What is Evidence?

There are differing views on what is meant by the term ‘evidence’ and its value, types and sources in the context of evidence-based health care. [1,2] The Canadian Health Services Research Foundation (2005) developed the following definition that reflects many considerations around evidence.

Evidence is information that comes closest to the facts of a matter. The form it takes depends on the context. The findings of high-quality, methodologically appropriate research are the most accurate evidence. Because research is often incomplete and sometimes contradictory or unavailable, other kinds of information are necessary supplements to or stand-ins for research. The evidence base for a decision is the multiple forms of evidence combined to balance rigour with expedience – while privileging the former over the latter. [3]

Where there is uncertainty or disagreement about practice or when new therapies are proposed, research is a way of providing evidence as to the most effective choice. Some research is carried out within the existing resources of academic, clinical or community organisations. Research may also be externally funded through grant schemes and tenders or through sponsorships, donations or commercial arrangements. The Australian Government provides significant research funds through its formal agencies, the National Health and Medical Research Council (NHMRC) and the Australian Research Council (ARC).

Research plays a significant role in healthcare. It is regulated by various ethics and governance frameworks. [4-6]

Palliative care as a discipline and area of clinical practice has been developing its evidence base and the capacity to carry out clinical research. [7,8] Within Australia, there has been a substantial investment in both research and project investigation within the National Palliative Care Program. This program included a series of research grant rounds managed by the NHMRC. The National Palliative Care Program is assisting in building a body of evidence to assist decision making and to guide implementation in palliative care.

  1. Lomas J, Culyer T, McCutcheon C, McAuley L, Law S. Conceptualizing and combining evidence for health system guidance. Ottawa: Canadian Health Services Research Foundation; 2005 May. (492kb pdf)
  2. Aoun SM, Kristjanson LJ. Challenging the framework for evidence in palliative care. Palliat Med. 2005 Sep;19(6):461-5.
  3. Canadian Health Services Research Foundation. Annual report 2005. Ottawa: Canadian Health Services Research Foundation; 2005. p. 9. (872kb pdf)
  4. National Health & Medical Research Council. Australian Code for the Responsible Conduct of Research. 2007.
  5. National Health and Medical Research Council. National Statement on Ethical Conduct in Human Research 2007 - Updated 2009
  6. Poustie SJ, Taylor DM, Forbes AB, Skiba MA, Nelson MR, McNeil JJ. Implementing a research governance framework for clinical and public health research. Med J Aust. 2006 Dec 4-18;185(11-12):623-6.
  7. Kaasa S, Hjermstad MJ, Loge JH. Methodological and structural challenges in palliative care research: how have we fared in the last decades? Palliat Med. 2006 Dec;20(8):727-34.
  8. Tieman J, Sladek R, Currow D. Changes in the quantity and level of evidence of palliative and hospice care literature: the last century. J Clin Oncol. 2008 Dec 10;26(35):5679-83. Epub 2008 Nov 10. 
Last updated 18 January 2017