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Evidence-Based Clinical Practice: Dispelling the Myths

Mary E. Hise, PhD, RD, CNSD^*, Kendra Kattelmann, PhD, RD and Melissa Parkhurst, MD

^* Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas; the Nutrition, Food Science, and Hospitality Department, South Dakota State University, Brookings, South Dakota; and the Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas

Correspondence: Mary E. Hise, The University of Kansas Medical Center, Department of Dietetics and Nutrition, 3901 Rainbow Blvd., Mail Stop 4013, Kansas City, KS 66160-7250. Electronic mail may be sent to mhise{at}kumc.edu.

Evidence-based practice merges the best and most relevant clinical research data with clinician experience, pathophysiology of disease state, and the specifics of individual patient care. Currently, there is a significant gap between the best research evidence in healthcare and application of this evidence to clinician practices. Consistent with this finding, nutrition support is not always applied effectively or consistently, despite available scientific evidence that could be used to enhance a given treatment protocol. Cited obstacles that prevent the incorporation of research evidence into daily practice include lack of time, inadequate research skills, and information overload. Identification and application of the most valid primary research and evidence summaries (clinical guides to practice and meta-analyses) should, however, be an integral part of appropriate nutrition care. Consequently, it is important that clinicians develop and improve upon the basic skills required to allow efficient and accurate searches and evaluations of the literature. This review describes the basic and practical components of evidence-based medicine and provides tools to determine whether current nutrition practices are based upon an analysis of valid clinical evidence or anecdotal nutrition traditions and myths.

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