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Evidence-based conservation is the application of evidence in conservation biology and environmental management actions and policy making. It is defined as systematically assessing scientific information from published, peer-reviewed publications and texts, practitioners' experiences, independent expert assessment, and local and indigenous knowledge on a specific conservation topic. This includes assessing the current effectiveness of different management interventions, threats and emerging problems and economic factors.
Evidence-based conservation was organized based on the observations that decision making in conservation was based on intuition and or practitioner experience often disregarding other forms of evidence of successes and failures (e.g. scientific information). This has led to costly and poor outcomes. Evidence-based conservation provides access to information that will support decision making through an evidence-based framework of "what works" in conservation.
The evidence-based approach to conservation is based on evidence-based practice which started in medicine and later spread to nursing, education, psychology and other fields. It is part of the larger movement towards evidence-based practices.
== Systematic review ==
A systematic review consists of a non-subjective assessment of available data and evidence related to management. Synthesizing results from different studies over different time periods, locations or sample sizes can reduce the bias present in individual studies. Systematic reviews differ from traditional reviews by being easily understood, peer-reviewed and repeatable. Detailed protocols remain available for conducting a thorough, unbiased systematic review.
In a Cochrane systematic review, there is little evidence that environmental conservation, and enhancement activities can have any effect on adults' well-being and health. However, there is a high level of perceived benefits based on the feedback of the participants.
== Synopsis ==
Part of implementing an evidence-based conservation analysis requires generating a synopsis. This refers to the brief description of a single study or a systematic review. Synopses form the building blocks of summaries when collated across specific themes.
== Summary ==
A summary is broader than a synopsis and refers to the standardized description of results extracted from several studies or systematic reviews on a particular topic. Summaries are regularly updated as more information becomes available and are ideally generated through a rigorous review process.
== History ==
Evidence-based conservation is inspired by evidence-based medicine. Evidence-based conservation was first noted in the literature in 2000. Over the last decade, the methodology for generating systematic reviews (e.g. protocols, systematic maps) have been improved and standardized. In addition, several collaborative networks have been formed and two journals have been launched. The Collaboration for Environmental Evidence has a journal titled Environmental Evidence dedicated to the publication of systematic reviews, review protocols and systematic maps on impacts of human activity and the effectiveness of management interventions. It currently has centres located in Australia, Sweden, South Africa, Canada, France and the UK. The Conservation Evidence group has a journal titled Conservation Evidence that was launched in 2004 to document the effectiveness of conservation interventions.
Conservation Evidence is a web-based database repository that systematizes and provides access to conservation efforts, programs, and research on the biodiversity and the environment based on high quality, reviewed publications.
== Critique ==
Since evidence-based conservation is based on the primary data on interventions, it is as good as the available data. Even when data are available, some authors have noted that evidence-based conservation may not be routinely used in decision making for management and conservation policy. Often there may be a disconnect between the science that is produced and the management interventions taken. Three reasons have been suggested for this in the literature:
the scope of the scientific questions may not cover adequately the management requirements (this translates to lack of "actionable evidence" for management),
the scientific research produced covers the management needs, yet the recommendations from the evidence may not be feasible for implementation due to practical constraints (time, financial budgets etc.) or
the conservation practitioners do not have access to the evidence. Often peer reviewed journal articles produced by scientists are not freely available (open access) or use complicated jargon that managers may not always comprehend. In a survey in eastern England, it was found that park managers get only 2.4% of their information from primary scientific literature. These areas need further attention in the future.
Evidence-based conservation has also been criticised in the past for ignoring traditional forms of knowledge and experience. However, the steps of evidence-based conservation can be designed to take traditional forms of knowledge also into consideration.
== See also ==
Effective altruism – Philosophical and social movement
Evidence-based legislation – Decisions and practices that use evidence to enact laws
Evidence based policy – Approach to decision-making and policy based on empirical data and analysisPages displaying short descriptions of redirect targets
Evidence-based practice – Pragmatic methodology
== Bibliography ==
Salafsky, Nick, et al. "Improving the practice of conservation: a conceptual framework and research agenda for conservation science." Conservation biology 16.6 (2002): 1469–1479.
Pullin, Andrew S., and Teri M. Knight. "Doing more good than harm–Building an evidence-base for conservation and environmental management." Biological Conservation 142.5 (2009): 931–934.
Sutherland, William J., et al. "The need for evidence-based conservation." Trends in ecology & evolution 19.6 (2004): 305–308.
Brooks, Jeremy S., et al. "Testing hypotheses for the success of different conservation strategies." Conservation biology 20.5 (2006): 1528–1538.
"Box 1 : Conservation: Dollars and sense", Nature, International Weekly Journal of Science. September 29, 2005. pp. 614–616
== References ==

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Evidence-based dentistry (EBD) is the dental part of the more general movement toward evidence-based medicine and other evidence-based practices. The pervasive access to information on the internet includes different aspects of dentistry for both the dentists and patients. This has created a need to ensure that evidence referenced to are valid, reliable and of good quality.
Evidence-based dentistry has become more prevalent than ever, as information, derived from high-quality, evidence-based research is made available to clinicians and patients in clinical guidelines. By formulating evidence-based best-practice clinical guidelines that practitioners can refer to with simple chairside and patient-friendly versions, this need can be addressed.
Evidence-based dentistry has been defined by the American Dental Association (ADA) as "an approach to oral healthcare that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient's oral and medical condition and history, with the dentist's clinical expertise and the patient's treatment needs and preferences."
Three main pillars or principles exist in evidence-based dentistry. The three pillars are defined as:
Relevant scientific evidence
Patient needs and preferences
Clinician's expertise
The use of high-quality research to establish the guidelines for best practices defines evidence-based practice. In essence, evidence-based dentistry requires clinicians to remain constantly updated on current techniques and procedures so that patients can continuously receive the best treatment possible.
== History ==
Evidence-based dentistry (EBD) was first introduced by Gordon Guyatt and the Evidence-Based Medicine Working Group at McMaster University in Ontario, Canada, in the 1990s as part of the larger movement toward evidence-based medicine and other evidence-based practices.
== Clinical decision making ==
Much praise has gone to the dentistry approach of clinical decision making. In an EB case report written by Miller SA, is focused on the "use of evidence-based decision-making in private practice for emergency treatment of dental trauma". The case concludes with high praise for this method, going as far to say that "[the] evidence-based method was efficient, and very helpful in optimizing the management of the emergency dental treatment". However, it is important to ensure that the collection of data in the evidence during evidence-based clinical decision making isn't corrupted. Crawford JM writes about publication bias, as well as the possible effects it can have on evidence-based clinical making. He writes that it is important to watch out for publication bias, as it can "hinder advancements in oral health care by decreasing the availability of scientific evidence and threatening the validity of evidence-based practice".
There are many tools that have been developed for dental-based clinical decision making. Authors Rios Santos JV, Castello Castaneda C, and Bullon P all documented the "development of a computer application to help the decision making process in teaching dentistry." It offers the ability to review information, to help reinforce information that is learned by students. Teaching staff can also "design any theme they wish, increasing the efficiency and support capabilities of the program".
== Principles ==
In summary, there are three main pillars exist in evidence-based dentistry which serves as its main principles. The three pillars are defined as:
Dentists' clinical expertise
Patient needs and preferences
Relevant scientific evidence
=== Dentists' clinical expertise ===
Much less attention is paid to both the other two spheres of EBD, clinical expertise and patient values.
Clinical expertise plays a part in the successful outcomes of treatment with diagnostic skills preventing over and under-treatments, technical dental skills maximizing the longevity of surgical and restorative procedures and communication skills being core to patient management and perceived success.
=== Patients needs and preferences ===
Not all patients have the same priorities for their care. Understanding a patient's individual needs, wants and circumstances gives the clinician a place from which to discuss treatment options available with the patient. This might be competing priorities between dentists, therapists, and hygienists who generally aim for longevity and aesthetics and patients who may be more interested in keeping costs down, aesthetics or would prefer less invasive treatments.
=== Relevant scientific evidence ===
Given that "Patient needs and preferences" and "Dentist's clinical expertise" are variable and will differ among numerous clinicians and population, "Relevant scientific evidence" is of critical importance. Therefore, it is imperative that information referenced to are derived from high-quality, evidence-based research, which can be used to establish the guidelines for providing the best practices.
In essence, Evidence-based dentistry can allow clinicians to remain constantly updated on the newest techniques and procedures so that patients can continuously receive the best treatment possible.
== Evidence based process ==
=== Best scientific evidence ===
The new model set by EBM uses a systematic process to incorporate current research into practice. The evidence-based process requires the practitioner to develop five key skills:
Formulate information needs/questions into four part questions to identify the patient/problem (P), intervention (I), comparison (C), and outcomes (O), known mnemonically as the PICO questions.
Conduct an efficient computerized search of the literature for the appropriate type and level of evidence.
Critically appraise the evidence for validity with an understanding of research methods.
Apply the results of the evidence to patient care or practice in consideration for the patient's preferences, values and circumstances.
Evaluate the process and your performance through self-evaluation.
The American Dental Association defined evidence-based dentistry like so:
Evidence-based dentistry (EBD) is an approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient's oral and medical condition and history, with the dentist's clinical expertise and the patient's treatment needs and preferences.
The American Dental Education Association (ADEA) has incorporated the definition of evidence-based dentistry into core competencies required by dental education programs. These competencies focus on graduates to become lifelong learners and consumers of current research findings and require students to develop skills that are reflective of evidence-based dentistry.
A dentist's learning curve for using the evidence-based process can be steep, but there are continuing education courses, workbooks and tools available to simplify the integration of current research into practice.
=== Assessing the quality of evidence ===

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== Need for continuing education ==
Dental graduates around the globe are possibly up to date at the time they graduate, but usually are fundamentally lacking in the understanding of trials/studies design and relevance/importance. Dental specialty training, however, stresses evidence-based outcomes, results and methodologies. But this becomes out of date as new information and technology appear. Hence it is important, especially with regards to patient safety, for dentists to be able to keep up to date with developments. Having an understanding of how to interpret research results, and some practice in reading the literature in a structured way, can turn the dental literature into a useful and comprehensible practice tool. For this to happen, EBD learning absolutely needs to be at the heart of dental education. Dental students can be taught EBD concept during their time in dental school so that they will develop the ability to evaluate critically new knowledge and determine its relevance to the clinical problems and challenges presented by the individual patient. They also acquire the ability to interpret, assess, integrate, and apply data and information in the process of clinical problem solving, reasoning, and decision making. EBD is a lifelong learning process and help to develop ability to learn independently.
=== Medication prescribing ===
Dentists can prescribe medications upon initial registration. This is important as evidence has shown that general practitioners prefer to refer to dentists for the management of dental emergencies. Research has shown that there are potential limitations in the knowledge of dental students for conventional and complementary and alternative medications.
== Organisations that develop evidence-based guidelines and policies ==
=== Scottish Intercollegiate Guidelines Network ===
Formed in 1993, the Scottish Intercollegiate Guidelines Network (SIGN) goals are to decrease the discrepancy in treatments and results, through the creation and dissemination of nationwide clinical guidelines encompassing recommendations for effective practice established on up-to-date evidence to improve the quality of health care for patients in Scotland.
SIGN guidelines are established using a clear methodology constructed on three fundamental principles, which are:
Development is carried out by multidisciplinary, nationwide representative groups
A systematic review is conducted to recognise and analytically evaluate the evidence
Recommendations are clearly connected to the supporting evidence
As of 2009, SIGN has also adopted the practise of implementing the GRADE methodology to all its SIGN guidelines.
=== Scottish Dental Clinical Effectiveness Programme ===
Part of NHS Education for Scotland (NES), the Scottish Dental Clinical Effectiveness Programme (SDCEP) is an initiative of the National Dental Advisory Committee (NDAC) which is an organisation of dental professionals, across all specialities, that functions as consultative wing to the Chief Dental Officer. Its main goal is to appraise the best available and pertinent information with regards to dentistry and convert it into guidelines which are easily comprehensible and executable.
The Scottish Dental Clinical Effectiveness Programme consist of a central group for Programme Development and multiple other groups for guideline development. With
the principal objective of developing guidance that delivers the best quality of patient care through supporting dental teams, the SDCEP uses the most suitable high-quality evidences from a plethora of sources to make guidelines recommendations.
Founded under the intention of NDAC to give a systematized methodology when providing clinical guidance for the dental profession, the SDCEP has since become a crucial factor between the gold standard practice guidelines and dental education and practice.
== Limitations and criticism ==
Despite the high praise for evidence-based dentistry, there are a number of limitation and criticism that has been given to the process. Chambers DW provides quite a bit of criticism, as well as a number of limitations that evidence-based dentistry provides. In no particular order of importance, a number of mentioned objections towards this format are:
Evidence-based dentistry is too clumsy due to the concept being poorly defined
The implementation of evidence-based dentistry has been distorted by too heavy of an emphasis of computerized searches for research findings that meet the standards of academics
Although EBD advocates enjoy sharing anecdotal accounts of mistakes others have made, faulting others is not proof that one's own position is correct
There is no systematic, high-quality evidence that EBD is effective
Patient and practitioner values are the shortest leg of the stool. As they are so little recognized, their integration in EBD is problematic and ethical tensions exist where paternalism privileges science over patient's self-determined best interests.
== Literature ==
Evidence-based dental journals have been developed as resources for busy clinicians to aid in the integration of current research into practice. These journals publish concise summaries of original studies as well as review articles. These critical summaries, consist of an appraisal of original research, with discussion of the relevant, practical information of the research study.
Evidence-Based Dentistry
Journal of Evidence-Based Dental Practice.
Systematic reviews are also helpful for the busy practitioner because they combine the results of multiple studies that have investigated the same specific phenomenon or question.
== References ==
== Further reading ==
== External links ==
ADA Policy Statement on Evidence-Based Dentistry
American Dental Association Center for Evidence-based Dentistry Archived 2011-04-09 at the Wayback Machine
American Student Dental Association on Evidence-Based Dentistry
Cochrane Oral Health Group
Evidentista

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Evidence-based design (EBD) is the process of constructing a building or physical environment based on scientific research to achieve the best possible outcomes. Evidence-based design is especially important in evidence-based medicine, where research has shown that environment design can affect patient outcomes. It is also used in architecture, interior design, landscape architecture, facilities management, education, and urban planning. Evidence-based design is part of the larger movement towards evidence-based practices.
== Background ==
Evidence-based design (EBD) was popularized by the seminal study by Ulrich (1984) that showed the impact of a window view on patient recovery. Studies have since examined the relationships between design of the physical environment of hospitals with outcomes in health, the results of which show how the physical environment can lower the incidence of nosocomial infections, medical errors, patient falls, and staff injuries; and reduce stress of facility users, improve safety and productivity, reduce resource waste, and enhance sustainability.
Evidence in EBD may include a wide range of sources of knowledge, from systematic literature reviews to practice guidelines and expert opinions. Evidence-based design was first defined as "the deliberate attempt to base design decisions on the best available research evidence" and that "an evidence-based designer, together with an informed client, makes decisions based on the best available information from research and project evaluations". The Center for Heath Design (CHD), a non-profit organization that supports healthcare and design professionals to improve the understanding and application of design that influence the performance of healthcare, patient satisfaction, staff productivity and safety, base their model on the importance of working in partnership with the client and interdisciplinary team to foster understanding of the client, preferences and resources.
The roots of evidence-based design could go back to 1860 when Florence Nightingale identified fresh air as "the very first canon of nursing," and emphasized the importance of quiet, proper lighting, warmth and clean water. Nightingale applied statistics to nursing, notably with "Diagram of the causes of mortality in the army in the East". This statistical study led to advances in sanitation, although the germ theory of disease was not yet fully accepted.
Nightingale was also an enthusiast for the therapeutic benefits of sunlight and views from windows. She wrote: "Second only to fresh air … I should be inclined to rank light in importance for the sick. Direct sunlight, not only daylight, is necessary for speedy recovery … I mention from experience, as quite perceptible in promoting recovery, the being able to see out of a window, instead of looking against a dead wall; the bright colours of flowers; the being able to read in bed by the light of the window close to the bed-head. It is generally said the effect is upon the mind. Perhaps so, but it is not less so upon the body on that account ...."
Nightingale's ideas appear to have been influential on E R Robson, architect to the London School Board, when he wrote: “It is well known that the rays of the sun have a beneficial influence on the air of a room, tending to promote ventilation, and that they are to a young child very much what they are to a flower.”
The evidence-based design movement began in the 1970s with Archie Cochranes's book Effectiveness and Efficiency: Random Reflections on Health Services. to collect, codify, and disseminate "evidence" gathered in randomised controlled trials relative to the built environment. A 1984 study by Roger Ulrich seemed to support Nightingale's ideas from more than a century before: he found that surgical patients with a view of nature suffered fewer complications, used less pain medication and were discharged sooner than those who looked out on a brick wall; and laid the foundation for what has now become a discipline known as evidence-based design. Studies exist about the psychological effects of lighting, carpeting and noise on critical-care patients, and evidence links physical environment with improvement of patients and staff safety, wellness and satisfaction. Architectural researchers have studied the impact of hospital layout on staff effectiveness, and social scientists studied guidance and wayfinding. In the 1960s and 1970s numerous studies were carried out using methods drawn from behavioural psychology to examine both people's behaviour in relation to buildings and their responses to different designs – see for example the book by David Canter and Terence Lee More recently, architectural researchers have conducted post-occupancy evaluations (POE) to provide advice on improving building design and quality. While the EBD process is particularly suited to healthcare, it may be also used in other fields for positive health outcomes and provision of healing environments.
While healthcare proved to be one of the most prominent sectors to examine the evidence base for how good design benefits building occupants, visitors and the public, other sectors also have considerable bodies of evidence. And, many sectors benefit from literature reviews that draw together and summarise the evidence. In the UK some were led by the UK Commission for Architecture and the Built Environment, a government watchdog established by the Labour Party following its election in 1997 and commitment to improving the quality of the UK stock of public sector buildings. Other reviews were supported by various public or private organisations, and some were undertaken in academia. Reviews were undertaken at the urban scale, some were cross-sectoral and others were sector based (hospitals, schools, higher education). An academic paper by Sebastian Macmillan) gives an overview of the field as it was in 2006.

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== A cautionary note about the strength of evidence in the built environment ==
In supporting evidence-based design, some caution is needed to ascertain the robustness of the evidence: the architectural psychology movement eventually drew criticism for its tendency towards ‘architectural determinism’ – a confusion between correlation and causality with the implication that there were mechanistic and causal links between the built environment and human behaviour. As some of the studies reviewed below reveal, the evidence is often weak or, worse, conflicting. In an early review of evidence in the healthcare sector, Rubin, Owens & Golden examined the medical literature for research papers on the effect of the physical environment on patient outcomes. They concluded that, if the demanding standards of proof used in medical research were used, almost all the studies would have to be regarded as methodologically flawed or at least limited. Unfortunately strongly held opinions are not the same as rigorously collected evidence.
== Evidence-base for architecture generally, housing and urban environments ==
In 2002, CABE published a cross-sectoral study that set a pattern by reviewing a selection of the evidence (which it called the key research) for healthcare buildings, educational buildings, housing, urban environments, and business premises. It claimed: “Good design is not just about the aesthetic improvement of our environment, it is as much about improved quality of life, equality of opportunity and economic growth. … Good design does not cost more when measured across the lifetime of the building or place …”
At the urban scale, in 2001, CABE and DETR published a study on the value of urban design which includes a literature review plus some case studies.
In New Zealand, a landmark review
was supported by the Ministry for the Environment. The study categorised the evidence as conclusive, strong, suggestive or anecdotal, and also noted the difficulty of establishing causation since various design elements may be found in combination with other features. The authors state that urban design is context-specific and cautions against automatically adopting what works elsewhere in New Zealand.
In its 2003 review of the evidence about housing CABE expressed similar concerns about the evidence base when it said: “The most striking finding in a review of the literature relating to the quality of residential design is the almost complete absence of any empirical attempts to measure the implications of high quality on costs, prices or values.”
David Halpern's book brings together and reviews a substantial number of studies covering among other issues: mental ill-health in city centres; social isolation in out of town housing estates; residential satisfaction; and estate layouts, semi-private spaces and a sense of community. He concludes that there is substantial evidence to show the physical environment has real and significant effects on group and friendship formation, and on patterns of neighbourly behaviour.
Other literature reviews include a 2006 study by the Scottish Executive and one by the UK NWDA/RENEW North West.
== Public open space ==
CABE's 2004 literature review on public open space draws attention to the physical and mental health benefits associated with access to recreational space, as well as the environmental value of biodiversity and improved air quality. In a follow up 2005 study entitled Does Money Grown on Trees? CABE assessed the impact on the value of residential property of proximity to a park, drawing on valuations prepared by local property experts in which external variables (shops, schools, busy roads) were controlled for. Economic and non-monetary benefits from the proximity were identified.
== Schools and Higher Education ==
A comprehensive review of the literature was undertaken in 2005 for the Design Council. It concluded that there was evidence for the effect of basic physical variables (air quality, temperature, noise) on learning but that once minimum standards were achieved, further improvements were less significant. The reviewers found forceful opinions on the effects of lighting and colour but that the supporting evidence was conflicting. It was difficult to draw generalizable conclusions about other physical characteristics, and the interactions between different elements was as important as single elements.
Other literature reviews of the education sector include two by Price Waterhouse Coopers and one by researchers at the University of Salford.
In the higher education sector, a review by CABE reports on the links between building design and the recruitment, retention and performance of staff and students. Fifty articles are reviewed, and five new case studies reported.
== Offices ==
The offices sector has been widely studied with the major concerns focusing on productivity. A study in 2000 by Sheffield Hallam University reported that apart from surveys of occupants of individual offices, the evidence base on new workplaces was mainly journalistic and biased towards interviews with successes and failures. Some companies claimed that new spatial arrangements led to reduced costs, reduced absenteeism and easier recruitment, faster development of new ideas, and increased profitability. But others reported the exact opposite; and the reasons for this remained unclear.
CABE and the British Council for Offices published a joint study in 2005. The paper reports that four main issues have been studied: the largest is environmental and ergonomic issues related to the comfort of individual office workers; secondly research on the efficiency with which office space is used; thirdly adaptability and flexibility and finally research related to supporting work processes. The report is critical of the disproportionate focus on the performance of building services compared with other aspects of buildings.

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== Evidence-based design for healthcare facilities ==
There is a growing awareness among healthcare professionals and medical planners for the need to create patient-centered environments that can help patients and family cope with the stress that accompanies illness. There is also growing supporting research and evidence through various studies that have shown both the influence of well-designed environments on positive patient health outcomes, and poor design on negative effects including longer hospital stays.
Using biophilic design concepts in interior environments is increasingly argued to have positive impacts on health and well-being through improving direct and indirect experiences of nature. Numerous studies have demonstrated improved patient health outcomes through environmental measures; exposing patients to nature has been shown to produce substantial alleviation of pain, and limited research also suggests that patients experience less pain when exposed to higher levels of daylight in their hospital rooms. Patients have an increased need for sleep during illness, but suffer from poor sleep when hospitalised. Approaches such as single-bed rooms and reduced noise have been shown to improve patient sleep. Natural daylight in patient rooms help to maintain circadian rhythms and improve sleep.
According to Heerwagen, an environmental psychologist, medical models of health integrate behavioral, social, psychological, and mental processes. Contact with nature and daylight has been found to enhance emotional functioning; drawing on research from studies (EBD) on well-being outcomes and building features. Positive feelings such as calmness increase, while anxiety, anger, or other negative emotions diminish with views of nature. In contrast there is also convincing evidence that stress could be worsened and ineffective in fostering restoration in built environments that lack nature.
Few studies have shown the restorative effects of gardens for stressed patients, families and staff. Behavioural observation and interview methods in post occupancy studies of hospital gardens have shown a faster recovery from stress by nearly all garden users. Limited evidence suggest increased benefits when these gardens contain foliage, flowers, water, pleasant nature sounds, such as birds and water.
== Related approaches ==
=== Performance-based building design ===
EBD is closely related to performance-based building design (PBBD) practices. As an approach to design, PBBD tries to create clear statistical relationships between design decisions and satisfaction levels demonstrated by the building systems. Like EBD, PBBD uses research evidence to predict performance related to design decisions.
The decision-making process is non-linear, since the building environment is a complex system. Choices cannot be based on cause-and-effect predictions; instead, they depend on variable components and mutual relationships. Technical systems, such as heating, ventilation and air-conditioning, have interrelated design choices and related performance requirements (such as energy use, comfort and use cycles) are variable components.
=== Evidence-based medicine ===
Evidence-based medicine (EBM) is a systematic process of evaluating scientific research which is used as the basis for clinical treatment choices. Sackett, Rosenberg, Gray, Haynes and Richardson argue that "evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients". It is used in the healthcare industry to convince decision-makers to invest the time and money to build better buildings, realizing strategic business advantages as a result. As medicine has become increasingly evidence-based, healthcare design uses EBD to link hospitals' physical environments with healthcare outcomes.
=== Research-informed design ===
Research-informed design (RID) is a less-developed concept that is commonly misunderstood and used synonymously with EBD, although they are different. It can be defined as the process of applying credible research in integration with the project team to inform the environmental design to achieve the project goals. Credible research here, includes qualitative, quantitative, and mixed methods approaches with the highest standards of rigor suitable for their methodology.
The literature for "research-informed" practices comes from education, and not from the healthcare disciplines. The process involves application of the outcomes from literature review and empirical investigation to inform design during the design phase, given the constraints; and to share the process and the lessons learnt just like in EDB.
== Research and accreditation ==
As EBD is supported by research, many healthcare organizations are adopting its principles with the guidance of evidence-based designers. The Center for Health Design developed the Pebble Project, a joint research effort by CHD and selected healthcare providers on the effect of building environments on patients and staff. Health Environment Research & Design journal and the Health Care Advisory Board are additional sources of information and database on EBD.
The Evidence Based Design Accreditation and Certification (EDAC) program was introduced in 2009 by The Center for Health Design to provide internationally recognized certification and promote the use of EBD in healthcare building projects, making EBD an accepted and credible approach to improving healthcare outcomes. EDAC identifies those experienced in EBD and teaches about the research process: identifying, hypothesizing, implementing, gathering and reporting data associated with a healthcare project.
== Process ==
There are four components to evidence-based design:
Gather qualitative and quantitative intelligence
Map strategic, cultural and research goals
Hypothesize outcomes, innovate, and implement translational design
Measure and share outcomes
=== Meta-analysis template for literature review ===
In his book Evidence-based Policy: A Realistic Perspective, Ray Pawson suggests a meta-analysis template which may be applied to EBD. With this protocol, the field will be able to provide designers with a source for evidence-based design.
A systematic review process should follow five steps:
Formulating the review question
Identifying and collecting evidence
Evaluating the quality of the evidence
Extracting, processing and systematizing data
Disseminating findings
=== Conceptual model ===
According to Hamilton, architects have a responsibility in translation of research in the field, and its application in informing designs. He further illustrates a conceptual model architects could use, that identifies four levels of addressing research and methods base on varying levels of commitment:

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Level 1
Informed design decisions based on available literature on environmental research, based on applicability, such as the use of a state of the art technology or strategy based on the physical setting of the project
Level 2
Design decisions based on predictive performance and measurable outcomes, rather than subjective decisions based on random choice
Level 3
Results reported publicly, with the objective of moving information on the methods and results moving information beyond the design team,
The peer review, makes the process more robust, as it could include varying perspectives from those who may or may not agree with the findings
Level 4
Publishing findings in peer-reviewed journals
Collaborating with academic and social scientists
=== Working model ===
A white paper (series 3/5) from the Center for Health Design presents a working model to help designers implement EBD decision-making. The primary goal is providing a healing environment; positive outcomes depend on three investments:
Designed infrastructure, including the built environment and technology
Re-engineered clinical and administrative practices to maximize infrastructure investment
Leadership to maximize human and infrastructure investments
All three investments depend on existing research.
=== Strategies ===
A white paper from the Center for Health Design identifies ten strategies to aid EBD decision-making:
Start with problems. Identify the problems the project is trying to solve and for which the facility design plays an important role (for example, adding or upgrading technology, expanding services to meet growing market demand, replacing aging infrastructure)
Use an integrated multidisciplinary approach with consistent senior involvement, ensuring that everyone with problem-solving tools is included. It is essential to stimulate synergy between different community to maximize efforts, outcomes and interchanges.
Maintain a patient- and family-centered approach; patient and family experiences are key to defining aims and assessing outcomes.
Focus on financial operations past the first-cost impact, exploring the cost-effectiveness of design options over time and considering multi-year investment returns.
Apply disciplined participation and criteria management. These processes use decision-making tools such as SWOT analysis, analytic hierarchy processes and decision trees which may also be used in design (particularly of technical aspects such as structure, fire safety or energy use).
Establish incentive-linked criteria to increase design-team motivation and involve end users with checklists, surveys and simulations.
Use strategic partnerships to create new products with hospital-staff expertise and influence.
Encourage simulation and testing, assuming the patient's perspective when making lighting and energy models and computer visualizations.
Use a lifecycle perspective (30–50 years) from planning to product, exploring the lifecycle return on investment of design strategies for safety and workforce outcomes.
Overcommunicate. Positive outcomes are connected with the involvement of clinical staff and community members with meetings, newsletters, webcams and other tools.
== Tools ==
Evidence-based design has been applied to efficacy measurements of a building's design, and is usually done at the post-construction stage as a part of a post-occupancy evaluation (POE). The POE assesses strengths and weaknesses of design decisions in relation to human behaviour in a built environment. Issues include acoustics, odor control, vibration, lighting and user-friendliness, and are binary-choice (acceptable or unacceptable). Other research techniques, such as observation, photography, checklists, interviews, surveys and focus groups, supplement traditional design-research methods.
Assessment tools have been developed by The Center for Health Design and the Picker Institute to help healthcare managers and designers gather information on consumer needs, assess their satisfaction and measure quality improvements:
The Patient Environmental Checklist assesses an existing facility's strong and weak points. Specific environmental features are evaluated by patients and their families on a 5-point scale, and the checklist quickly identifies areas needing improvement.
The Patient Survey gathers information on patients' experiences with the built environment. The questions range is wide, since patients' priorities may differ significantly from those of administrators or designers.
Focus Groups with consumers learn about specific needs and generate ideas for future solutions.
== References ==
Cama, R., "Patient room advances and controversies: Are you in the evidence-based healthcare design game?", Healthcare Design, March 2009.
Cochrane, A. L. (1972). Effectiveness and Efficiency: Random Reflections on Health Services. Nuffield Provincial Hospitals Trust. ISBN 978-0-900574-17-7.
Hall, C.R., "CHD rolls out evidence-based design accreditation and certification", Health Facilities Management, July 2009.
Kirk, Hamilton D., "Research Informed Design & Outcomes for Healthcare" in Evidence Based Hospital Design Forum, Washington, January 2009.
Stankos, M. and Scharz, B., "Evidence-Based Design in Healthcare: A Theoretical Dilemma", IDRP Interdisciplinary Design and Research e-Journal, Volume I, Issue I (Design and Health), January 2007.
Ulrich, R.S., "Effects of Healthcare Environmental Design on Medical Outcomes" in Design & Health – The therapeutic benefits of design, proceedings of the 2nd Annual International Congress on Design and Health. Karolinska Institute, Stockholm, June 2000.
Webster, L. and Steinke, C., "Evidence-based design: A new direction for health care". Design Quarterly, Winter 2009
Sadler, B.L., Dubose, J.R., Malone, E.B. and Zimring, C.M., "The business case for building better hospitals through evidence based design". White Paper Series 1/5, Evidence-Based Design Resources for Healthcare Executives Archived 2017-04-19 at the Wayback Machine, Center for Health Design, September 2008.
Ulrich, R.S., Zimring, C.M., Zhu, X., Dubose, J., Seo, H.B., Choi, Y.S., Quan, X. and Joseph, A., "A review of the research literature on evidence based healthcare design", White Paper Series 5/5, Evidence-Based Design Resources for Healthcare Executives Archived 2017-04-19 at the Wayback Machine, Center for Health Design, September 2008.

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== Further reading ==
A Visual Reference to Evidence-Based Design by Jain Malkin.
Study Guide 1: An Introduction to Evidence-Based Design: Exploring Healthcare and Design.
Study Guide 2: Building the Evidence-Base: Understanding Research in Helathcare Design.
Study Guide 3: Integrating Evidence-Based Design: Practicing the Healthcare Design Process.
A Practitioner's Guide to Evidence-Based Design by Debra D. Harris, PhD, Anjali Joseph, PhD, Franklin Becker, PhD, Kirk Hamilton, FAIA, FACHA, Mardelle McCuskey Shepley, AIA, D.Arch.
Evidence-Based Design for Multiple Building Types by D. Kirk Hamilton and David H. Watkins.
Stout, Chris E. and Hayes, Randy A. The evidence-based practice: methods, models, and tools for mental health professionals. John Wiley and Sons, January 2005.
Ulrich, R., Quan, X., Zimring, C., Joseph, A. and, Choudhary, R., "The Role of the Physical Environment in the Hospital of the 21st Century". Report to the Center for Health Design, September 2004.
Cama, R., (2009). Evidence-Based Healthcare Design. Hoboken, New Jersey: John Wiley & Sons, Inc.
Phiri, M. (2015). Design Tools for Evidence-Based Healthcare Design. Abingdon & New York: Routledge.
Phiri, M. & Chen, B. (2014). Sustainability and Evidence-Based Design in Healthcare Estate. Heidelberg: Springer.
== External links ==
The Center for Health Design
Role of the Physical Environment in the Hospital of the 21st Century: Report published by The Center for Health Design in 2004 summarizing evidence-based design research for healthcare
InformeDesign: Research database of studies linking environment to outcomes
Center for Health Systems and Design
Picker Institute
Tulane Center for Evidence-Based Global Health

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Evidence-based education (EBE) is the principle that education practices should be based on the best available scientific evidence, with randomised trials as the gold standard of evidence, rather than tradition, personal judgement, or other influences. Evidence-based education is related to evidence-based teaching, evidence-based learning, and school effectiveness research.
The evidence-based education movement has its roots in the larger movement towards evidence-based practices, and has been the subject of considerable debate since the late 1990s. However, research published in 2020 showed that, despite absence of empirical evidence, belief is high amongst educators in teaching techniques such as matching instruction to a few supposed learning styles and the cone of learning.
== History ==
The English author and academic David H. Hargreaves presented a lecture in 1996 in which he stated "Teaching is not at present a research-based profession. I have no doubt that if it were it would be more effective and satisfying". He compared the fields of medicine and teaching, saying that physicians are expected to keep up to date on medical research, whereas many teachers may not even be aware of the importance of research to their profession. In order for teaching to become more research-based, he suggested, educational research would require a "radical change" and teachers would have to become more involved in the creation and application of research.
Following that lecture, English policy makers in education tried to bring theory and practice closer together. At the same time, existing education research faced criticism for its quality, reliability, impartiality and accessibility.
In 2000 and 2001 two international, evidence-based, studies were created to analyze and report on the effectiveness of school education throughout the world: the Programme for International Student Assessment (PISA) in 2000 and the Progress in International Reading Literacy Study (PIRLS) in 2001.
Also, around the same time three major evidence-based studies about reading were released highlighting the value of evidence in education: the US National Reading Panel in 2000, the Australian report on Teaching reading in 2005, and the Independent review of the teaching of early reading (Rose Report 2006), England. Approximately a year before the Rose Report, the Scottish Executive Education Department (SEED) published the results of a study entitled A Seven Year Study of the Effects of Synthetic Phonics Teaching on Reading and Spelling Attainment (Clackmannanshire Report), comparing synthetic phonics with analytic phonics.
Scientifically based research (SBR) (also evidence-based practice in education) first appeared in United States Federal legislation in the Reading Excellence Act and subsequently in the Comprehensive School Reform program. However, it came into prominence in the U.S. under the No child left behind act of 2001 (NCLB), intended to help students in kindergarten through grade 3 who are reading below grade level. Federal funding was made available for education programs and teacher training that are "based on scientifically based reading research". NCLB was replaced in 2015 by the Every Student Succeeds Act (ESSA).
In 2002 the U.S. Department of Education founded the Institute of Education Sciences (IES) to provide scientific evidence to guide education practice and policy.
The State driven Common Core State Standards Initiative was developed in the United States in 2009 in an attempt to standardize education principles and practices. There appears to have been some attempt to incorporate evidence-based practices. For example, the core standards website has a comprehensive description of the specific details of the English Language Arts Standards that include the areas of the alphabetic principle, print concepts, phonological awareness, phonics and word recognition, and fluency. However, it is up to the individual States and school districts to develop plans to implement the standards, and the National Governors Guide to Early Literacy appears to lack details. As of 2020, 41 States had adopted the standards, and in most cases it has taken three or more years to have them implemented. For example, Wisconsin adopted the standards in 2010 and implemented them in the 2014–2015 school year, yet in 2020 the state Department of Public Instruction was in the process of developing materials to support the standards in teaching phonics.
According to reports, the Common Core State Standards Initiative does not appear to have led to a significant national improvement in students' performance. The Center on Standards, Alignment, Instruction, and Learning (C-SAIL) conducted a study of how the Common Core is received in schools. It reported these findings: a) there is moderately high buy-in for the standards among teachers, principals, and superintendents, but buy-in was significantly lower for teachers, b) there is wide variation in teachers' alignment to the standards by content area and grade level, c) specificity is desired by some educators, however states and districts are reluctant to provide too much specificity, d) State officials generally agree that accountability changes under ESSA have allowed them to adopt a "smart power" message that is less punitive and more supportive.
Subsequently, in England the Education Endowment Foundation of London was established in 2011 by The Sutton Trust, as the lead charity of the government-designated What Works Centre for high quality evidence in UK Education.
In 2012 the Department for Education in England introduced an evidence-based "phonics reading check" to help support primary students with reading. (In 2016, the Minister for Education reported that the percentage of primary students not meeting reading expectations reduced from 33% in 2010 to 20% in 2016.)
Evidence-based education in England received a boost from the 2013 briefing paper by Dr. Ben Goldacre. It advocated for systemic change and more randomized controlled trials to assess the effects of educational interventions. He said this was not about telling teachers what to do, but rather "empowering teachers to make independent, informed decisions about what works". Following that a U.K. based non-profit, researchED, was founded to offer a forum for researchers and educationalists to discuss the role of evidence in education.
Discussion and criticism ensued. Some said research methods that are useful in medicine can be entirely inappropriate in the sphere of education.
In 2014 the National Foundation for Educational Research, Berkshire, England published a report entitled Using Evidence in the Classroom: What Works and Why.
The review synthesises effective approaches to school and teacher engagement with evidence and discusses challenges, areas for attention and action. It is intended to help the teaching profession to make the best use of evidence about what works in improving educational outcomes.
In 2014 the British Educational Research Association (BERA) and the Royal Society of Arts (RSA) conducted an inquiry into the role of research in teacher education in England, Northern Ireland, Scotland and Wales. The final report made it clear that research and teacher inquiry were of paramount importance in developing self-improving schools. It advocated for a closer working partnership between teacher-researchers and the wider academic research community.
The 2015 Carter Review of Initial Teaching Training in the UK suggested that teacher trainees should have access and skills in using research evidence to support their teaching. However, they do not receive training in utilizing research.
NCLB in the US was replaced in 2015 by the Every Student Succeeds Act (ESSA) that replaced "scientifically based research" with "evidence-based interventions" (any "activity, strategy, or intervention that shows a statistically significant effect on improving student outcomes or other relevant outcomes"). ESSA has four tiers of evidence that some say gives schools and policy makers greater control because they can choose the desired tier of evidence. The evidence tiers are as follows:

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Tier 1 – Strong Evidence: supported by one or more well-designed and well-implemented randomized controlled experimental studies.
Tier 2 – Moderate Evidence: supported by one or more well-designed and well-implemented quasi-experimental studies.
Tier 3 – Promising Evidence: supported by one or more well-designed and well-implemented correlational studies (with statistical controls for selection bias).
Tier 4 – Demonstrates a Rationale: practices that have a well-defined logic model or theory of action, are supported by research, and have some effort underway by state educational agencies (SEA), local educational agencies (LEA), or outside research organization to determine their effectiveness.
In 2016 the Department for Education in England published the White Paper Educational Excellence Everywhere. It states its intention to support an evidence-informed teaching profession by increasing teachers' access to and use of "high quality evidence". It will also establish a new British education journal and expand the Education Endowment Foundation. In addition, on October 4, 2016, the Government announced an investment of around £75 million in the Teaching and Leadership Innovation Fund, to support high-quality, evidence-informed, professional development for teachers and school leaders. A research report in July 2017 entitled Evidence-informed teaching: an evaluation of progress in England
concluded this was necessary, but not sufficient. It said that the main challenge for policy makers and researchers was the level of leadership capacity and commitment to make it happen. In other words, the attitudes and actions of school leaders influence how classroom teachers are supported and held accountable for using evidence informed practices.
In 2017 the British Educational Research Association (BERA) examined the role of universities in professional development, focusing especially on teacher education and medical education.
Critics continue, saying "Education research is great but never forget teaching is a complex art form." In 2018, Dylan Wiliam, emeritus Professor of Educational Assessment at University College London, speaking at researchED stated that "Educational research will never tell teachers what to do; their classrooms are too complex for this ever to be possible." Instead, he suggests, teachers should become critical users of educational research and "aware of when even well-established research findings are likely to fail to apply in a particular setting".
== Reception ==
=== Acceptance ===
Since many educators and policy makers are not experienced in evaluating scientific studies and studies have found that "teachers' beliefs are often guided by subjective experience rather than by empirical data", several non-profit organizations have been created to critically evaluate research studies and provide their analysis in a user-friendly manner. They are outlined in research sources and information.
EBP has not been readily adopted in all parts of the education field, leading some to suggest the K-12 teaching profession has suffered a loss of respect because of its science-aversive culture and failure to adopt empirical research as the major determinant of its practices. Speaking in 2017, Harvey Bischof, Ontario Secondary School Teachers' Federation (OSSTF), said there is a need for teacher-centred education based upon what works in the classroom. He suggested that Ontario education "lacks a culture of empiricism" and is vulnerable to gurus, ideologues and advocates promoting unproven trends and fads.
Neuroscientist Mark Seidenberg, University of Wisconsin–Madison, stated that "A stronger scientific ethos (in education) could have provided a much needed defense against bad science", particularly in the field of early reading instruction. Other influential researchers in psychopedagogy, cognitive science and neuroscience, such as Stanislas Dehaene and Michel Fayol have also supported the view of incorporating science into educational practices.
=== Critics and skeptics ===
Skeptics point out that EBP in medicine often produces conflicting results. Others feel that EBE "limits the opportunities for educational professionals to exert their judgment about what is educationally desirable in particular situations".
Some suggest teachers should not pick up research findings and implement them directly into the classroom; instead they advocate for a modified approach some call evidence-informed teaching that combines research with other types of evidence plus personal experience and good judgement; "practice that is influenced by robust research evidence".
Others say there is "a mutual interdependence between science and education", and teachers should become better trained in research science and "take science sufficiently seriously" to see how its methods might inform their practice.
Straight talk on evidence has suggested that reports about evidence in education need to be scrutinized for accuracy or subjected to Metascience (research on research).
In a 2020 talk featured on ResearchED, Dylan Wiliam argues that when looking at the cost, benefit and practicality of research, more impact on student achievement will come from a knowledge-rich curriculum and improving teachers' pedagogical skills.
=== Philosophical concerns ===
Some of the criticisms about evidence-based approaches to education relate to concerns about the generalisability of educational research, specifically that research findings are context dependent and that it is difficult to generalise findings from one context to another using a positivist approach. Counter to this position is a view that education researchers have a responsibility to consider the practical value of their research.
There has also been some discussion of a philosophical nature about the validity of scientific evidence. This led James M. Kauffman, University of Virginia, and Gary M. Sasso, University of Iowa, to respond in 2006 suggesting that problems arise with the extreme views of a) the "unbound faith in science" (i.e. scientism) or b) the "criticism of science" (that they label as the "nonsense of postmodernism"). They go on to say that science is "the imperfect but best tool available for trying to reduce uncertainty about what we do as special educators".
==== Meta-analysis ====

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A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. A concern of some researchers is the unreliability of some of these reports due to mythological features. For example, it is suggested that some meta-analyses findings are not credible because they do not exclude or control for studies with small sample sizes or very short durations, and where the researchers are doing the measurements. Such reports can yield "implausible" results. According to Robert Slavin, of the Center for Research and Reform in Education at Johns Hopkins University and Evidence for ESSA, "Meta-analyses are important, because they are widely read and widely cited, in comparison to individual studies. Yet until meta-analyses start consistently excluding, or at least controlling for studies with factors known to inflate mean effect sizes, then they will have little if any meaning for practice."
== Research sources and information ==
The following organizations evaluate research on educational programs, or help educators to understand the research.
=== Best Evidence Encyclopedia (BEE) ===
Best Evidence Encyclopedia (BEE) is a free website created by the Johns Hopkins University School of Education's Center for Data-Driven Reform in Education (established in 2004) and is funded by the Institute of Education Sciences, U.S. Department of Education. It gives educators and researchers reviews about the strength of the evidence supporting a variety of English programs available for students in grades K–12. The reviews cover programs in areas such as mathematics, reading, writing, science, comprehensive school reform, and early childhood education; and includes such topics as effectiveness of technology and struggling readers.
BEE selects reviews that meet consistent scientific standards and relate to programs that are available to educators.
Educational programs in the reviews are rated according to the overall strength of the evidence supporting their effects on students as determined by the combination the quality of the research design and their effect size. The BEE website contains an explanation of their interpretation of effect size and how it might be viewed as a percentile score. It uses the following categories of ratings:
Strong evidence of effectiveness
Moderate evidence of effectiveness
Limited evidence of effectiveness: Strong evidence of modest effects
Limited evidence of effectiveness: Weak evidence with notable effect
No qualifying studies
==== Reading programs ====
In 2021, BEE released a review of research on 61 studies of 51 different programs for struggling readers in elementary schools. 84% were randomized experiments and 16% quasi-experiments. The vast majority were done in the US, the programs are replicable, and the studies, done between 1990 and 2018, had a minimum duration of 12 weeks. Many of the programs used phonics-based teaching and/or one or more of the following: cooperative learning, technology-supported adaptive instruction (see Educational technology), metacognitive skills, phonemic awareness, word reading, fluency, vocabulary, multisensory learning, spelling, guided reading, reading comprehension, word analysis, structured curriculum, and balanced literacy (non-phonetic approach). Significantly, table 5 (pg. 88) shows the mean weighted effect sizes of the programs by the manner in which they were conducted (i.e. by school, by classroom, by technology-supported adaptive instruction, by one-to-small-group tutoring, and by one-to-one tutoring). Table 8 (pg. 91) lists the 22 programs meeting ESSA standards for strong and moderate ratings, and their effect size.
The review concludes that a) outcomes were positive for one-to-one tutoring, b) outcomes were positive but not as large for one-to-small group tutoring, c) there were no differences in outcomes between teachers and teaching assistants as tutors, d) technology-supported adaptive instruction did not have positive outcomes, e) whole-class approaches (mostly cooperative learning) and whole-school approaches incorporating tutoring obtained outcomes for struggling readers as large as those found for one- to-one tutoring, and benefitted many more students, and f) approaches mixing classroom and school improvements, with tutoring for the most at-risk students, have the greatest potential for the largest numbers of struggling readers.
The site also offers a newsletter, originated by Robert Slavin the former Director of the Center for Research and Reform in Education, containing information on education around the world. The issue for January 28, 2021 has a chart showing that proven tutoring programs during the regular school year are significantly more effective than other approaches such as summer school (without tutoring), after school, extended-day, and technology. The February 11, 2021 issue makes a case for using Federal Government COVID-19 funding (the Learning Recovery Act) to provide for the "implementation of proven tutoring programs during ordinary school times".
=== Blueprints for healthy youth development ===
Blueprints for Healthy Youth Development, University of Colorado Boulder, offers a registry of evidence-based interventions with "the strongest scientific support" that are effective in promoting a healthy course of action for youth development.
=== Education Endowment Foundation ===
The Education Endowment Foundation of London, England was established in 2011 by The Sutton Trust, as a lead charity in partnership with Impetus Trust, together being the government-designated What Works Centre for UK Education.
It offers an online, downloadable Teaching & Learning Toolkit evaluating and describing a variety of educational interventions according to cost, evidence and impact.
As an example, it evaluates and describes a 2018 phonics reading program with low cost, extensive evidence and moderate impact.
=== Evidence for ESSA ===
Evidence for ESSA began in 2017 and is produced by the Center for Research and Reform in Education (CRRE) at Johns Hopkins University School of Education, Baltimore, MD. It is reported to have received "widespread support ", and offers free up-to-date information on current PK-12 programs in reading, math, social-emotional learning, and attendance that meet the standards of the Every Student Succeeds Act (ESSA) (the United States K–12 public education policy signed by President Obama in 2015). It also provides information on programs that do meet ESSA standards as well as those that do not.

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==== Evidence-based PK-12 programs ====
There are three program categories 1) whole class, 2) struggling readers and 3) English learners. Programs can be filtered by a) ESSA evidence rating (strong, moderate, and promising), b) school grade, c) community (rural, suburban, urban), d) groups (African American, Asian American, Hispanic, White, free and reduced price lunch, English learners, and special education), and e) a variety of features such as cooperative learning, technology, tutoring, etc.
For example, as of June 2020 there were 89 reading programs in the database. After filtering for strong results, grades 1–2, and free and reduced-price lunches, 23 programs remain. If it is also filter for struggling readers, the list is narrowed to 14 programs. The resulting list is shown by the ESSA ratings, Strong, Moderate or Promising. Each program can then be evaluated according to the following: number of studies, number of students, average effect size, ESSA rating, cost, program description, outcomes, and requirements for implementation.
=== Social programs that work and Straight Talk on Evidence ===
Social programs that work and Straight Talk on Evidence are administered by the Arnold Ventures LLC's evidence-based policy team, with offices in Houston, Washington, D.C., and New York City. The team is composed of the former leadership of the Coalition for Evidence-Based Policy, a nonprofit, nonpartisan organization advocating the use of well-conducted randomized controlled trials (RCTs) in policy decisions. It offers information on twelve types of social programs including education.
Social programs that work evaluates programs according to their RCTs and gives them one of three ratings:
Top Tier: Programs with two or more replicable and well conducted RCTs (or one multi-site RTC), in a typical community settings producing sizable sustained outcomes.
Near Top Tier: Programs that meet almost all elements of the Top Tier standard but need another replication RCT to confirm the initial findings.
Suggestive Tier: Programs appearing to be a strong candidate with some shortcomings. They produce sizeable positive effects based on one or more well conducted RCTs (or studies that almost meet this standard); however, the evidence is limited by factors such as short-term follow-up or effects that are not statistically significant.
Education programs include K-12 and postsecondary. The programs are listed under each category according to their rating and the update date is shown. For example, as of June 2020 there were 12 programs under K-12; two were Top Tier, five were Near Top Tier, and the remainder were Suggestive Tier. Each program contains information about the program, evaluation methods, key findings and other data such as the cost per student. Beyond the general category, there does not appear to be any way to filter for only the type of program of interest, however the list may not be especially long.
Straight Talk on Evidence seeks to distinguish between programs that only claim to be effective and other programs showing credible findings of being effective. It reports mostly on randomized controlled trial (RCT) evaluations, recognizing that RCTs offer no guarantee that the study was implemented well, or that its reported results represented the true findings. The lead author of a study is given an opportunity to respond to their report prior to its publication.
=== What Works Clearinghouse (WWC) ===
What Works Clearinghouse (WWC) of Washington, DC, was established in 2002 and evaluates numerous educational programs in twelve categories by the quality and quantity of the evidence and the effectiveness. It is operated by the federal National Center for Education Evaluation and Regional Assistance (NCEE), part of the Institute of Education Sciences (IES)
==== Publications ====
WWC publications are available for a variety of topics (e.g. literacy, charter schools, science, early childhood, etc.) and Type (i.e. Practice guide or Intervention report).
==== Practice guides, tutorials, videos and webinars ====
Practice guides with recommendations are provided covering a wide variety of subjects such as Using Technology to Support Postsecondary Student Learning and Assisting Students Struggling with Reading, etc. Other resources such as tutorials, videos and webinars are also available.
==== Reviews of individual studies ====
Individual studies are available that have been reviewed by WWC and categorized according to the evidence tiers of the United States Every student succeeds act (ESSA). Search filters are available for the following:
WWC ratings (e.g. meets WWC standards with or without reservations, meets WWC standards without reservations, etc.)
Topic (e.g. behavior, charter schools, etc.)
Studies meeting certain design standards (e.g. Randomized controlled trial, Quasi-experiment design, etc.)
ESSA ratings (e.g. ESSA Tier 1, ESSA Tier 2, etc.)
Studies with one or more statistically positive findings
==== Intervention reports, programs and search filters ====
Intervention reports are provided for programs according to twelve topics (e.g. literacy, mathematics, science, behavior, etc.).
The filters are helpful to find programs that meet specific criteria. For example, as of July 2020 there were 231 literacy programs in the WWC database. (Note: these are literacy programs that may have several individual trials and some of the trials were conducted as early as 2006.) If these programs are filtered for outcomes in Literacy-Alphabetics the list is narrowed to 25 programs that met WWC standards for evidence and had at least one "potentially positive" effectiveness rating. If the list is further filtered to show only programs in grades one or two, and delivery methods of individual, or small group, or whole class the list is down to 14 programs; and five of those have an effectiveness rating of "strong evidence that intervention had a positive effect on outcomes" in alphabetics.
The resulting list of programs can then be sorted by a) evidence of effectiveness, or b) alphabetically, or c) school grades examined. It is also possible to select individual programs to be compared with each other; however it is advisable to recheck each individual program by searching on the Intervention Reports page. The resulting programs show data in the following areas:

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outcome domain (e.g. alphabetics, oral language, general mathematics achievement, etc.)
effectiveness rating (e.g. positive, potentially positive, mixed, etc.)
number of studies meeting WWC standards
grades examined (e.g. K-4)
number of students in studies that met the WWC standards, and
improvement index (i.e. the expected change in percentile rank).
It is also possible to view the program's Evidence snapshot, detailed Intervention report and Review protocols. For other independent "related reviews", go to the evidence snapshot then the WWC Summary of Evidence.
The following chart, updated in July 2020, shows some programs that had "strong evidence" of a "positive effect on outcomes" in the areas specified. The results may have changed since that time, however current information is available on the WWC website, including the outcome domains that did not have "strong evidence".Some of the concerns expressed about WWC are that it appears to have difficulty keeping up with the research so it may not be current; and when a program is not listed on their database, it may be that it did not meet their criteria or they have not yet reviewed it, but you don't know which. In addition Straight Talk on Evidence, authored by the Arnold Ventures LLC' Evidence-Based Policy team, on January 16, 2018, expressed concerns about the validity of the ratings provided by WWC. It says WWC in some cases reported a "preliminary outcome when high-quality RCTs found no significant effects on more important and final educational outcomes".
A summary of the January 2020 changes to the WWC procedures and standards is available on their site.
=== Other sources of information ===
The British Educational Research Association (BERA) claims to be the home of educational research in the United Kingdom. It is a membership association that aims to improve the knowledge of education by advancing research quality, capacity and engagement. Its resources include a quarterly magazine, journals, articles, and conferences.
Campbell Collaboration is a nonprofit organization that promotes evidence-based decisions and policy through the production of systematic reviews and other types of evidence synthesis. It has wide spread international support, and allows users to easily search by topic area (e.g. education) or key word (e.g. reading).
Doing What Works is provided by WestEd, a San Francisco-based nonprofit organization, and offers an online library that includes interviews with researchers and educators, in addition to materials and tools for educators. WestEd was criticized in January 2020, claiming they did not interview all interested parties prior to releasing a report.
Early Childhood Technical Assistance Center (ECTA), of Chapel Hill, NC, provides resources on evidence-based practices in areas specific to early childhood care and education, professional development, early intervention and early childhood special education.
Florida Center for Reading Research is a research center at Florida State University that explores all aspects of reading research. Its Resource Database allows you to search for information based on a variety of criteria.
Institute of Education Sciences (IES), Washington, DC, is the statistics, research, and evaluation arm of the U.S. Department of Education. It funds independent education research, evaluation and statistics. It published a Synthesis of its Research on Early Intervention and Early Childhood Education in 2013. Its publications and products can be searched by author, subject, etc.
The International Initiative for Impact Evaluation (3ie) is a registered non-governmental organisation, since 2008, with offices in New Delhi, London and Washington, DC. Its self-described vision is to improve lives through evidence-informed action in developing countries. In 2016 their researchers synthesised evidence from 238 impact evaluations and 121 qualitative research studies and process evaluations in 52 low-and middle-income countries (L&MICs). It looked at children's school enrolment, attendance, completion and learning.The results can be viewed in their report entitled The impact of education programmes on learning and school participation in low- and middle-income countries.
National Foundation for Educational Research (NFER) is a non-profit research and development organization based in Berkshire, England. It produces independent research and reports about issues across the education system, such as Using Evidence in the Classroom: What Works and Why.
Office for Standards in Education (Ofsted), in England, conducts research on schools, early education, social care, further education and skills.
The Ministry of Education, Ontario, Canada offers a site entitled What Works? Research Into Practice. It is a collection of research summaries of promising teaching practice written by experts at Ontario universities.
RAND Corporation, with offices throughout the world, funds research on early childhood, K-12, and higher education.
ResearchED, a U.K. based non-profit since 2013 has organized education conferences around the world (e.g. Africa, Australia, Asia, Canada, the E.U., the Middle East, New Zealand, the U.K. and the U.S.) featuring researchers and educators in order to "promote collaboration between research-users and research-creators". It has been described as a "grass-roots teacher-led project that aims to make teachers research-literate and pseudo-science proof". It also publishes an online magazine featuring articles by practicing teachers and others such as professor Daniel T. Willingham (University of Virginia) and Professor Dylan Wiliam (Emeritus professor, UCL Institute of Education). And finally, it offers frequent, free online video presentations on subjects such as curriculum design, simplifying your practice, unleashing teachers' expertise, the bridge over the reading gap, education post-corona, remote teaching, teaching critical thinking, etc. The free presentations are also available on its YouTube channel. ResearchED has been featured in online debates about so called "teacher populism".
Research 4 Schools, University of Delaware is supported by the Institute of Education Sciences, U.S. Department of Education and offers peer-reviewed research about education.
== See also ==
Educational research
Educational psychology
Evidence-based legislation
Evidence-based policy
Science of reading
== References ==
== External links ==
The Evidence Based Teachers Network (EBTN)
Institute for Effective Education (IEE)
researchED.org.uk
Evidence based interventions, McGill University, Canada
Evidence based practice, The Office of Special Education and Rehabilitative Services (OSERS), A.S.A Archived 2020-07-02 at the Wayback Machine
Evidence based education, UK

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Evidence-based legislation (EBL) is a legislative concept which calls for the use of the best available scientific evidence and systematically collected data, when available, by legislatures as a basis for their formulation and writing of law. Evidence-based legislation has its roots in the larger movement towards evidence-based practices, and depends on multiple other factors, including evidence gathering, qualitative and quantitative data analyses, stakeholder assessments, expert input, cost-benefit analyses, and continued monitoring and equation.
== Overview ==
This concept was originally mentioned at a conference entitled "At the Margins. A Conference on Sex Offender Management in Minnesota 2006. Policy and Management Options for the Most Dangerous Sex Offenders" by Gerald T. Kaplan, a psychologist. This conference was organized by Eric Janus, Esq. Vice-Dean, the William Mitchell College of Law, and was held on February 24, 2006, in Minneapolis, Minnesota. The conference was devoted to considerations of policy involving management of dangerous sex offenders. It was noted that much of the legislation involving sex offenders that has been passed has been done so by legislatures reacting to public sentiment and fear, without the interposition of rational consideration of policy options and of policy consequences. Given the evolving standard of evidence-based medicine, and because policies regarding sex offenders often involve medical and psychological care, it was suggested that a similar standard of care be articulated for legislatures for the formation of legislation affecting sex offenders. This concept and standard could well be applied to other areas of legislation, but are most needed where there is an impetus to pass legislation quickly in reaction to emotionally charged events, such as publicized sex crimes.
== History ==
This concept is new and an exhaustive search of the legal and encyclopedic literature has not revealed any references to it until recently. This concept is first cited in the legal literature by Shajnfeld and Krueger (p 96). The irrational nature of sex offender legislation passed to date is described in this article as well as in a book by Jenkins, and the concept of "evidence-based legislation" is one suggestion to remedy the continuing passage of reactive, emotionally based, legislation to manage sex offenders and reduce sexual crime, which often has not been well conceived or well planned, and where little thought has been given to its economic and practical consequences.
This concept was also mentioned in an op-ed in the Los Angeles Times on March 11, 2007, entitled "The new American witch hunt" by Richard B. Krueger, M.D.
== See also ==
Evidence-based policing
Evidence-based policy
Evidence-based practices
== References ==
BMJ.com Sackett, DL, et al. 'Evidence based medicine: what it is and what it isn't: It's about integrating individual clinical expertise and the best external evidence', (editorial) British Medical Journal, vol 312, p 71-72 (January 13, 1996).
http://www.law.northwestern.edu/jclc/backissues/v101/n4/1014_1337.Weitzer.pdf

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Evidence-based nursing (EBN) is an approach to making quality decisions and providing nursing care based upon personal clinical expertise in combination with the most current, relevant research available on the topic. This approach is using evidence-based practice (EBP) as a foundation. EBN implements the most up to date methods of providing care, which have been proven through appraisal of high quality studies and statistically significant research findings. The goal of EBN is to improve the health and safety of patients while also providing care in a cost-effective manner to improve the outcomes for both the patient and the healthcare system. EBN is a process founded on the collection, interpretation, appraisal, and integration of valid, clinically significant, and applicable research. The evidence used to change practice or make a clinical decision can be separated into seven levels of evidence that differ in type of study and level of quality. To properly implement EBN, the knowledge of the nurse, the patient's preferences, and multiple studies of evidence must all be collaborated and utilized in order to produce an appropriate solution to the task at hand. These skills are taught in modern nursing education and also as a part of professional training.
Muriel Skeet, a British nurse, was an early advocate for the development of the evidence base for health care. She produced studies and surveys including Waiting in Outpatients (1965), which received widespread publicity and resulted in the introduction of appointment systems, and Marriage and Nursing (with Gertrude Ramsden, 1967), which resulted in staff creches for nurses.
== Cultivate spirit of inquiry ==
A spirit of inquiry refers to an attitude in which questions are encouraged to be asked about existing practices. Cultivating a spirit of inquiry allows healthcare providers to feel comfortable with questioning current methods of practice and challenging these practices to create improvements and change. A culture that fosters this should have a philosophy that incorporates EBP, access to tools that can enhance EBP, and administrative support and leadership that values EBP.
Key Elements to Foster EBP
Always question current practices as nursing professional.
Integrate EBP as higher standard/mission/philosophy and include competencies for EBP.
EBP mentors for skills and knowledge availability to others to provide and help.
Tools to enhance EBP (e.g. meetings, educational/classroom time, access to, etc.).
Higher level support and ability for leaders to model valued EBP skills.
Recognition of use of EBP often
== Ask clinical question (PICOT) ==
PICOT formatted questions address the patient population (P), issue of interest or intervention (I), comparison group (C), outcome (O), and time frame (T). Asking questions in this format assists in generating a search that produces the most relevant, quality information related to a topic, while also decreasing the amount of time needed to produce these search results.
An example of an intervention focused PICOT question would be: In total knee arthroplasty patients (Population), what is the effect of nerve blocks (Intervention) compared to opioid pain medication (Comparison) in controlling post-operative pain (Outcome) within the first 24 hours after surgery (Time)?
An example of an issue of interest focused PICOT question would be: How do post-rehab chronic obstructive pulmonary disease (COPD) patients (Population) with stage 3 (Issue of Interest) perceive their ability to perform activities of daily living (Outcome) after first month (Time) of rehabilitation? [No comparison group].
== Search for and collect relevant evidence ==
To begin the search for evidence, use each keyword from the PICOT question that was formed. Once results have been found on the intervention or treatment, the research can be rated to determine which provides the strongest level of evidence. There are seven levels of evidence, with a level I being of the strongest quality and a level VII being of the weakest quality:
Level I: Evidence from systematic reviews or meta-analysis of randomized control trials
Level II: Evidence from well-designed randomized control trials
Level III: Evidence from well-designed control trials that are not randomized
Level IV: Evidence from case-control or cohort studies
Level V: Evidence from systematic reviews of descriptive or qualitative studies
Level VI: Evidence from a single descriptive or qualitative study
Level VII: Evidence from expert opinions
The strongest levels of evidence, systematic reviews and meta-analyses, summarize evidence related to a specific topic by finding and assessing studies that specifically relate to the question being asked. Meta-analyses are systematic reviews that also use quantitative measures such as statistics to summarize the results of the studies analyzed.
Pyramid framework. Thinking of the information resources used to obtain evidence as a pyramid can help determine what the most valid and least biased evidence is. The top of the pyramid is just that. This is where decision support can be found, which is found within the medical record. The middle of the pyramid is the reviews of the evidence. This includes systematic reviews, practice guidelines, topic summaries, and article synopses. The bottom of the pyramid is the original studies. The bottom is also considered the foundation of the pyramid and where evidence begins. This includes research articles. Those who look for evidence here need special knowledge and skills to not only find the evidence itself but how to evaluate its worthiness.
== Critically appraise the evidence ==
To begin the critical appraisal process, three questions need to be asked to determine the relevance of evidence and if evidence applies to population being cared for. The three questions are:

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Are the results of the study valid?
What are the results?
Will the results be applicable in caring for patients?
Question 1 measures the validity. In order to be valid, the results of the study must be as close to the truth as possible. Also, the study must be conducted using best available research methods.
Question 2 measures the reliability of the study. If it is an intervention study, reliability consists of: whether the intervention worked, how large the effect was, and whether a clinician could repeat the study with similar results. If it is a qualitative study, reliability would be measured by determining if the research accomplished the purpose of the study.
Question 3 measures the applicability. The study may be used in practice when caring for patients if the subjects are similar to the patients being cared for, the benefit outweighs the harm, the study is feasible, and the patient desires the treatment.
After asking these three questions, evidence appraisal continues by creating an evidence synthesis. This synthesis compares multiple studies to see if they are in agreement with each other.
== Integrate the evidence ==
After appraising the evidence, it is necessary to integrate it with the provider's expertise and patient's preferences. The patient is encouraged to practice autonomy and participate in the decision-making process. Therefore, even if the study had successful outcomes, the patient may refuse to receive a treatment. Assessment findings and patient history may reveal further contraindications to a certain evidence-based treatment. Lastly, availability of healthcare resources may limit the implementation of a treatment even if it is found to be effective in a study.
== Evaluate outcomes ==
The next step in the evidence-based practice process is to evaluate whether the treatment was effective in terms of patient outcomes. It is important to evaluate the outcomes in a real-world clinical setting to determine the impact of the evidence-based change on healthcare quality.
== Disseminate outcomes ==
The last step is to share the information especially if positive outcomes are achieved. By sharing the results of evidence-based practice process, others may benefit. Some methods to disseminate the information include presentations at conferences, rounds within one's own institution, and journal publications.

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== Qualitative research process ==
One method of research for evidence-based practice in nursing is 'qualitative research': The word implies an entity and meanings that are not experimentally examined or measured in terms of quantity, amount, frequency, or intensity.
With qualitative research, researchers learn about patient experiences through discussions and interviews. The point of qualitative research is to provide beneficial descriptions that allow insight into patient experiences.
"Hierarchies of research evidence traditionally categorize evidence from weakest to strongest, with an emphasis on support for the effectiveness of interventions. That this perspective tends to dominate the evidence-based practice literature makes the merit of qualitative research unclear;" 1 Some people view qualitative research as less beneficial and effective, with its lack of numbers, the fact that it is "feeling-based" research, makes the opponents associate it with bias. Nevertheless, the ability to empathetically understand an individual's experience (whether it be with cancer, pressure ulcers, trauma, etc.), can benefit not only other patients, but the health care workers providing care.
For qualitative research to be reliable, the testing must be unbiased. To achieve this, researchers must use random and non-random samples to obtain concise information about the topic being studied. If available, a control group should be in use, if possible with the qualitative studies that are done. Evidence should be gathered from every available subject within the sample to create balance and dissolve any bias. There should also be several researchers doing the interviewing to obtain different perspectives about the subject. Researchers must also obtain negative information as well as the positive information gathered to support the data. This will help to show the researchers were unbiased and were not trying to hide negative results from readers, and actually makes it possible to objectively understand the phenomenon under investigation. The inclusion of this negative information will strengthen the researchers' initial study, and may actually work in favor to support the hypothesis. Any data that has been gathered must be appropriately documented. If the data collected was obtained from interviews or observation, it must all be included.
Dates, times and gender of the sample may be needed, providing background on subjects, such as breast cancer in women over thirty-five. Any pertinent information pertaining to the sample must be included for the reader to judge the study as worthy.
In addition, the current evidence-based practice (EBP) movement in healthcare emphasizes that clinical decision making should be based on the "best evidence" available, preferably the findings of randomized clinical trials. Within this context qualitative research findings are considered to have little value and the old debate in nursing has been re-ignited related as to whether qualitative versus quantitative research findings provides the best empirical evidence for nursing practice.
In response to this crisis qualitative scholars have been called upon by leaders in the field to clarify for outsiders what qualitative research is and to be more explicit in pointing out the utility of qualitative research findings.
In addition, attention to "quality" in qualitative research has been identified as an area worthy of renewed focus. Within this paper two key problems related to addressing these issues are reviewed: disagreement not only among "outsiders" but also some nursing scholars related to the definition of "qualitative research", and a lack of consensus related how to best address "rigor" in this type of inquiry.
Based on this review a set of standard requirements for qualitative research published in nursing journals is proposed that reflects a uniform definition of qualitative research and an enlarged yet clearly articulated conceptualization of quality. The approach suggested provides a framework for developing and evaluating qualitative research that would have both defensible scholarly merit and heuristic value. This will help solidify the argument in favor of incorporating qualitative research findings as part of the empirical "evidence" upon which evidence-based nursing is founded.
== Legal and ethical issues of research ==
Both legal and ethical issues are important in considering patient-based research. The American Nurses Association (ANA) has set up five basic rights for patient protection:
Right to self-determination
Right to privacy and dignity
Right to anonymity and confidentiality
Right to fair treatment
Right to protection from discomfort and harm.
These rights apply to both researchers and participants. Informed consent is one area that nurses must be familiar with in order to complete research. Informed consent is "the legal principle that governs the patient's ability to accept or reject individual medical interventions designed to diagnose or treat an illness". Informed consent can only be obtained before the procedure and after potential risks have been explained to the participant. When dealing with the ethical portion of evidence-based practice, the Institutional Review Boards (IRB) review research projects to assess that ethical standards are being followed. The institutional review board is responsible for protecting subjects from risk and loss of personal rights and dignity. The IRB also come into play when deciding on which populations can be included in research. Vulnerable groups such as children, pregnant women, physically disabled or elderly maybe excluded from the process. Nurses must notify the IRB of any ethical or legal violations.
It is important to be up to date on all the appropriate state laws and regulations regarding vulnerable populations. This may mean consulting with lawyers, clinicians, ethicists, as well as the affiliated IRB. It is imperative that researchers act as advocates for these vulnerable persons that cannot do so for themselves.

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== Barriers to promoting evidence-based practice ==
The use of evidence-based practice depends a great deal on the nursing student's proficiency at understanding and critiquing the research articles and the associated literature that will be presented to them in the clinical setting. According to, Blythe Royal, author of Promoting Research Utilization in nursing: The Role of the Individual, Organization, and Environment, a large amount of the preparation requirements of nursing students consists of creating care plans for patients, covering in depth processes of pathophysiology, and retaining the complex information of pharmacology. These are indeed very important for the future of patient care, but their knowledge must consist of more when they begin to practice. Evidence-based nursing in an attempt to facilitate the management of the growing literature and technology accessible to healthcare providers that can potentially improve patient care and their outcomes. Nancy Dickenson-Hazard states, "Nurses have the capacity to serve as caregivers and change agents in creating and implementing community and population-focused health systems." There is also a need to overcome the barriers to encourage the use of research by new graduates in an attempt to ensure familiarity with the process. This will help nurses to feel more confident and be more willing to engage in evidence-based nursing. A survey that was established by the Honor Society of Nursing and completed by registered nurses proved that 69% have only a low to moderate knowledge of EBP and half of those that responded did not feel sure of the steps in the process. Many responded, "lack of time during their shift is the primary challenge to researching and applying EBP." There is always and will always be a desire to improve the care of our patients. The ever-increasing cost of healthcare and the need for more accuracy in the field proves a cycle in need of evidence-based healthcare. The necessity to overcome the current issues is to gain knowledge from a variety of literature not just the basics. There is a definite need for nurses, and all practitioners, to have an open mind when dealing with the modern inventions of the future because these could potentially improve the health of patients.
There are many barriers to promoting evidence-based practice. The first of which would be the practitioner's ability to critically appraise research. This includes having a considerable amount of research evaluation skills, access to journals, and clinic/hospital support to spend time on EBN. Time, workload pressures, and competing priorities can impede research and development. The causes of these barriers include nurses' and other professional practitioners' lack of knowledge of research methods, lack of support from professional colleagues and organizations, and lack of confidence and authority in the research arena.
Another barrier is that the practice environment can be resistant to changing tried and true conventional methods of practice. This can be caused because of reluctance to believe results of research study over safe, traditional practices, cost of adopting new practices, or gaining momentum to rewrite existing protocols. It is important to show nurses who may be resistant to changes in nursing practice the benefits that nurses, their patients, and their institutions can reap from the implementation of evidence-based nursing practice, which is to provide better nursing care. Values, resources and evidence are the three factors that influence decision-making with regard to health care. All registered nurses and health care professionals should be taught to read and critically interpret research and know where to find articles which relate to their field of care. In addition, nurses need to be more aware of how to assess the information and determine its applicability to their practice.
Another barrier to implementing EBN into practice is lack of continuing education programs. Practices do not have the means to provide workshops to teach new skills due to lack of funding, staff, and time; therefore, the research may be tossed dismissed. If this occurs, valuable treatments may never be utilized in patient care. Not only will the patients suffer but the staff will not have the opportunity to learn a new skill. Also, the practitioners may not be willing to implement change regardless of the benefits to patient care.
Another barrier to introducing newly learned methods for improving treatments or patients' health is the fear of "stepping on one's toes". New nurses might feel it is not their place to suggest or even tell a superior nurse that newer, more efficient methods and/or practices are available.
Even if clinicians do act consistently it is possible that their decisions are consistently biased. People put different values on gains and losses. Tversky and Kahneman gave people the two identical problems (with the same probabilities of life and death outcomes – see fig 1) but framed the outcome choices as either lives saved or as deaths.10 Most people wanted to avoid taking risks with gains which could be safeguarded, but would take risks with losses which might be avoided; this is a framing effect. If people are given identical options but different words are used to emphasize a gain rather than a loss, then a different response is given by a large proportion of the population under study. Such a change in response appears to be inconsistent.
== Implementation and sustainability ==
The Iowa Model is used to promote quality of care. It is a guideline for nurses in their decision-making process. The decision making can include clinical and administration practices. These practices affect patient outcomes. The model is based on problem-solving steps that are a part of the scientific process. Recognition for applicability and ease of use. Key components of using the Iowa Model:

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Identify "triggers"
Clinical applications
Organizational priorities
Forming a team
Piloting a practice change
Evaluating the pilot
Evaluate change and share results
First, identify "triggers", which can be either problem focused or knowledge focused. These can be the important questions that arise from current practices. With knowledge focus, nurses can question a current practice due to shared scientific knowledge. This knowledge can be in the form of research or national guidelines for example. With problem focus, nurses can find room for improvement from already existing facts.
Second, clinical application is how nurses figure out the importance of the question identified and the relevance by using the EBP process.
Third, organizational priorities is ranking the question by the priorities of the organization. High priority given to areas that focus on high-volume/risk/cost, organization's plan, or motivated by other forces. Knowing where a question lies in priorities can be a determination factor of getting the necessities needed to do an EBP projection for that organization.
Fourth, forming a team is possible once agreeance occurs. The team is assembled to create, do, and evaluate the change. It is a multi-disciplinary functioning team with various skill sets and networks.
Fifth, the piloting of a practice change is the essential step to this process. Having a selected area of the organization to pilot the practice change can help identify any issues that arise from implementation of the change before the change is spread throughout the organization. This is a multiple step process.
Sixth, the evaluation of the pilot is the decision-making process that evaluates if the pilot is accomplishing the goals of implementation, which is the quality of care provided improving, due to this pilot or not. It can involve either problem solving of the issues being had, dropping the implementation completely/postponing, or going ahead and implementing.
Lastly, the EBP changes continued to be monitored with reports of quality and performance improvements being noted. Sharing the results with the rest of the organization is key for learning. It also promotes the EBP culture.
== See also ==
Evidence-based practices
https://www.varhealthcare.com/
== References ==
== External links ==
Indiana Center for Evidence-Based Nursing Practice, a collaborating center of The Joanna Briggs Institute, located at Purdue University Calumet's School of Nursing
Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, an Evidence Based Practice teaching center within the College of Nursing at The Ohio State University
University of Minnesota Libraries, a tutorial on evidence-based nursing
Centre for Evidence-Based Medicine, University Health Network
Academic Center for Evidence-Based Practice", The University of Texas Health Science Center at San Antonio
"What Is Evidence-Based Practice in Nursing?" from the University of Saint Mary
Medscape Today, online nursing resource and a source of CEU credit articles
Evidence Based Medicine Toolkit
Systems to Rate the Strength of Scientific Evidence
Construct Well-Built Clinical Questions using PICO

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Many developing nations have developed national drug policies, a concept that has been actively promoted by the WHO. For example, the national drug policy for Indonesia drawn up in 1983 had the following objectives:
To ensure the availability of drugs according to the needs of the population.
To improve the distribution of drugs in order to make them accessible to the whole population.
To ensure efficacy, safety quality and validity of marketed drugs and to promote proper, rational and efficient use.
To protect the public from misuse and abuse.
To develop the national pharmaceutical potential towards the achievements of self-reliance in drugs and in support of national economic growth.
To achieve these objectives in Indonesia, the following changes were implemented:
A national list of essential drugs was established and implemented in all public sector institutions. The list is revised periodically.
A ministerial decree in 1989 required that drugs in public sector institutions be prescribed generically and that Pharmacy and Therapeutics committees be established in all hospitals.
District hospitals and health centers have to procure their drugs based on the essential drugs list.
Most drugs are supplied by three government-owned companies.
Training modules have been developed for drug management and rational drug use and these have been rolled out to relevant personnel.
The central drug laboratory and provincial quality control laboratories have been strengthened.
A major teaching hospital has developed a program on rational drug use, developing a hospital formulary, guidelines for rational diagnosis and treatment guidelines for the rational use of antibiotics.
Generic drugs have been available at affordable costs to low-income groups.
== Encouraging rational prescribing ==
One of the first challenges is to promote and develop rational prescribing, and a number of international initiatives exist in this area. WHO has actively promoted rational drug use as one of the major elements in its Drug Action Programme. In its publication A Guide to Good Prescribing the process is outlined as:
define the patient's problem
specify the therapeutic objectives
verify whether your personal treatment choice is suitable for this patient
start the treatment
give information, instructions and warnings
monitor (stop) the treatment.
The emphasis is on developing a logical approach, and it allows for clinicians to develop personal choices in medicines (a personal formulary) which they may use regularly. The program seeks to promote appraisal of evidence in terms of proven efficacy and safety from controlled clinical trial data, and adequate consideration of quality, cost and choice of competitor drugs by choosing the item that has been most thoroughly investigated, has favorable pharmacokinetic properties and is reliably produced locally. The avoidance of combination drugs is also encouraged.
The routine and irrational use of injections should also be challenged. One study undertaken in Indonesia found that nearly 50% of infants and children and 75% of the patients aged five years or over visiting government health centers received one or more injections. The highest use of injections was for skin disorders, musculoskeletal problems and nutritional deficiencies. Injections, as well as being used inappropriately, are often administered by untrained personnel; these include drug sellers who have no understanding of clean or aseptic techniques.
Another group active in this area is the International Network for the Rational Use of Drugs (INRUD). This organization, established in 1989, exists to promote rational drug use in developing countries. As well as producing training programs and publications, the group is undertaking research in a number of member countries, focused primarily on changing behavior to improve drug use. One of the most useful publications from this group is entitled Managing Drug Supply. It covers most of the drug supply processes and is built up from research and experience in many developing countries. There a number of case studies described, many of which have general application for pharmacists working in developing countries.
In all the talk of rational drug use, the impact of the pharmaceutical industry cannot be ignored, with its many incentive schemes for doctors and pharmacy staff who dispense, advise or encourage use of particular products. These issues have been highlighted in a study of pharmaceutical sales representative (medreps) in Mumbai. This was an observational study of medreps' interactions with pharmacies, covering a range of neighborhoods containing a wide mix of social classes. It is estimated that there are approximately 5000 medreps in Mumbai, roughly one for every four doctors in the city. Their salaries vary according to the employing organization, with the multinationals paying the highest salaries. The majority work to performance-related incentives. One medrep stated "There are a lot of companies, a lot of competition, a lot of pressure to sell, sell! Medicine in India is all about incentives to doctors to buy your medicines, incentives for us to sell more medicines. Even the patient wants an incentive to buy from this shop or that shop. Everywhere there is a scheme, that's business, that's medicine in India.'
The whole system is geared to winning over confidence and getting results in terms of sales; this is often achieved by means of gifts or invitations to symposia to persuade doctors to prescribe. With the launch of new and expensive antibiotics worldwide, the pressure to sell with little regard to the national essential drug lists or rational prescribing. One medrep noted that this was not a business for those overly concerned with morality. Such a statement is a sad reflection on parts of the pharmaceutical industry, which has an important role to play in the development of the health of a nation. It seems likely that short-term gains are made at the expense of increasing problems such as antibiotic resistance. The only alternatives are to ensure practitioners have the skills to appraise medicine promotion activities or to more stringently control pharmaceutical promotional activities.

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== Rational dispensing ==
In situations where medicines are dispensed in small, twisted-up pieces of brown paper, the need for patient instruction takes on a whole new dimension. Medicines should be issued in appropriate containers and labelled. While the patient may be unable to read, the healthcare worker is probably literate. There are many tried-and-tested methods in the literature for using pictures and diagrams to aid patient compliance. Symbols such as a rising or setting sun to depict time of day have been used, particularly for treatments where regular medication is important, such as cases of tuberculosis or leprosy.
Poverty may force patients to purchase one day's supply of medicines at a time, so it is important to ensure that antibiotics are used rationally and not just for one or two days' treatment. Often, poor patients need help from pharmacists to understand which are the most important medicines and to identify the items, typically vitamins, that can be missed to reduce the cost of the prescription to a more manageable level.
== The essential drugs concept ==
The essential drugs list concept was developed from a report to the 28th World Health Assembly in 1975 as a scheme to extend the range of necessary drugs to populations who had poor access because of the existing supply structure. The plan was to develop essential drugs lists based on the local health needs of each country and to periodically update these with the advice of experts in public health, medicine, pharmacology, pharmacy and drug management. Resolution number 28.66 at the Assembly requested the WHO Director-General to implement the proposal, which led subsequently to an initial model list of essential drugs (WHO Technical Series no 615, 1977). This model list has undergone regular review at approximately two-yearly intervals and the current 14th list was published in March 2005. The model list is perceived by the WHO to be an indication of a common core of medicines to cover most common needs. There is a strong emphasis on the need for national policy decisions and local ownership and implementation. In addition, a number of guiding principles for essential drug programs have emerged.
The initial essential drugs list should be seen as a starting point.
Generic names should be used where possible, with a cross-index to proprietary names.
Concise and accurate drug information should accompany the list.
Quality, including drug content stability and bioavailability, should be regularly assessed for essential drug supplies.
Decisions should be made about the level of expertise required for drugs. Some countries make all the drugs on the list available to teaching hospitals and have smaller lists for district hospitals and a very short list for health centers.
Success depends on the efficient supply, storage and distribution at every point.
Research is sometimes required to settle the choice of a particular product in the local situation.
=== The model list of essential drugs ===
The model list of essential drugs is divided into 27 main sections, which are listed in English in alphabetical order. Recommendations are for drugs and presentations. For example, paracetamol appears as tablets in strengths of 100 mg to 500 mg, suppositories 100 mg and syrup 125 mg/5ml. Certain drugs are marked with an asterisk (previously a ៛), which denotes an example of a therapeutic group, and other drugs in the same group could serve as alternatives.
The lists are drawn up by consensus and generally are sensible choices. There are ongoing initiatives to define the evidence that supports the list. This demonstrates the areas where RCTs (randomized controlled trials) or systematic reviews exist and serves to highlight areas either where further research is needed or where similar drugs may exist which have better supporting evidence.
In addition to work to strengthen the evidence base, there is a proposal to encourage the development of Cochrane reviews for drugs that do not have systematic review evidence.
Application of NNTs (numbers needed to treat) to the underpinning evidence should further strengthen the lists. At present, there is an assumption among doctors in some parts of the world that the essential drugs list is really for the poor of society and is somehow inferior. The use of NNTs around analgesics in the list goes some way to disprove this and these developments may increase the importance of essential drugs lists.
== Communicating clear messages ==
The impact of pharmaceutical representatives and the power of this approach has led to the concept of academic detailing to provide clear messages. A study by Thaver and Harpham described the work of 25 private practitioners in area around Karachi. The work was based on assessment of prescribing practices, and for each practitioner included 30 prescriptions for acute respiratory infections (ARIs) or diarrhea in children under 12 years of age. A total of 736 prescriptions were analysed and it was found that an average of four drugs were either prescribed or dispensed for each consultation. An antibiotic was prescribed in 66% of prescriptions, and 14% of prescriptions were for an injection. Antibiotics were requested for 81% of diarrhea cases and 62% of ARI cases. Of the 177 prescriptions for diarrhea, only 29% were for oral rehydration solution. The researchers went on to convert this information into clear messages for academic dealing back to the doctors. The researchers went on to implement the program and assessed the benefits. This was a good piece of work based on developing messages that are supported by evidence.

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== Drug donations ==
It is a natural human reaction to want to help in whatever way possible when face with human disaster, either as a result of some catastrophe or because of extreme poverty. Sympathetic individuals want to take action to help in a situation in which they would otherwise be helpless, and workers in difficult circumstances, only too aware of waste and excess at home, want to make use of otherwise worthless materials. The problem is that these situations do not lend themselves to objectivity. There are numerous accounts of tons of useless drugs being air-freighted into disaster areas. It the requires huge resources to sort out these charitable acts and often the drugs cannot be identified because the labels are not in a familiar language. In many cases, huge quantities have to be destroyed simply because the drugs are out of date, spoiled, unidentifiable, or totally irrelevant to local needs. Generally, had the cost of shipping been donated instead, then many more people would have benefited.
In response to this, the WHO has generated guidelines for drug donations from a consensus of major international agencies involved in emergency relief. If these are followed, a significant improvement in terms of patient benefit and use of human resources will result.
=== WHO guidelines for drug donations 2005 ===
==== Selection of drugs ====
Drugs should be based on expressed need, be relevant to disease pattern and be agreed with the recipient.
Medicines should be listed on the country's essential drugs list or WHO model list.
Formulations and presentations should be similar to those used in the recipient country.
==== Quality assurance (QA) and shelf life ====
Drugs should be from a reliable source and WHO certification for quality of pharmaceuticals should be used.
No returned drugs from patients should be used.
All drugs should have a shelf life of at least 12 months after arrival in the recipient country.
==== Presentation, packing and labelling ====
All drugs must be labelled in a language that is easily understood in the recipient country and contain details of generic name, batch number, dosage form, strength, quantity, name of manufacturer, storage conditions and expiry date.
Drugs should be presented in reasonable pack sizes (e.g. no sample or patient starter packs).
Material should be sent according to international shipping regulations with detailed packing lists. Any storage conditions must be clearly stated on the containers, which should not weigh more than 50 kg. Drugs should not be mixed with other supplies.
==== Information and management ====
Recipients should be informed of all drug donations that are being considered or under way.
Declared value should be based on the wholesale price in the recipient country or on the wholesale world market price.
Cost of international and local transport, warehousing, etc., should be paid by the donor agency unless otherwise agreed with the recipient in advance.
== Evidence-based pharmacy practice ==
While modern practices, including the development of clinical pharmacy, are important, many basic issues await significant change in developing countries.
Medicines can often be found stored together in pharmacological groups rather than in alphabetical order by type.
Refrigerator space is often inadequate and refrigerators unreliable.
There are different challenges, such as ensuring that termites do not consume the outer packages and labels or that storage is free of other vermin such as rats.
Dispensary packaging and labelling can be woefully inadequate and patients leave with little or no understanding of how to take medicines which may have cost them at least one week's earnings.
Medicines are often out of stock, not just for a few hours but for days or even weeks, particularly at the end of the financial year.
Protocols and standard operating procedures are rarely found.
Even when graduate pharmacists are employed, they often have little opportunity to perform above the level of salesperson, simply issuing medicines and collecting payment. For example, several hospital pharmacies in Mumbai, India, are open 24 hours per day for 365 days per year but only to function as retail outlets selling medicines to outpatients or to relatives of inpatients who then hand over the medicines to the nursing staff for administration.
== Conclusions ==
Evidence is as important in the developing world as it is in the developed world. Poverty comes in many forms. While the most noticed are famine and poor housing, both potent killers, medical and knowledge poverty are also significant. Evidence-based practice is one of the ways in which these problems can be minimized. Potentially, one of the greatest benefits of the internet is the possibility of ending knowledge poverty and in turn influencing the factors that undermine wellbeing. Essential drugs programs have been a major step in ensuring that the maximum number benefit from effective drug therapy for disease.
== See also ==
Essential medicines
WHO Model List of Essential Medicines
Department of Essential Drugs and Medicines
Campaign for Access to Essential Medicines
Evidence-based practice
Universities Allied for Essential Medicines
== References ==
== Useful sources of information ==
The following is a list of useful publications from the WHO Department of Essential Drugs and Medicines Policy about essential drugs programs.
=== General publications ===
Essential Drugs Monitor - periodical issued twice a year, covering drug policy, research, rational drug use and recent publications.
WHO Action Programme on Essential Drugs in the South-East Asia Region - report on an Intercountry Consultative Meeting, New Delhi, 4–8 March 1991. 49 pages, ref no SEA/Drugs/83 Rev.1.
=== National drug policy ===
Report of the WHO Expert Committee on National Drug Policies - contribution to updating the WHO Guidelines for Developing Drug Policies. Geneva. 19–23 June 1995. 78 pages, ref no WHO/DAP/95.9.
Guidelines for Developing National Drug Policies - 1988, 52 pages, ISBN 92-4-154230-6.
Indicators for Monitoring National Drug Policies - P Brudon-Jakobowicz, JD Rainhorn, MR Reich, 1994, 205 pages, order no 1930066.

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=== Selection and use ===
Rational Drug Use: consumer education and information - DA Fresle, 1996, 50 pages, ref no DAP/MAC/(8)96.6.
Estimating Drug Requirements: a practical manual - 1988, 136 pages, ref no WHO/DAP/88.2.
The Use of Essential Drugs. Model List of essential drugs - updated every two years. Currently 14th edition, 2005. The list is available at: www.who.int/medicines
Drugs Used in Sexually Transmitted Diseases and HIV Infection - 1995, 97 pages, ISBN 92-4-140105-2.
Drugs Used in Parasitic Diseases (2e) - 1995, 146 pages, ISBN 92-4-140104-4.
Drugs Used in Mycobacterial Diseases - 1991, 40 pages, ISBN 92-4-140103-6.
Who Model Prescribing Information: Drugs Used in Anaesthesia - 1989, 53 pages, ISBN 978-9-241-40101-2.
Guidelines for Safe Disposal of Unwanted Pharmaceuticals In and After Emergencies - ref no WHO/EDM/PAR/99.4.
=== Supply and marketing ===
Guidelines for Drug Donations - interagency guidelines, revised 1999. Ref no WHO/EDM/PAR/99.4.
Operational Principles for Good Pharmaceutical Procurement - Essential Drugs and Medicines Policy / Interagency Pharmaceutical Coordination Group, Geneva, 1999.
Managing Drug Supply - Management Sciences for Health in collaboration with WHO, 1997, 832 pages, ISBN 1-56549-047-9.
Ethical Criteria for Medicinal Drug Promotion - 1988, 16 pages, ISBN 978-9-241-54239-5.
=== Quality assurance ===
WHO/UNICEF Study on the Stability of Drugs During International Transport - 1991, 68 pages, ref no WHO/DAP/91.1.
=== Human resources and training ===
The Role of the Pharmacist in the Health Care System - 1994, 48 pages, ref no WHO/PHARM 94.569.
Guide to Good Prescribing - TPGM de Vries, RH Henning, HV Hogerzeil, DA Fresle, 1994, 108 pages, order no. 1930074. Free to developing countries.
Developing Pharmacy Practice: a Focus on Patient Care - 2006, 97 pages, World Health Organization (WHO) and International Pharmaceutical Federation (FIP). [1]
=== Research ===
No 1 Injection Practices Research - 1992, 61 pages, ref no WHO/DAP92.9.
No 3 Operational Research on the Rational Use of Drugs - PKM Lunde, G Tognoni, G Tomson, 1992, 38 pages, ref no WHO/DAP/92.4.
No 24 Public Education in Rational Drug Use: a global survey - 1997, 75 pages, ref no WHO/DAP/97.5.
No 25 Comparative Analysis of National Drug Policies - Second Workshop, Geneva, 10–13 June 1996. 1997, 114 pages, ref no WHO/DAP/97.6.
No 7 How to Investigate Drug Use in Health Facilities: selected drug use indicators - 1993, 87 pages, order no 1930049.
== External links ==
WHO Medicines Policy and Standards, Technical Cooperation for Essential Drugs and Traditional Medicine
WHO Global Medicines Strategy: Countries at the Core 2004-2007

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Evidence-based policing (EBP) is an approach to policy making and tactical decision-making for police departments. It has its roots in the larger movement towards evidence-based practices.
Advocates of evidence-based policing emphasize the value of statistical analysis, empirical research, and ideally randomized controlled trials. EBP does not dismiss more traditional drivers of police decision-making, but seeks to raise awareness and increase the application of scientific testing, targeting, and tracking of police resources, especially during times of budget cuts and greater public scrutiny.
== Origins ==
Experiments had been used in earlier decades to find better policing methods, before Lawrence Sherman first outlined a definition of "evidence-based policing" in 1998.
The Police Foundation was founded in 1970. In 1971-72 the Police Foundation worked with the Kansas City Police Department to carry out a landmark study on patrol cars in what is known as the Kansas City preventive patrol experiment.
In the early 1980s, Sherman worked with Richard Berk and the Police Foundation to carry out the Minneapolis Domestic Violence Experiment. The study showed that arresting domestic violence suspects was a deterrent against repeat offending. The study had a "virtually unprecedented impact in changing then-current police practices." Sherman later worked with fellow criminologist David Weisburd for a 1995 study which showed the efficacy of focusing police crime prevention resources on small hot spots of crime.
In a 1998 Police Foundation "Ideas in American Policing" lecture, Sherman outlined the concept of "evidence-based policing". His core idea was that police practice can be made far more effective if tactics proven to work during controlled field experiments are prioritized. Angel Cabrera later described Sherman as the "father" of evidence-based policing.
=== Societies of Evidence Based Policing ===
In February 2000, Sherman co-founded the Campbell Collaboration's Crime and Justice Group, which has pursued the synthesis of research evidence on the effectiveness of policing and other crime prevention practices. In 2013 Sherman established the Cambridge Centre for Evidence-Based Policing as a global police training and research consultancy service for members, and in 2017 he launched the Cambridge Journal of Evidence-Based Policing as the membership journal of the Cambridge Centre. The journal's priority is to publish original, applied research led by "pracademic" police officers, with many articles based on master's degree theses completed under supervision of Sherman and his Cambridge colleagues, Heather Strang and Sir Denis O'Connor, by police leaders who were mid-career, part-time students in the Cambridge Police Executive Programme.
The first professional Society of Evidence-Based Policing was founded at Cambridge University in 2010, and now has some 2,000 members from mostly UK police agencies. In 2013, police in collaboration with the University of Queensland established the Australian-New Zealand Society of Evidence-Based Policing, which now has over 2000 members. In 2015, both Canada, and the United States established their own branches of this learned professional society. The Police Foundation provided support for the establishment of the American Society of Evidence-Based Policing, as it once did to create the Police Executive Research Forum (PERF) and the National Organization of Black Law Enforcement Executives (NOBLE).
== United Kingdom ==
In 2008, Sherman made EBP the core of the Police Executive Programme at Cambridge University, a part-time course of study for senior police leaders from around the world to earn a Diploma or Master’s in applied criminology. In that year, the National Policing Improvement Agency (NPIA) funded the first international conference on EBP, which was attended by police executives from Asia, Australia, Europe and the US. Since then the conference has been held each July, with the 10th International Conference in 2017 attended by over 300 police and scholars from six continents.
In 2010, a group of UK police officers founded the Society of Evidence-Based Policing, and elected Sherman Honorary President, along with Sir Peter Fahy, Chief Constable of the UK's Greater Manchester Police; as of 2015 the Society has over 2,800 members, including its 750-member Australia-New Zealand affiliate, consisting primarily UK police officers but with membership from Australia to Argentina and North America. The Society's twice-annual UK meetings have attracted over 200 attendees per meeting (including 2015), as well as press coverage.
In 2012, the UK Home Office founded the College of Policing, which took over many of the responsibilities of the National Police Improvement Agency (formally abolished in 2013). One of the College's five strategic objectives is "identifying, developing and promoting good practice based on evidence". The College is committed to identifying and sharing with police practitioners "what works". In 2013, the UK's largest police force, London's Metropolitan Police Service committed to "crime fighting based on what we know works".
=== What Works Centre For Crime Reduction Toolkit ===
The College of Policing in the UK has created the What Works Centre for Crime Reduction, part of a network of What Works Centres created to provide easy access to robust and comprehensive evidence to guide decision-making on public spending. The Crime Reduction Toolkit is an online tool that allows users to obtain information on the evidence for and against various interventions (including their impact, cost and implementation) and use this to help shape their crime reduction efforts. The What Works Centre Crime Reduction Toolkit currently includes 35 evaluations of interventions and has identified over 300 systematic reviews covering 60 different interventions.

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== United States ==
EBP is acknowledged by some senior police leaders as a valuable approach to improve policing. The FBI Academy offers a course on EBP.
EBP has become the subject of debate in research journals, deliberating the extent to which policing should be guided by experimental criminology. There is a consensus that more needs to be done to bridge the 'translation gap' between frontline police officers and academics.
Academics from the Department of Criminology, Law and Society at George Mason University launched the Center for Evidence-Based Crime Policy in 2008. Their Evidence-Based Policing Matrix records, orders and rates scientific evaluations in policing and seeks to enable police departments to access and assess existing evidence.
In 2015, a group of working police officers and crime analysts formed the American Society of Evidence-Based Policing. This organization was formed with the intent of educating police officers about the concept of EBP, advocating for the use of best available research to drive policing strategies and tactics, and facilitating the creation of new research findings by connecting researchers and practitioners. Membership is open to all serving police officers, civilian staff members, researchers, and academics. The first annual ASEBP conference was held on the campus of Arizona State University in Phoenix, Arizona on May 22 and 23, 2017, with conference attendees and panelists representing the United States, Canada, Mexico and the United Kingdom.
== Australia ==
The Australia & New Zealand Society of Evidence Based Policing (ANZSEBP) was formed in April 2013 in Brisbane, Australia. The ANZSEBP is a police practitioner-led Society. The mission of the ANZSEBP is to develop, disseminate and advocate for police to use scientific research (“the evidence”) to guide best practice in all aspects of policing.
The Society comprises both full members (current, serving police officers in Australia and New Zealand) and honorary members including police staff members (non-sworn), research professionals and others who aim to make evidence-based approaches part of everyday policing in Australia and New Zealand.
The ANZSEBP held its inaugural conference at the Australian Institute of Police Management, Sydney, Australia in March 2015. The Society was fortunate to secure Professor David Weisburd (George Mason University), Mr Peter Neyroud (Cambridge University), Professor Lorraine Mazerolle (University of Queensland), Chief Superintendent Alex Murray West Midlands Police (Chair of the UK SEBP) and Assistant Commissioner Peter Martin (Chair of the ANZ SEBP) to present at the conference. Further to that six short shot presentations were made that highlighted experiments or research throughout Australasia.
== Canada ==
The Canadian Society of Evidence Based Policing (CAN-SEBP) was launched in April 2015 in Manchester, UK, as an affiliate of the UK-based Society of Evidence Based Policing, as well as ASEBP and ANZ-SEBP. CAN-SEBP is a collaborative effort between police practitioners and academic researchers aimed at generating actionable research to inform policy, practice, education and training in the field of public safety. Partners in the Society - who maintain executive-level steering and oversight functions - include representatives from several Canadian police forces and universities. Other agencies and researchers serve as active collaborators.
CAN-SEBP's membership consists of active and retired police officers, civilian police members, applied policing researchers, graduate researchers and representatives from provincial, federal and municipal community safety groups.
CAN-SEBP's international advisory group includes: Professor David Weisburd (George Mason University), Mr Peter Neyroud (Cambridge University), Professor Lorraine Mazerolle (University of Queensland), Chief Superintendent Alex Murray West Midlands Police (Chair of the UK SEBP) and Assistant Commissioner Peter Martin (Chair of the ANZ SEBP).
== New Zealand ==
In December 2017, a joint partnership between New Zealand Police, the University of Waikato, the Institute of Environmental Science and Research (ESR), and Vodafone New Zealand established the New Zealand Evidence-Based Policing Centre (EBPC). Considered the first of its kind in the world, the centre is dedicated to supporting evidence-based policing research projects and experiments being run by New Zealand Police staff as well as academic researchers. The centre's "blueprint" was a finalist in the 2019 World Class Policing Awards. In March 2020, as part of New Zealand's civil emergency response to the COVID-19 pandemic, the centre produced an evidence scan to inform NZ Police's response to COVID-19. Also, the Centre's Lambton Quay, Wellington, offices were repurposed as the All-Of-Government COVID-19 Operations Command Centre in 3 days, with the ability to house 70 operational staff from across the government sector. Under the leadership of out-going Police Commissioner Mike Bush, the operations centre opened on 23 March 2020.
== See also ==
Crime science
Evidence-based legislation
Evidence-based policy
Evidence-based practices
Peelian principles
Problem-oriented policing
== References ==
== External links ==
Center for Evidence-Based Crime Policy
Experimental Criminology at University of Cambridge
Society of Evidence-Based Policing
Cambridge Centre for Evidence-Based Policing Ltd.
Canadian Society of Evidence-Based Policing

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Evidence-based policy (also known as evidence-informed policy or evidence-based governance) is a concept in public policy that advocates for policy decisions to be grounded on, or influenced by, rigorously established objective evidence. This concept presents a stark contrast to policymaking predicated on ideology, 'common sense', anecdotes, or personal intuitions. The methodology employed in evidence-based policy often includes comprehensive research methods such as randomized controlled trials (RCT). Good data, analytical skills, and political support to the use of scientific information are typically seen as the crucial elements of an evidence-based approach.
An individual or organisation is justified in claiming that a specific policy is evidence-based if, and only if, three conditions are met. First, the individual or organisation possesses comparative evidence about the effects of the specific policy in comparison to the effects of at least one alternative policy. Second, the specific policy is supported by this evidence according to at least one of the individual's or organisation's preferences in the given policy area. Third, the individual or organisation can provide a sound account for this support by explaining the evidence and preferences that lay the foundation for the claim.
The effectiveness of evidence-based policy hinges upon the presence of quality data, proficient analytical skills, and political backing for the utilization of scientific information.
While proponents of evidence-based policy have identified certain types of evidence, such as scientifically rigorous evaluation studies like randomized controlled trials, as optimal for policymakers to consider, others argue that not all policy-relevant areas are best served by quantitative research. This discrepancy has sparked debates about the types of evidence that should be utilized. For example, policies concerning human rights, public acceptability, or social justice may necessitate different forms of evidence than what randomized trials provide. Furthermore, evaluating policy often demands moral philosophical reasoning in addition to the assessment of intervention effects, which randomized trials primarily aim to provide.
In response to such complexities, some policy scholars have moved away from using the term evidence-based policy, adopting alternatives like evidence-informed. This semantic shift allows for continued reflection on the need to elevate the rigor and quality of evidence used, while sidestepping some of the limitations or reductionist notions occasionally associated with the term evidence-based. Discussions on evidence-informed policy have considered, for example, the inclusion of policy, practice and public stakeholders in the production of evidence; the relevance, adaptability and acceptability of evidence, alongside issues of rigour and quality; and how power and politics permeate the production and use of evidence. Despite these nuances, the phrase "evidence-based policy" is still widely employed, generally signifying a desire for evidence to be used in a rigorous, high-quality, and unbiased manner, while avoiding its misuse for political ends.
== History ==
The shift towards contemporary evidence-based policy is deeply rooted in the broader movement towards evidence-based practice. This shift was largely influenced by the emergence of evidence-based medicine during the 1980s. However, the term 'evidence-based policy' was not adopted in the medical field until the 1990s. In social policy, the term was not employed until the early 2000s.
The initial instance of evidence-based policy was manifested in tariff-making in Australia. The legislation necessitated that tariffs be informed by a public report issued by the Tariff Board. This report would cover the tariff, industrial, and economic implications.
=== History of evidence-based medicine ===
Evidence-based medicine (EBM) is a term that was first introduced by Gordon Guyatt. Nevertheless, examples of EBM can be traced back to the early 1900s. Some contend that the earliest instance of EBM dates back to the 11th century when Ben Cao Tu Jing from the Song dynasty suggested a method to evaluate the efficacy of ginseng.
Many scholars regard evidence-based policy as an evolution from "evidence-based medicine", where research findings are utilized to support clinical decisions. In this model, evidence is collected through randomized controlled trials (RCTs) which compare a treatment group with a placebo group to measure outcomes.
While the earliest published RCTs in medicine date back to the 1940s and 1950s, the term 'evidence-based medicine' did not appear in published medical research until 1993. In the same year, the Cochrane Collaboration was established in the UK. This organization works to keep all RCTs up-to-date and provides "Cochrane reviews", which present primary research in human health and health policy.
The usage of the keyword EBM has seen a significant increase since the 2000s, and the influence of EBM has substantially expanded within the field of medicine.

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=== History of evidence-based policy making ===
The application of randomized controlled trials in social policy was notably later than in the medical field. Although elements of an evidence-based approach can be traced back as far as the fourteenth century, it was popularized more recently during the tenure of the Blair Government in the United Kingdom. This government expressed a desire to shift away from ideological decision-making in policy formulation. For instance, a 1999 UK Government white paper, Modernising Government, emphasized the need for policies that "really deal with problems, are forward-looking and shaped by evidence rather than a response to short-term pressures; [and] tackle causes not symptoms."
This shift in policy formulation led to an upswing in research and activism advocating for more evidence-based policy-making. As a result, the Campbell Collaboration was established in 1999 as a sibling organization to the Cochrane Collaboration. The Campbell Collaboration undertakes reviews of the most robust evidence, analyzing the impacts of social and educational policies and practices.
The Economic and Social Research Council (ESRC) furthered the drive for more evidence-based policymaking by granting £1.3 million to the Evidence Network in 1999. One outcome of this investment was the establishment of the first international, peer-reviewed journal dedicated to the study of the field, Evidence and Policy in 2005. Similar to both the Campbell and Cochrane Collaborations, the Evidence Network functioned as a hub for evidence-based policy and practice. From 2011 to 2022 the Alliance for Useful Evidence was established, funded by the ESRC, Big Lottery, and Nesta, to advocate for the use of evidence in social policy and practice. The Alliance, operating throughout the UK, promoted the use of high-quality evidence to inform decisions on strategy, policy, and practice through advocacy, research publication, idea sharing, advice, event hosting, and training. It also supported the development of the UK's What Works network. Current collaborations in the UK supporting the field include Transforming Evidence and the Transforming Evidence Network (TEN).
The application of evidence-based policy varies among practitioners. For instance, Michael Kremer and Rachel Glennerster, curious about strategies to enhance students' test scores, conducted randomized controlled trials in Kenya. They experimented with new textbooks and flip charts, and smaller class sizes, but they discovered that the only intervention that boosted school attendance was treating intestinal worms in children. Their findings led to the establishment of the Deworm the World Initiative, a charity highly rated by GiveWell for its cost-effectiveness.
Recent discussions have emerged about the potential conflicts of interest in evidence-based decision-making applied to public policy development. In their analysis of vocational education in prisons run by the California Department of Corrections, researchers Andrew J. Dick, William Rich, and Tony Waters found that political factors inevitably influenced "evidence-based decisions," which were ostensibly neutral and technocratic. They argue that when policymakers, who have a vested interest in validating previous political judgments, fund evidence, there is a risk of corruption, leading to policy-based evidence making.
== Methodology ==
Evidence-based policy employs various methodologies, but they all commonly share the following characteristics:
They test a theory as to why the policy will be effective and what the impacts of the policy will be if it is successful.
They include a counterfactual: an analysis of what would have occurred if the policy had not been implemented.
They incorporate some measurement of the impact.
They examine both direct and indirect effects that occur because of the policy.
They identify uncertainties and control for external influences outside of the policy that may affect the outcome.
They can be tested and replicated by a third party.
The methodology used in evidence-based policy aligns with the cost-benefit framework. It is designed to estimate a net payoff if the policy is implemented. Due to the difficulty in quantifying some effects and outcomes of the policy, the focus is primarily on whether benefits will outweigh costs, rather than assigning specific values.
== Types of evidence in evidence-based policy making ==
Various types of data can be considered evidence in evidence-based policy making. The scientific method organizes this data into tests to validate or challenge specific beliefs or hypotheses. The outcomes of various tests may hold varying degrees of credibility within the scientific community, influenced by factors such as the type of blind experiment (blind vs. double-blind), sample size, and replication. Advocates for evidence-based policy strive to align societal needs (as framed within Maslow's Hierarchy of needs) with outcomes that the scientific method indicates as most probable.
=== Quantitative evidence ===
Quantitative evidence for policymaking includes numerical data from peer-reviewed journals, public surveillance systems, or individual programs. Quantitative data can also be collected by the government or policymakers themselves through surveys. Both evidence-based medicine (EBM) and evidence-based public health policy constructions extensively utilize quantitative evidence.
=== Qualitative evidence ===
Qualitative evidence comprises non-numerical data gathered through methods such as observations, interviews, or focus groups. It is often used to craft compelling narratives to influence decision-makers. The distinction between qualitative and quantitative data does not imply a hierarchy; both types of evidence can be effective in different contexts. Policymaking often involves a combination of qualitative and quantitative evidence. However, it is important to note that EBPM tends to prioritize qualitative evidence over quantitative evidence; for instance, the U.S. Commission of Evidence-Based Policymaking's 2017 report used the work "Evidence" only to refer to information produced by “statistical activities” for a “statistical purpose” explicitly overlooking qualitative forms of evidence.
== Scholarly communication in policy-making ==
Academics provide input to policy beyond the production of content relating to issues addressed via policy through various channels:
some studies investigate existing policies (policy studies)
some studies include policy options with varying levels of specificity or detail or compare possible rough pathway-options
some science-related organizations devise concrete policy proposals
some academics engage in science communication or activism in various ways such as by holding press conferences, actively engaging with news media, engaging direct action themselves to attract media attention, writing collectively-signed public documents, social media activities, or creating open letters.

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== Evidence-based policy initiatives by non-governmental organizations ==
=== Overseas Development Institute ===
The Overseas Development Institute (now ODI Global) asserts that research-based evidence can significantly influence policies that have profound impacts on lives. Illustrative examples mentioned in the UK's Department for International Development's (DFID) new research strategy include a 22% reduction in neonatal mortality in Ghana, achieved by encouraging women to initiate breastfeeding within one hour of childbirth, and a 43% decrease in mortality among HIV-positive children due to the use of a widely accessible antibiotic.
Following numerous policy initiatives, the ODI conducted an evaluation of their evidence-based policy efforts. This analysis identified several factors contributing to policy decisions that are only weakly informed by research-based evidence. Policy development processes are complex, seldom linear or logical, thus making the direct application of presented information by policy-makers an unlikely scenario. These factors encompass information gaps, secrecy, the necessity for rapid responses versus slow data availability, political expediency (what is popular), and a lack of interest among policy-makers in making policies more scientifically grounded. When a discrepancy is identified between the scientific process and political process, those seeking to reduce this gap face a choice: either to encourage politicians to adopt more scientific methods or to prompt scientists to employ more political strategies.
The ODI suggested that, in the face of limited progress in evidence-based policy, individuals and organizations possessing relevant data should leverage the emotional appeal and narrative power typically associated with politics and advertising to influence decision-makers. Instead of relying solely on tools like cost–benefit analysis and logical frameworks, the ODI recommended identifying key players, crafting compelling narratives, and simplifying complex research data into clear, persuasive stories. Rather than advocating for systemic changes to promote evidence-based policy, the ODI encouraged data holders to actively engage in the political process.
Furthermore, the ODI posited that transforming a person who merely 'finds' data into someone who actively 'uses' data within our current system necessitates a fundamental shift towards policy engagement over academic achievement. This shift implies greater involvement with the policy community, the development of a research agenda centered on policy issues instead of purely academic interests, the acquisition of new skills or the formation of multidisciplinary teams, the establishment of new internal systems and incentives, increased investment in communications, the production of a different range of outputs, and enhanced collaboration within partnerships and networks.
The Future Health Systems consortium, based on research undertaken in six countries across Asia and Africa, has identified several key strategies to enhance the incorporation of evidence into policy-making. These strategies include enhancing the technical capacity of policy-makers; refining the presentation of research findings; leveraging social networks; and establishing forums to facilitate the connection between evidence and policy outcomes.
=== The Abdul Latif Jameel Poverty Action Lab (J-PAL) ===
J-PAL is a Research Organization which was founded in 2003 and is based at the Massachusetts Institute of Technology. As of 2020, the organization has "over 1,000 completed and ongoing RCTs in 84 countries" and receives funding from many sources including the Gates Foundation and the United Kingdom's Foreign, Commonwealth & Development Office. The work of J-PAL highlights a potential limit of the efficacy of this form of intervention as only "Eleven, or 2%, of the 543 RCTs conducted and completed by J-PAL (of the 811 launched) have actually been scaled up."
=== The Pew Charitable Trusts ===
The Pew Charitable Trusts is a non-governmental organization dedicated to using data, science, and facts to serve the public good. One of its initiatives, the Results First, collaborates with different US states to promote the use of evidence-based policymaking in the development of their laws. The initiative has created a framework that serves as an example of how to implement evidence-based policy.
Pew's five key components of evidence-based policy are:
Program Assessment: This involves systematic reviews of the available evidence on the effectiveness of public programs, the development of a comprehensive inventory of funded programs, categorization of these programs by their proven effectiveness, and identification of their potential return on investment.
Budget Development: This process incorporates the evidence of program effectiveness into budget and policy decisions, prioritizing funding for programs that deliver a high return on investment. It involves integrating program performance information into the budget development process, presenting information to policymakers in user-friendly formats, including relevant studies in budget hearings and committee meetings, establishing incentives for implementing evidence-based programs and practices, and building performance requirements into grants and contracts.
Implementation Oversight: This ensures that programs are effectively delivered and remain faithful to their intended design. Key aspects include establishing quality standards for program implementation, building and maintaining capacity for ongoing quality improvement and monitoring of fidelity to program design, balancing program fidelity requirements with local needs, and conducting data-driven reviews to improve program performance.
Outcome Monitoring: This involves routinely measuring and reporting outcome data to determine whether programs are achieving their desired results. It includes developing meaningful outcome measures for programs, agencies, and the community, conducting regular audits of systems for collecting and reporting performance data, and regularly reporting performance data to policymakers.
Targeted Evaluation: This process involves conducting rigorous evaluations of new and untested programs to ensure they warrant continued funding. This includes leveraging available resources to conduct evaluations, targeting evaluations to high-priority programs, making better use of administrative data for program evaluations, requiring evaluations as a condition for continued funding for new initiatives, and developing a centralized repository for program evaluations.

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== Cost-benefit analysis in evidence-based policy ==
Cost-benefit analysis (CBA) is a method used in evidence-based policy. It is an economic tool used to assess the economic, social, and environmental impacts of policies. The aim is to guide policymakers toward decisions that increase societal welfare.
The use of cost-benefit analysis in policy-making was first mandated by President Ronald Reagan's Executive Order 12291 in 1981. This order stated that administrative decisions should use sufficient information regarding the potential impacts of regulation. Maximizing the net benefits to society was a primary stated focus among the five general requirements of the order. EO 12291 built on the Nixon administration's expansion of federal control over agencies; in particular, his Quality of Life Review which directed agencies to submit "significant" proposed rules, including a "a comparison of expected costs and benefits" to the Office of Management and Budget.
Later presidents, including Bill Clinton and Barack Obama, modified but still emphasized the importance of cost-benefit analysis in their executive orders. For example, Clinton's Executive Order 12866 maintained cost-benefit analysis but also stressed the importance of flexibility, public involvement, and coordination among agencies.
During the Obama administration, Executive Order 13563 further strengthened the role of cost-benefit analysis in regulatory review. The EO encouraged agencies to consider values that are difficult or impossible to quantify, like equity, human dignity, and fairness.
The use of cost-benefit analysis in these executive orders highlights its central role in evidence-based policy. By comparing the potential impacts of different policy options, cost-benefit analysis can aid in policy decisions that are based on empirical evidence and designed to maximize societal benefits.
== Critiques ==
Evidence-based policy has faced several critiques. Paul Cairney, a professor of politics and public policy at the University of Stirling in Scotland, contends that proponents of the approach often underestimate the complexity of policy-making and misconstrue how policy decisions are typically made. Nancy Cartwright and Jeremy Hardie question the emphasis on randomized controlled trials (RCTs), arguing that evidence from RCTs is not always sufficient for making decisions. They suggest that applying experimental evidence to a policy context requires an understanding of the conditions present within the experimental setting and an assertion that these conditions also exist in the target environment of the proposed intervention. Additionally, they argue that the prioritization of RCTs could lead to the criticism of evidence-based policy being overly focused on narrowly defined 'interventions', which implies surgical actions on one causal factor to influence its effect.
The concept of intervention within the evidence-based policy movement aligns with James Woodward's interventionist theory of causality. However, policy-making also involves other types of decisions, such as institutional reforms and predictive actions. These other forms of evidence-based decision-making do not necessitate evidence of an invariant causal relationship under intervention. Hence, mechanistic evidence and observational studies are often adequate for implementing institutional reforms and actions that do not alter the causes of a causal claim.
Furthermore, there have been reports of frontline public servants, such as hospital managers, making decisions that detrimentally affect patient care to meet predetermined targets. This argument was presented by Professor Jerry Muller of the Catholic University of America in his book The Tyranny of Metrics.
== See also ==
== References ==
== Further reading ==
Cartwright, Nancy; Stegenga, Jacob (2011). "A theory of evidence for evidence-based policy". In Dawid, A.P.; Twining, W.; Vasilaki, M. (eds.). Evidence, Inference and Enquiry. Proceedings of the British Academy. Vol. 171. Oxford University Press. pp. 290–322. doi:10.5871/bacad/9780197264843.003.0011. ISBN 978-0-19-726484-3.
Davies, H.T.O.; Nutley, S.M.; Smith, P.C. (2000). What Works? Evidence-based Policy and Practice in the Public Services. Bristol: Policy Press. doi:10.2307/j.ctt1t892t3. ISBN 1-86134-191-1. OCLC 472670136.
Hammersley, M. (2002). Educational Research, Policymaking and Practice. Paul Chapman/Sage. ISBN 978-1-84787-645-4.
Hammersley, M. (2013). The Myth of Research-Based Policy and Practice. Sage. ISBN 978-1-4462-9171-9.
McKinnon, Madeleine C.; Cheng, Samantha H.; Garside, Ruth; Masuda, Yuta J.; Miller, Daniel C. (2015). "Sustainability: Map the evidence". Nature. 528 (7581): 185–7. Bibcode:2015Natur.528..185M. doi:10.1038/528185a. PMID 26659166.
Schneider, Mike D. et al. 2026. "Revisiting the Base in Evidence-Based Policy." Political Studies 74(1).
== External links ==
"Modernising Government". Archived from the original on 10 August 2009.
"U.S. Evidence-Based Policymaking Commission Act of 2016" (PDF).
"U.S. Commission on Evidence-based Policy". Archived from the original on 17 January 2020.
"U.S. House bill passed to enact some of CEP recommendations". November 2017.

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Evidence-based scheduling is a software estimation approach created by Joel Spolsky, a commentator on software engineering principles. Evidence-based Scheduling is based on at least two core ideas: including all time spent, and using a Monte Carlo completion date prediction method. Evidence-based scheduling is an example of an evidence-based practice.
== Including all time spent ==
One of the core ideas of evidence-based scheduling, that adds to the normal estimation practices, is the idea of including all time spent, regardless of relevance.
Most people, when estimating, measure the time they actually spend on a project – classic Time Accounting categories such as cited in McConnell's Software Project Survival Guide do not allow for accounting for non-project activities. While McConnell goes on to include less obvious activities such as holidays, sick days and project support, he and most others identify such as activities to be separately recorded.
However, recording and attempting to budget for secondary activities often leads to political pressure to drop such activities. In practice, people find themselves unable to avoid them and compensate by working overtime. Similarly, as Spolsky points out, your bosses' stories about his fishing trips, or model helicopter, are both a time-sink and politically dangerous to put on a time-reporting system.
The key insight in evidence-based scheduling is that the only thing which needs measuring is the actual delivery of tasks. Over time, it is assumed that all other distractions will average out. For the purposes of estimation, variations due to interruption will show up as inaccuracies in estimation and will be compensated for by statistical analysis. The reasons for anomalies may come out if the organisation wishes to dig deeper into why people have irregular estimates.
The appeal of this idea is simplicity – the amount of evidence to be created is simply the elapsed time between completing tasks and, another vital point, time spent debugging is applied back to the original task.
== Monte Carlo method ==
Another core idea is the use of the Monte Carlo method to predict project completion dates. This method evaluates how reliable previous estimates have been. Instead of a single completion date, the method results in multiple possible completion dates, each with an associated probability of being correct.
== References ==