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Evidence Supporting Evidence-Based Thinking
Across Disciplines Eduardo Mendez, RN, MPH,
Barbarie Hill, MA, Carol Tierney, RN, MSN, Jerry
Edens, RRT, MEd
Problem/Background In his 2001 article, Peter
French suggests that evidence-based practice
lacks consensus and that there is little evidence
to support that a new process exists. This might
imply that it is a concept that will not survive
over time and thus would not be observed /
propagated in future healthcare publications.
Disagreement with this finding spurred inquiry
into the utilization of evidence-based
terminology within healthcare publications and
across the continuum of healthcare
disciplines. French P. What is the evidence on
evidence-based nursing? An epistemological
concern. Journal of Advanced Nursing. 2002 Feb
37(3) 250-7.
Categorization by Publication Types In order to
see how the term evidence-based is being used in
the literature, the results from the frequency
analysis sorted into categories within the
previously mentioned root suffixes. The
following sub categorization was used to filter
by the publication types SR Systematic
review (Cinahl) or meta analysis (Medline) RCT
Clinical trial (Cinahl and Medline) or
randomized controlled trial (Medline) OR Case
study or practice guidelines or research (Cinahl)
or guideline or multicenter study or
case reports (Medline) ED All other publication
types
Results Publications by Year The first
publication using the term evidence-based
appeared in a 1991 journal article. A
statistically significant rise in the numbers of
evidence-based publications begins around 1999
and continues through 2005. Evidence-Based
Medicine still leads in publication volume, yet
other disciplines (particularly Nursing) have
experienced a rise in embracing an evidence-based
philosophy and thus have increasingly published
regarding this concept. Abbreviated Terms (EB
Evidence-Based) EBHC EB Health Care
EBC EB Care EBDM EB Decision Making
EBP EB Practice EBM EB Medicine
EBN(NP) EB
Nursing/Nursing Practice EB Allied Disciplines
group included Evidence-Based
. Respiratory, Occupational, Physical
and Speech Therapies Dentistry and Ophthalmology
Research Questions Does the literature support
that the use of evidence-based terminology is
growing amongst all disciplines? Has the
literature using these evidence-based terms
continued to grow in volume beyond 2001?

• Conclusion and Significance
• The 1996 Institute of Medicine report that
  addressed quality healthcare practices
  recommended that clinicians and other providers
  make evidence-based decisions. This report may
  have influenced the tipping point expressed in
  the continuous rise of evidence-based terms in
  healthcare publications immediately after 1996.
  The rise in the number of publications referring
  to the term evidence-based is still increasing
  today. The majority of the articles were, as
  expected, not formal study designs, but fell
  under publication types considered to be more
  information sharing (educational). There were
  similar percent distributions by publication type
  among the various EB term subgroups, except for
  EBM where the formal study designs were diluted
  by the large volume of EB termed publications
  over the past 15 years. Evidence-based health
  care is a viable construct being used in
  medicine, nursing (currently in continued pursuit
  of evidence-based practices) and many other
  disciplines (just beginning to have their
  cultures of care impacted by increased
  evidence-based thinking being presented in the
  literature).

Theoretical Framework Lewins Change Theory was
utilized to explain this move. Unfreezing
involves letting go of certain attitudes, (weve
always done it that way). "Changing" involves
alteration of self-conceptions and ways of
thinking through the influence of research and
evidence collection. "Refreezing" involves
making changes based on the new evidence and
incorporating them into practice.
Methods A frequency analysis on the use of
evidence-based key terms in Ovids Cinahl and
Medline was conducted. English language only,
1997 2006, search was done 02/1/07. A total of
29,472 publications were found with
evidence-based in the title, abstract or as
keywords in the following subgroups. The
publications were subdivided by their
evidence-based plus root suffix Nursing
(nursing practice), Medicine, Practice, Care,
Decision making, Health care, and other Allied
therapy groups (included Respiratory, Physical,
Occupational, Speech, Dentistry and
Ophthalmology). Additionally these subgroups
were further subdivided by publication types,
both as coded / categorized by the Ovid search
engine.

• Acknowledgements
• Eloise Clark, Program Administrator, Center for
  Health Policy Clinical Effectiveness, for her
  assistance with analyzing the citation databases.
• Peggy Hopkins, Application Specialist I, Clinical
  Development and Education, for her assistance
  with printing this poster.