Effective Decisions In Health Care

Brownson, Chriqui, & Stamatakis (2009) Define evidence based practice as transparent, balanced use of evidence for making effective decisions in health care. The authors argue that effective policy formulation in decision making, in health care, should be on the basis of sound evidence. This ensures that there is an exploration of all aspects of anticipated changes in the decision making process. Evidence based practice is effective in health care practice because the future implications of the decisions are weighted prior to the change. The three domains of evidence include theoretical and empirical evidence, stakeholder’s opinions and trials and observational studies. Empirical and theoretical evidence are whereby the evidence is sourced from cases similar to the one which the decision is to be made. They provide the expected outcomes of the decisions.

Theoretical evidence is from past records of cases involving similar decisions; it is comparable to literature review. The literature review provides a framework to the policy makers on how to go about in the decisions and what to expect. Empirical evidence is from the field whereby the decision makers may visit institutions having similar decisions in the past to source evidence. For example, an institution in the process of embracing electronic health record may want to visit another one which works with the systems to study what they need to make such a change. Stakeholders’ opinions evidence is where the evidence is from the stakeholders of the institutions, for example; it could be the institutions’ staff or its client. This is paramount to effective decisions. Involving the respective stakeholders in the change process is imperative to effective decisions.

They may provide useful information about the decision case; it also ensures that all the stakeholders are ready to embrace the decisions due to collective involvement. Trials and observational studies are the third domain of evidence; a trial is like a control experiment which the decision makers carry prior to implementation of the decisions; it enables them identify implications of the change yet to happen. For example, an institution in the process of embracing EHR may first select one department to try the systems in; the results of the trial provide a blue print to whether the system will be detrimental or detrimental to the institution. Observational studies can also be a source of evidence, whereby an organization carries out observations in cases similar to that at hand to see what the implications of changes or decisions are; this prints a road map for the decision or change team on how to go about the practice.

The three evidence domains provide a basis for the ban of the use of trans fats.  The first domain of trials and observational studies show the negative implications of the semi saturated fats. Clinical trials indicate that use of trans fats has a high correlation to the Alzheimer’s diseases. Trial experiments with rats indicate that intake of trans fats causes destruction of proteins in the brain critical to neurological functions in the body; they also causes inflammation to the part of the brain responsible. Research indicates that these conditions are symptomatic to the onset of Alzheimer’s disease, and it is evidence to the ramifications of the use of trans fats, therefore, they are worth a ban. The Alzheimer’s disease is a condition which is usually for the old whereby the patients experience memory loss.

Observation and interrogation of cancer patients also indicates that the fats raise the chances for suffering from the prostate and breast cancer. Observational studies of prostate and breast cancer patients show high positive relationship between trans fats and the incidence of cancer. This is evidence to support the ban of the fats; this could reduce cases of cancer.Theoretical and empirical evidence also support the ban of the fats. Historical data show a high correlation of type II diabetes to the fats. Authors postulate that high intake of trans fats is a precursor to the incidence of diabetes; evidence from scholars supports the ban. Empirical evidence also indicates high relationship between the fats and coronary disease.

Laboratory investigation of the arteries of coronary disease patients shows that trans fats cause cholesterol deposits in the coronary arteries which could lead to cholesterol disease. This is evidence supporting the ban. It could see a reduction in the intake of cholesterol rich fats and could reduce the incidence of coronary heart disease. Stakeholder’s opinions that are from the patients and doctors fraternity also provide evidence towards the ban of trans fats; doctors argue that most obese persons and infertile woman in the United States usually have a long history of trans fats consumption; this indicates that the consumption of the fats could lead to infertility in women and obesity. It is an evidence for the ban. The fats could also lead to liver conditions through interference of the fats with enzyme functions. All in all the ban of trans fats is a positive move because it will lead reduction of disease incidences and a more healthy population.


Brownson, R., Chriqui, J., & Stamatakis, K. (2009). Understanding Evidence-Based Public          Health Policy. American Journal of Public Health, 99(9), 1576-83.

Centers for Disease Control and Prevention (2010). Public Health Law Program. Artificial            Trans-Fat. DOI: http://www2.cdc.gov/phlp/winnable/transfat.asp. Retrieved on 5th November 2012

Herdman, R., McGuire, W. and Simone, J. (2006). Influencing Cancer Policy. Health Affairs 25             (3): 800.

Mays, G. P., McHugh, M. C., Shim, K., Perry, N. et al. (2006). Institutional and Economic           Determinants of Public Health System Performance. American Journal of Public Health       96 (3): 523.

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