The current buzzword Evidence-based medicine
We all want good evidence when we make decisions about how to treat our clients. We want to share reliable, best-possible information with our clients when we help them to make sense of the issues and conditions they bring to our clinics.
“Evidence-based medicine” is the current buzzword for describing the efforts of both conventional and complementary/alternative practitioners to sort out causal relationships between particular interventions or therapeutic practices and client outcomes. But what does it really mean?
We all know that why clients get better is a complex mix of the right assessment, the right intervention, the attitude of the client, the relationship with the therapist and sometimes a fair bit of luck. This complex, synergistic relationship between all the variables in the practice of massage therapy is not easily isolated into the discreet components of traditional research methodology such as a randomized controlled trial – although RCTs are considered by mainstream science as the highest, most reliable form of evidence.
Since the mid-’80s and Tiffany Field’s initial research on the positive effects of touch on premature infant weight gain, there has been an explosion of interest in research on massage therapy. Increasingly, as
the economic drivers of escalating health care costs and managed care fuel our search to find the most cost-effective means of delivering health care, scientists, government policy makers, consumers, insurance
companies and practitioners alike are looking for the research evidence that massage therapy works.
Massage therapists today need to know how to find the evidence, how to critically evaluate or appraise it, how to incorporate new information into their practices and how to communicate their findings to clients. Given the explosion of information, so much of which may not be worth the Internet site it is written on, it is a tall order for massage therapists to find the time and the skill set necessary to meet this demand.
We also need massage therapists with a passion for research to continue their education and work
in collaboration with conventional researchers to ask and answer the questions we have as a profession.
We need to be in charge of the research agenda for massage therapy and there is enormous pressure and increasing money, for others to ask and answer our questions for us, in a manner that may fit traditional paradigms of inquiry but may not, ultimately, fit us.
The bottom line is simply this; the quest for reliable, pragmatic information about massage therapy will help us to better help our clients. Not all of this knowledge will be generated through formal research – informal networks of information sharing and good old intuitive practitioner gut hunches and experimentation will always be at the core of what we do. But we also need to test our hypotheses, find a shared language to communicate our ideas with, and keep a sharp and skeptical eye out for that most illusive, moving target of concepts – the truth.
Research: May 2002
A look at the need for research
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