Title: Consider EBP

1. Which of the three elements research evidence, clinical expertise, or patient values do you think is hardest to balance in real-world health care? Why?

Patient values, preferences and circumstances are arguably the most challenging to balance in real-world care. While research evidence and clinical expertise are relatively stable, patient values are highly individualised, contextual, and sometimes in tension with evidence or resource constraints.

Due to the limited quality and poor reporting of some of the published research, clinicians need to have a good understanding of study design and bias to assess internal validity, impact and applicability of the research.

2. The authors describe EBP as a process rather than a single skill. Which part of that process (asking, acquiring, appraising, applying, assessing) do you feel most confident about? Which do you find most challenging?

This is a personal question, there is no correct answer.

3. In your view, what risks exist when “evidence” dominates over experience or patient voice?

Evidence alone is never sufficient for high-quality decision making. When evidence is applied without proper integration of clinical judgement or patient context, there is a risk of: (a) ignoring patient values and circumstances; (b) over-reliance on quantitative evidence with marginalisation of qualitative insights into lived experiences of patients; (c) applying evidence from populations that is not applicable to the patient.

4. How might AI help or hinder the process of practicing EBP as the authors describe it?

AI can help EBP through efficient searching of evidence, monitoring for new evidence, and supporting appraisal of evidence to identify bias or methodological weaknesses of studies.

AI may hinder EBP by creating over-reliance on AI-summarised evidence (and ignoring patient factors); amplifying poor-quality evidence (i.e. many peer-reviewed studies are often flawed); and undermining clinical expertise and patient voice (i.e. all elements of EBP, evidence, expertise, patient values and context, must be integrated).

AI will likely change the evidence landscape, as precision medicine shifts from static population level evidence toward highly tailored, continuously updating inferences, thus potentially reframing what counts as evidence in clinical decision making.

5. Do you agree with the criticisms of EBM raised in the chapter?

Key criticisms of EBP include: (a) over-reliance on quantitative research; (b) limitations when evidence is sparse or inconsistent (practice may be constrained or uncertain which requires more reliance on clinical expertise and patient values); (c) overwhelming volume of research (thus the importance of efficient searching and critical appraisal); (d) large trials focusing on small clinical effects; (e) clinicians may follow evidence dogmatically; (f) heavily standardised care around evidence may lead to unintended consequences.