Читать книгу Practitioner's Guide to Using Research for Evidence-Informed Practice - Allen Rubin - Страница 45

One of the thornier issues in making your intervention decision concerns the number of strong studies needed to determine which intervention has the best evidence. For example, will 10 relatively weak, but not fatally flawed, studies with positive results supporting Intervention A outweigh one very strong study with positive results supporting Intervention B? Will one strong study suggesting that Intervention C has moderate effects outweigh one or two relatively weak studies suggesting that Intervention D has powerful effects? Although we lack an irrefutable answer to these questions, many EIP experts would argue that a study that is very strong from a scientific standpoint, such as one that has only a few minor flaws, should outweigh a large number of weaker studies containing serious (albeit perhaps not fatal) flaws. Supporting this viewpoint is research that suggests that studies with relatively weaker methodological designs can overestimate the degree of effectiveness of interventions (e.g., Cuijpers et al., 2010; Wykes et al., 2008). If you find that Intervention A is supported by one or two very strong studies and you find no studies that are equally strong from a scientific standpoint in supporting any alternative interventions, then your findings would provide ample grounds for considering Intervention A to have the best evidence.

However, determining that Intervention A has the best evidence is not the end of the story. Future studies might refute the current ones or might show newer interventions to be more effective than Intervention A. Although Intervention A might have the best evidence for the time being, you should remember that EIP is an ongoing process. If you continue to provide Intervention A for the next 10 or more years, your decision to do so should involve occasionally repeating the EIP process and continuing to find it to have the best supportive evidence.