What Works? Outside the Box

By October 23, 2016 Advocate, ePatient, Researcher

Outside Of The Box

I’m committed to and invested in evidence-based health and wellness. I get my flu shots, exercise every day, and take my cholesterol meds. I check out studies so I’m informed when I make decisions with my neurologist. I am committed to patient-centered research. This week I was intrigued by a conversation in Washington @PCORI (Patient Center Outcomes Research Institute) about the challenge of following up with people using medications in off-label ways (no formal evidence, many experiments of one).  The thing about evidence is how does evidence happen when there is patient and/or clinician creativity? People try something, it helps. They share on @PatientsLikeMe,@mypatientsMatch or social media. Someone else tries it. It helps some and not others. How does that experience turn into evidence? A challenge is that such data is either not collected or so spread out that it can’t become evidence. Plus, it’s tough to collect data about how stuff works. How can studies be done about people after they feel better? When you feel bad or are unhappy with your health, you’re more likely to pay attention and be responsive in any activity related to your health. But when you feel better, you want to get on with life and naturally pay less attention to health and ill-health. @FrankRiderMS of American Institutes for Research suggested that involving people with lived experience could help with follow-up.  People with lived experience understand the life flow of fellow sufferers better than researchers and have the motivation to keep at it. How about when treatments are non-medical? Say, massage or acupuncture for pain relief. It’s  even harder to create evidence.

How can we expand the scope of evidence?

2 Comments

  • Anonymous says:

    Danny,
    Some of the best research guiding my practice comes from qualitative nursing research. Early in my career I studied Parse’s Theory of Human Becoming, and found a framework and language to describe what had previously been ignored by medical colleagues. At this point professionally, I am working to find an EHR or even database that can integrate the N of 1 experience into a cohort for creation of new knowledge. Between wearables, self collected anecdotal data, social media data etc. we have possibility to gain new insights and knowledge in ways we never have before. As a provider, I don’t want to make the platform but I sure would like it if anyone would make a useable integrated platform. I’m keeping the faith and keeping up the search. Thanks to you and all at PCORI for carrying the torch!

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