspects of the Saudi woman. The study recommends activating the media role in disseminating sport culture and awareness among (children- teenager- elderly) women by publishing a sport activity supervised-bulletin to cover the sport activities, objectives, programs, as well as time and place of practice. In turn, this could promote positive aspects towards the practice of sport activities.   Received: 29 March 2021 / Accepted: 26 May 2021 / Published: 8 July 2021


Author(s):  
Manuel Francisco Romero Oliva ◽  
Ester Trigo Ibáñez

Resumen:Esta investigación analiza la repercusión del MAES en la formación inicial de los futuros docentes de Lengua Castellana y Literatura como base de una identidad profesional que se produce en la confrontación de sus creencias apriorísticas y los procesos reflexivos experimentados en los diferentes momentos del máster. Se ha tomado como población del estudio al grupo que cursó este máster en el año 2013-2014 en la UCA. La metodología combina diversas técnicas cualitativas y cuantitativas para triangular la información consignada en los instrumentos utilizados: cuestionario mixto, observación directa de los investigadores y narrativa biográfica. Los resultados demuestran que el MAES supone un salto cualitativo en la formación inicial de futuros docentes respecto a la enseñanza de la literatura. Abstract:This research analyzes the impact of MAES in the initial training of future teachers of Spanish Language and Literature as the basis of their professional identity in confrontation with their prior beliefs and the reflection processes experienced at different stages during the Master program. The population of the study has been taken from the group that attended the MAES in 2013-2014 at UCA. The methodology combines various qualitative and quantitative techniques to analyze and combine the information contained in the three different instruments used: mixed questionnaire, direct observation and biographical narrative. The results show that the MAES has been a meaningful leap in the quality of initial training of future teachers, especially regarding the teaching of Literature.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Saeideh Daryazadeh ◽  
Payman Adibi

Background: Morning reports are important training programs (especially for residents) as they enhance clinical decision-making skills, social interactions, and participatory learning. Given the need to eliminate the educational gap and provide optimal conditions, educational interventions regarding morning reports are often implemented in the form of evidence-based morning reports with an interactive and consultative approach. Objectives: The present study aimed to evaluate the quality of evidence-based morning reports using an interactive and consultative approach. Methods: This qualitative study was conducted with an inductive approach in 2019 in Iran. Changes were made to develop an evidence-based morning report and create a friendly educational environment between faculty members and residents, as well as interactive learning among the residents. The intervention was assessed through explaining the experiences of 16 participants via individual semi-structured interviews. Purposive sampling continued until data saturation. Data analysis was performed in the MAXQDA10 software. Results: In total, 153 codes, two main categories (education and dimensions of change), six categories (educational deficiencies, influential factors in the quality of education, requirements, barriers, benefits, and response to change), and 20 subcategories were extracted. Conclusions: According to the results, the residents were satisfied with the changes, while the faculty members needed more justification and motivation. The strengths and weaknesses identified in the intervention could lay the groundwork for broader changes in the same clinical fields.


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