The evidence-based practice movement rests on the premise that the scientific evidence regarding treatment should be used judiciously to inform treatment decisions. This article focuses on the most fundamental question regarding evidence-based practice: What is evidence? To address this question, the authors first review several of the definitions, criteria, and strategies that have been used to define scientific evidence. Second, a number of critical issues that have been raised regarding the nature of treatment evidence are discussed. Finally, suggestions for further consideration in the process of synthesizing evidence for clinicians are offered.
aNew Hampshire–Dartmouth Psychiatric Research Center, Dartmouth Medical School, 2 Whipple Place, Suite 202, Lebanon, NH 03766, USA
bDepartment of Psychiatry, McGill University, Services, Policy, and Population Health Theme, Douglas Hospital Research Centre, 875 LaSalle Blvd., Verdun, Québec H4H 1R3, Canada
cHuman Services Research Institute, 2336 Massachusetts Avenue, Cambridge, MA 02140, USA
dHarvard Medical School Department of Psychiatry at the Cambridge Health Alliance, 2336 Massachusetts Avenue, Cambridge, MA 02140, USA
eServices Effectiveness Research Program, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 3454 DUMC, Durham, NC 27710, USA
ABSTRACT