PBE: Practice Based Evidence

PBR refers to evidence that is collected in real world scenarios, rather than the more tightly controlled environments that are common in many research studies. This is an important area of evidence for many reasons: firstly that it reflects the kind of practice that most clinicians experience on the ground – patients with co-morbidities and subject to the financial and resource limitations that exist for many services. Also because it is an empirical question whether the outcomes of research studies collected using EBP are generalisable to situations that usually contain far more complexity than the original research study could handle.

Details #

We think the first paper putting forward the idea of PBE was Margison, F. R., Barkham, M., Evans, C., McGrath, G., Mellor-Clark, J., Audin, K., & Connell, J. (2000). Measurement and psychotherapy: Evidence-based practice and practice-based evidence. The British Journal of Psychiatry, 177(2), 123–130. https://doi.org/10.1192/bjp.177.2.123 which seems to be open access now but if you want it and can’t get it, contact me and I can send you a copy.

Very generally, PBE is the complement to Evidence Based Practice and provides evidence of general utility from routine practice rather than from specific research projects. In principle it embraces any potentially generalisable evidence coming from routine practice: case studies, case series, aggregated service data, pooled data from many services and it can be qualitative, quantitative, mixed, hybrid or genuinely blended in data and analytic methods.

This is not just a psychological therapy idea: in pharmacological research the “yellow card” system and the structures of “post-marketing surveillance” are vital PBE complements to the EBP processes, culminating in double blind, randomised controlled trials (DBRCTs) that get pharmaceutical products cleared for use. Ideally PBE should be recognised as vital to all healthy webs of evidence in relation to any therapies: physical health or psychological (and, of course, their constant interplay) whether pharmaceutical, psychological or psychosocial.

Try also … #

Evidence Based Practice (EBP)
Hierarchy of evidence

Chapters #

Chapter 10.

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