The chair searches for supportive evidence to help the Board formulate a rational response. He asks for performance indicators on how the hospital compares with others to determine potential cost-saving strategies and optimal budget allocations which would not sacrifice patient and provider needs. He is told that, although large amounts of data are available, the information is not useful for making budgetary decisions and, at the end of the day, program trade-offs are made with little evidence to support the final decisions. Health and health care decisions are complex and tough. While some decisions are grounded on sound evidence, many are not.
Evidence is but one of the elements in decision making.
The values and interests of the decision maker, as well as the situation or context in which the decision is being made, influence the process and outcome. Applying the best available evidence in the decision-making process does not in itself guarantee good decisions or outcomes, but it does improve the odds of both. We believe that using the best available evidence is key to improving decisions and outcomes that affect health. The physician and the patient, both concerned with the family history, want to find current information about the risks and prognosis and what potential preventive strategies might be available. Unable to find information specific to her ethnic origins, lifestyle and socioeconomic status, the family physician refers her to the Cancer Society for the information.