Evidence-based practice efforts at KU Medical Center earn federal designation

Evidence-based medicine — that is, health care based on the best available data and research — is widely believed to be the way to make the best decisions for patients. But in a world that is continuously and rapidly producing new research studies, it can be tough to gather and evaluate the research to determine what the best evidence is.

For the better part of the past decade, making those determinations has been the task of the Evidence-Based Practice, Outcomes and Impact Center (EPIC) at the University of Kansas Medical Center. This summer, EPIC was awarded designation as an Evidence-based Practice Center (EPC) by the Agency for Healthcare Research and Quality, which is part of the U.S. Department of Health and Human Services.

EPIC is now one of just 11 EPCs in the country, which include those at Mayo Clinic and Johns Hopkins University. “This designation is the highest level a center can reach in terms of expertise and ability to perform evidence syntheses,” said Reem Mustafa, M.D., Ph.D., MPH, director of EPIC and professor of nephrology and hypertension at KU School of Medicine.

EPIC uses quantitative and qualitative methods to synthesize the evidence from research studies conducted around the world and then assess the quality of that evidence for clinicians, patients, guideline developers, policymakers, researchers and other health care decision-makers. They also collaborate with colleagues around the KU campuses who have knowledge of the subject area.

“We don't just put the evidence together, we actually evaluate if it’s providing us with a high-quality answer, or if we have doubts about this answer, and why. Is there bias? Are there problems with these studies? We provide that overall summary to different organizations or policymakers to help guide health care decisions,” said Mustafa.

EPIC is led by Mustafa and Simon Lee, Ph.D., MPH, chair of the Department of Population Health at KU School of Medicine, and there are currently five post-doctoral fellows also working on the effort. KU medical students, residents and doctoral and master’s students have worked on different projects through EPIC as well. In addition to evidence syntheses, EPIC also provides support for KU researchers when designing studies and establishing research methods.

So far, EPIC has produced more than 110 systematic reviews and supported more than 130 guidelines for different groups over the past 10 years.

They are currently collaborating with the American Society of Hematology to evaluate the diagnostic thresholds for iron deficiency. And they also respond to clinicians who come to them with questions about a new kind of clinical test they are considering, for example, when there isn’t much published data on it. EPIC reviews all sources, including unpublished ones, to find the best answer possible, and then updates the evidence as more becomes available.

“How can we use the best available evidence that's out there today to improve the health of Kansans, of Americans, of the citizens of the world? This is the lens we take with what we do,” said Mustafa.