What is it about?
The National Institute for Health and Care Excellence (NICE) has a long history of integrating evidence-based medicine into current practice. Its emphasis on quantitative research, such as clinical trials, as a foundation for much of its recommendations has led to a neglect of qualitative research. We argue that qualitative research, which is centred on describing people's experiences, is essential in making the most valid recommendations which are most useful to the professional and patient alike. We chose one guideline to demonstrate some of the weaknesses of the current approach and to give concrete suggestions on how it could be improved.
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Why is it important?
Pain is experienced by everyone, and severe pain is experienced by many with palliative needs. This guideline helps professionals prescribe strong analgesia for such pain. However we argue that it is founded on a disease-centred model of care. Integration of more of the available qualitative data on these issues would allow the recommendations to be more patient-centred.
Perspectives
It was a pleasure to collaborate with the co-authors, who are currently supervising my PhD in experiences of breast cancer in Mauritania with the University of Lancaster. This article has allowed me to further explore how different approaches to knowledge and knowledge creation have real implications on practice. It is concerning to see the quality and biases of some research accepted as evidence in this guideline.
Dr david fearon
Lancaster University
Read the Original
This page is a summary of: A philosophical critique of the UK’s National Institute for Health and Care Excellence guideline ‘Palliative care for adults: strong opioids for pain relief’, British Journal of Pain, January 2018, SAGE Publications,
DOI: 10.1177/2049463717753021.
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