Know and Use ADA's Evidence-Based Practice Resources

Abstract

As evidence-based medicine has evolved and become more sophisticated, so has the approach used by the American Dietetic Association … . (E)vidence-based nutrition practice guidelines, protocols, and other guides for practice will continue to shape dietetics practice in the years ahead (1Myers E.F. Pritchett E. Johnson E.Q. Evidence-based practice guides vs. protocols: What's the difference?.J Am Diet Assoc. 2001; 101: 1085-1090Google Scholar). These statements, published in the September 2001 Journal, heralded ADA's commitment to evidence-based practice and emphasized the need for all practitioners to understand evidence analysis and use evidence-based guidelines in our work with patients and clients. Possibly the most visible demonstration of ADA's commitment is the development and growth of a free benefit of membership (available to nonmembers via subscription), the Evidence Analysis Library (EAL), http://www.adaevidencelibrary.com. Since the EAL's debut in late 2004, well over 7 million page views have been recorded and more than 3,600 nutrition articles have been abstracted. Thirteen guidelines have been published on some of the most crucial practice issues we face: Diabetes Type 1 and 2, Disorders of Lipid Metabolism, Adult Weight Management, Critical Illness, Pediatric Weight Management, Oncology, Hypertension, Heart Failure, Chronic Obstructive Pulmonary Disease, Gestational Diabetes, Celiac Disease, Spinal Cord Injury, and Unintended Weight Loss. More are in the pipeline, including Chronic Kidney Disease, HIV, and Vegetarian Nutrition. I have the opportunity to see the guideline development process in action as a member of the Chronic Kidney Disease workgroup. The EAL also offers answers to practice-based questions; systematic reviews; educator modules for teaching the evidence analysis process; PowerPoint slides of EAL practice guidelines and projects; companion materials such as toolkits, available for purchase in downloadable and print versions, for applying guidelines; guides to implementing the Nutrition Care Process using standardized language; and Nutrition Care Process Toolkits. Since October 2008, the EAL has been featured prominently in the Journal, with research articles related to EAL guidelines tagged with an icon encouraging readers to visit the EAL for more information. The American Association of Diabetes Educators, American Society of Parenteral and Enteral Nutrition, and the Centers for Disease Control and Prevention are just some of the organizations that have found subscribing to the Evidence Analysis Library to be valuable for their members and employees. Also, as part of ADA's commitment to the Alliance Healthcare Initiative—the first coordinated national effort by professional associations, insurers, and employers to offer health benefits to prevent, assess, and treat childhood obesity—ADA is providing members with training on the use of the Pediatric Weight Management guideline. International interest in ADA's evidence-based approach is growing as well. Visitors to the EAL have come from 191 different countries—virtually every nation in the world—and dietetic associations from Australia and Israel have purchased subscriptions for their members. As always, the primary beneficiary of ADA's evidence-based work is you, the member. And we still need to do more to help individual members overcome barriers to access and use of evidence-based practice resources and to take more personal responsibility for accessing the wealth of information that is available to us. The House of Delegates conducted a dialogue at its Fall 2009 meeting to better understand evidence-based practice and to identify steps to broaden access to resources and the use of evidence-based practice across all areas of practice. The House of Delegates has since approved a motion to develop a plan to increase broad-based usage by registered dietitians and dietetic technicians, registered, to measure success in increasing practitioners' knowledge, and to deliver evidence-based practice that provides quality services to the public. The plan is expected by May. As our colleagues wrote in the Journal in 2001: “As a practitioner, your time with clients is limited. It is critical that the counseling time be spent on the things that are most likely to achieve successful outcomes” (1Myers E.F. Pritchett E. Johnson E.Q. Evidence-based practice guides vs. protocols: What's the difference?.J Am Diet Assoc. 2001; 101: 1085-1090Google Scholar). Those words are just as true in 2010, and the EAL has become what it was envisioned to be from the start: a world-class way for all practitioners to access the best practice recommendations that science has to offer.