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Navigating Evidence and Opinions in Decision-Making

Explore the interplay between evidence and opinions, tackle conflicts, and assess validity and applicability in research and healthcare decisions. Adapting to dissonance and understanding implications for clinical practice and policy-making. Addressing critiques and questions in the realm of evidence-based practices.

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Navigating Evidence and Opinions in Decision-Making

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    2. Evidence & Opinion evidence, n. Ground for belief; testimony or facts tending to prove or disprove any conclusion. opinion, n. What or how one thinks about something; judgment or belief. In my opinion: according to my thinking; as it seems to me. A matter of opinion: a matter about which each may have his or her own opinion; a disputable point. What happens when evidence & opinion are perceived to conflict?

    3. 2 Case Studies Screening mammography for breast cancer Albumin for fluid resuscitation

    4. Screening mammography Australian nationwide program since 1992 Approx 1.25 million women screened each year (70% target) Early detection allows early treatment & better chance of cure

    7. Critique: Methods of primary studies Interpretation by reviewers Personal slander Defence of programs Protection of women

    10. Cochrane Review (updated 2006)

    11. Albumin Plasma protein solution given to patients needing fluids in ICU Large protein molecules encourage fluid to stay in the circulation longer than crystalloids

    14. Responses: Disbelief Denial Personal attacks through letters pages

    16. Evidence & decision-making Evidence is important but one of several drivers in decision-making Clinical practice: Best evidence – Experience & judgment – Patient values Policy-making: Many stakeholders ‘Hidden’ drivers of opinion & behaviour

    17. Dealing with Dissonance If it’s the evidence itself – can we improve it? If it’s other factors – can there be more constructive ways than we have witnessed in these examples? Therefore need to acknowledge & clarify source of dissonance

    18. Validity of evidence “Should I believe the evidence?” Design and quality of primary research Methods and quality of a review Currency of the research Theoretical basis underpinning the research

    19. Applicability & relevance of evidence “Is it relevant to me and my jurisdiction?” Similarity of patients Similarity of contexts Feasibility of the intervention Important outcomes of the intervention Alternatives

    20. Implications of evidence “What are the likely consequences of agreeing with or acting on the evidence?” Professional Socio-political Medico-legal Financial

    22. Questions Do I have a problem with this research? Does the problem relate to validity of the research? Does the problem relate to applicability or relevance of the research? Does the problem relate to the implications of the research?

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