EBHC DPhil rep, Ranin Soliman, writes poem about the concepts of evidence-based medicine/healthcare (EBM/EBHC), and its role in guiding researchers, clinicians, and policy-makers to make informed decisions for patients and the public regarding care delivery and clinical practice.
“And then evidence resonates” presents scientific and academic EBM resources in an artistic way, for awareness and educational purposes, through evoking an imaginative dialogue in a narrative approach, expressed by figures of speech.
Language is truly an art form to communicate a message, through words sensibly chosen and arranged for meaning, sound, and rhythm.1 And this is what this poem brings about; introducing EBM in an interesting, heart-felt and resonating piece of work.
Me, indulged in my clinical studies,
Searching for papers and looking for new trials.
When I found myself lost in a pool of literature,
And can’t decide which study to follow in particular
What shall I trust? where shall I go?
There are plenty of papers, that I can’t read though
And me, just when I thought everything was in control, and
I am good at deciding how my patients would benefit more
I found myself confused; what decision to make, and which treatment to recommend?
Shall I listen to my intuition, or ask a senior clinician, or just follow the trend?
Or maybe I’d pick a trial with a significantly positive effect,
And convince the patient this is what suits him best
Then, here I come,
with a more complex one.
I have to set the rules for the health of groups of people,
Yet, I am not sure how to make them right and legal
The public need to hear the proven truth, or otherwise they’d argue
But how can I get it across to them? I definitely have no clue.
I am all three;
a researcher, a clinician, and a health policy-maker
Now, I –all three– am lost in confusion,
And battling so hard to reach a solid conclusion.
When all of a sudden, a resonating voice lingers in my ears.
It seems to know it all, it seems to end my fears.
Evidence talks between quotations
And I hear it whispering,
“Don’t worry, I got it all settled for you,
I feel your uncertainty, and want to help you through.”
“I will be your guidance in all the decisions you make,
I am the reality, while the rest is all a fake.”
“Now, let me tell you some of my key assets,
But promise to follow them, and you will have no regrets.”
“My practice is a blend of three mutual recipes;
Clinical expertise, best available evidence, and patient values.”2
“And let me tell you about my five golden steps;
Ask a focused question, then search, critically appraise, and implement the evidence,
Finally, evaluate the impact and performance.” 3
“To formulate a good clinical question, follow the PICO rule of thumb,
The patient or problem, intervention, comparator, and outcome.” 4
“In finding the evidence, turn your question into a search strategy with results, 5
Look for the most relevant literature with the right study design.” 6
“And please note that not all evidence is a randomized controlled trial,
It depends on the research question type and the category of each level.” 7
“Then here comes the most interesting part,
Assessing the quality of papers and appraising them by heart.” 8
“Also, beware of any flaws in the methods or the results,
To help you find these, they even created a Catalogue of Bias.” 9
“Now it is time to implement the evidence and translate it into practice,
So, check the “knowledge into action” framework and learn some tactics.” 10
“Don’t forget to include a qualitative part to understand the local context,
Listening to the experts’ and patients’ opinions will serve you best.” 11
“For your research integrity, always declare your conflict of interest,
And be transparent in reporting your research findings.” 12
“Regarding public policy-making, use balanced evidence that combines:
Scientific evidence from trials, and empirical evidence about human behaviors.” 13
“One last thing before I go, if you want to know some more bits,
You can read my collection of the ten greatest hits.” 14
“After all, if something is still tricky and needs more attention,
Don’t hesitate to ask Professor Heneghan,15 but don’t ask a silly question.”
“I am here for you, and you will always need me,
Reflect my thoughts in this mystery.”
Who am I?!”
Back to the narrative voice of all three
Now, I –all three– wondered who this voice belonged to,
It seemed to answer my questions and help me through.
Then my eyes started to shine brighter a little,
as I was about to solve the riddle.
It is the sound of “Evidence” in health care practice
That turned my doubts into confidence, and saved me from my reluctance
Once, I –all three– was lost in confusion,
And couldn’t reach a solid conclusion.
And then Evidence Resonates, and
Everything falls right in place.
What to read next
Ranin Soliman, DPhil Student in EBHC, describes her experience of the qualitative research methods module.