FEATURE COMMENTARY Discussion and debate What’s in a name: Evidence-informed or evidence-based practice? T BY CARLA CIRACO, DR. PETER EMARY (DC), DR. CHARLES FISCHER (DC) scientific evidence to support a par-ticular treatment approach. Although this may provide clinicians with a perception of added clinical flexibility, it can be detrimental to patient out-comes and ultimately the reputation of the healthcare profession, especially if new high-quality research evidence becomes available (e.g., Côté et al. 14 ) and this is either dismissed or ignored. The purpose of this commentary is to differentiate between evidence-based and evidence-informed terminology in relation to chiropractic education and clinical practice. In addition, we hope to stimulate future discussion and de-bate regarding the appropriate usage of these terms within the wider chiroprac-tic and naturopathy professions. here is a common mis-conception within chiro-practic and other health-care professions that evidence-based practice prioritizes research evi-dence while ignoring clinician experience and patient pref-erence, when in fact it incorporates and emphasizes all three of these pillars equally. 1,2 Historically, chiropractors have often relied on their clinical expe-riences and professional judgements to inform decisions on how to manage patients in clinical practice. 3 As a col-lective, chiropractors have also been very good at valuing the patient’s per-spective in clinical decision-making, as evidenced by consistently high patient satisfaction rates with chiropractic services. 4-6 However, where chiroprac-tors and other healthcare providers continue to fall short is with incorpo-rating research evidence into routine day-to-day practice. 3,7-10 In recent years, the term evidence-informed practice has been integrated within the vernacular of evidence-based medi-cine/evidence-based practice, 11-13 and it seems to be a more palatable term to many clinicians as it de-emphasizes research evidence, particularly in instances when there may be a lack of As illustrated during the recent COVID-19 pandemic, there can be a danger to “informing” one’s clinical decisions and patient communications with evidence such as anecdote or case reports, or relying on experience at the expense of up-to-date, high-quality clinical research. 15 One needs to look no further than the International Chi-ropractors Association (ICA) and their recent reports regarding chiropractic EVIDENCE-INFORMED VS. EVIDENCE-BASED PRACTICE CARLA CIRACO is a 3rd-year chiropractic student at D’Youville College in Buffalo, NY. She graduated from the University of Toronto in 2018 with a Bachelor’s Degree in Kinesiology. DR. CHARLES FISCHER is a chiropractor in private practice in Lancaster, NY. He also serves as an adjunct professor at D’Youville College in the Chiropractic Department. DR. PETER EMARY is a chiropractor at a Community Health Centre in Cambridge, Ontario. He is a PhD candidate at McMaster University, and he also teaches in the Chiropractic Department at D’Youville College in Buffalo, New York. 18 Chiropractic and Naturopathic Doctor May/June 2021 care and its purported benefits on immune function that were posted on the association’s public website shortly after the beginning of the global pan-demic in March 2020. 16,17 The claims in these reports were based on low-level evidence, and were swiftly criti-cized and debunked by international chiropractic researchers and students from across the profession. 15,18 Despite the recognition and adoption of evidence-based practice and its prin-ciples among a growing number of healthcare professions in the last several decades, there has been an increase in the use of the term, evidence-informed practice, within the chiropractic profes-sion in the past few years. 11 We are un-sure if this same shift has been occurring within the naturopathic profession? Some have felt that the “evidence-based” term is either too rigid, or, is not rele-vant to clinicians when there is a per-ceived (or real) lack of research evidence to help answer a particular clinical question. The debate between the use www.Cndoctor.ca Photo: © cunaplus / Adobe Stock
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