In modern medicine, making informed and effective decisions plays a key role in providing quality healthcare. However, with the increasing amount of data that clinicians are faced with, it is important to pay attention to methods and technologies that can systematize and synthesize evidence. In this article, we will explore the significance of medical decision-making, introduce the concept of evidence synthesis, and examine how this innovative practice can impact healthcare quality improvement.
The Art of Medical Decision-Making
In healthcare, where every decision affects the lives of patients, physicians regularly face various complexities and challenges. One of the major challenges is the overabundance of information and the uncertainty and diversity of clinical scenarios. Physicians are faced with the need to assess risks, take into account individual patient characteristics, and make decisions under time constraints.
The use of evidence in decision-making allows for systematization of information, consideration of statistical trends, and scientific approaches to evaluate the effectiveness of treatments.
Evidence-based decision-making improves patient outcomes. Accurate diagnoses, individualized approach and optimally chosen therapeutic strategies provide more effective treatment and increase the chances of recovery. Thus, evidence-based decision-making is becoming an integral element of modern medicine, ensuring the quality and safety of patient care.
What is Evidence Synthesis?
Evidence synthesis is a methodological approach that involves combining data from different sources to create a generalized view of a particular issue or problem. In medicine, evidence synthesis refers to the process of systematically combining and summarizing the results of different studies to obtain a comprehensive understanding of a particular issue or phenomenon.
This method includes:
- systematic reviews (systematic and objective evaluation of studies);
- meta-analysis (a statistical method of summarizing data from several studies to arrive at a common conclusion).
The process of evidence synthesis itself is accomplished in several steps:
- collecting data, various studies, and information on a particular issue in medicine;
- systematic analysis of the selected evidence, including its quality, methodology, and results;
- summarizing the findings to highlight major trends, patterns, and conclusions suitable for use in clinical practice.
Evidence synthesis in health care can be used for a variety of tasks:
- Drug efficacy review. Clinicians can conduct a systematic review of studies to determine the effectiveness of a particular drug based on the results of multiple clinical trials.
- Analyzing the effects of a particular treatment modality. Data synthesis can be used to evaluate the effects of a particular treatment modality, such as surgery, based on the results of various observational studies and research.
- Identification of risk factors for disease. A systematic literature review identifies and synthesizes evidence on risk factors associated with a particular disease, which can be useful for developing preventive strategies.
In other words, evidence synthesis helps clinicians and researchers better understand and use the body of scientific knowledge in public health.
Impact of Evidence Synthesis on Clinical Practice
By systematically analyzing and combining data from different studies, clinical guidelines can be updated and refined. Evidence synthesis results in more accurate and up-to-date protocols, which helps physicians make informed decisions about diagnostic and treatment methods.
Evidence synthesis improves medical procedures and treatments. It highlights effective strategies, optimizes treatment approaches, and adapts them to the changing clinical environment. This leads to improved efficiency and safety in medical practice.
For example, when choosing a treatment for breast cancer, physicians must consider the type of cancer, stage of disease, age, and general health of the patient, as well as the results of clinical trials comparing different treatments. For treatment, doctors may decide on surgery, radiation therapy, chemotherapy, or a combination of these treatments. The choice of treatment depends on many factors, including the size and location of the tumor, the patient’s age, her reproductive plans, and her overall health. Physicians can use evidence synthesis to determine which treatment method is most effective for a particular patient. They can access data from clinical trials that have compared different treatments, as well as data on treatment outcomes in actual clinical practice.
Also, evidence synthesis is becoming an increasingly important tool for research because it allows researchers to access a wider range of data. For example, In 2022, a team of researchers from Johns Hopkins University published a study designed as a systematic review and meta-regression that examined the effectiveness of COVID-19 vaccines. Researchers used evidence synthesis to collect data on clinical trial outcomes as well as vaccine outcomes in real-world clinical practice. The results of the study provide valuable information about the impact of vaccination:
- Protection against serious illness. The researchers found that the level of protection against SARS-CoV-2 infection decreased by an average of about 21 percentage points between one and six months after full vaccination. However, the level of protection against the severe form of COVID-19 decreased by only about 10 percentage points over the same period.
- Efficacy even without symptoms after vaccination. The study showed that mRNA vaccines (such as those developed by Pfizer and Moderna) remain effective even if a person has no symptoms after vaccination or has had a previous COVID-19 infection.
- Safety and efficacy. The Pfizer and Moderna vaccines are strongly recommended as safe and effective in preventing serious illness or death from COVID-19.
The study results served as evidence that COVID-19 vaccines are effective in preventing serious illness, hospitalization, and death.
Thus, synthesizing evidence actively forms the basis for current treatments, providing clinicians with tools to make informed and evidence-based decisions in clinical practice.
Evidence Synthesis in Health Policy
Evidence synthesis also plays an important role in shaping health policy and regulations, ensuring informed decision-making based on sound scientific evidence. It helps identify priorities and optimize resource allocation in health care, enabling managers and policymakers to make decisions to improve the efficiency of the health care system and the quality of life of payers.
An example of policy decisions influenced by evidence synthesis is the UK government’s decision to introduce the Soft Drinks Industry Tax (SDIL), known as the Sugar Tax, which came into effect in 2018. This tax was introduced in response to research that showed that high sugar consumption is linked to diseases such as obesity, diabetes, and cardiovascular disease.
SDIL’s main objective was to encourage soft drinks to be reformulated so that they become less sugary. Despite criticism from manufacturers, SDIL has been widely recognized as a successful initiative. The total amount of sugar added to soft drinks by retailers and manufacturers decreased by 35.4% between 2015 and 2019, from 135,500 tons to 87,600 tons. In the same period, the average sugar content of soft drinks decreased by 43.7%, falling from 5.7g/100ml to 2.2g/100ml.
The introduction of a sugar tax in the UK led to an 18% reduction in the consumption of sugary drinks. In addition, consumers were more likely to choose diet drinks over regular drinks. Overall, the tax contributed to a reduction in soft drink consumption of 6,500 calories per year per UK resident. More than 80% of this reduction was due to manufacturers reducing the sugar content of their products in the two years following the announcement of the tax.
The Future of Evidence Synthesis in Medicine
With the advent of big data in medicine, such as health records and genetic research, the process of collecting and analyzing information in medicine is becoming more complex. Many organizations are looking to create one common platform to more easily combine and examine data from different sources.
Also, emerging trends in evidence synthesis include:
- Artificial Intelligence. The use of AI in analyzing and interpreting medical data will help automate synthesis processes, identify new relationships, and improve the accuracy of predicting patient outcomes.
- Cloud technologies. Advances in cloud technology will provide accessibility to real-time data that will accelerate synthesis processes and enable faster decision-making.
- Advanced meta-analysis methodologies. Improved meta-analysis methods will better account for differences in studies and integrate data from different levels of evidence.
- Personalized medicine. Evidence synthesis will increasingly focus on creating personalized diagnostics and treatments, taking into account individual patient characteristics.
Thus, evidence synthesis aims to create more accurate, efficient, and personalized healthcare decision-making in the future.
In conclusion, evidence synthesis is becoming an integral part of modern medicine, playing a key role in medical decision-making. Evidence-based decision-making not only improves the accuracy of diagnoses, but also optimizes treatment choices, contributing to better health care outcomes. Evidence synthesis capabilities are already contributing to the continuous improvement of healthcare practices and systems today and have the potential to provide the best possible care and well-being for every patient in the future.