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Dear All, Without wishing to propose a contribution on the general nature of evidence, I do want to offer a few comments on “evidence-based practice” in design. The term “evidence-based design” is not new. It is simply a designation that adapts the term “evidence-based practice” from one field of professional practice to another. The thread on evidence-based design began when David Durling posted a note to the list on January 1. David pointed to a recent item from the UK Design Council. David has been arguing for the concept of evidence-based design for nearly as long as I have known him. He adapted the term “evidence-based design” from the field of medicine, where the standard term is now “evidence-based practice.” The designation “evidence-based design” isn’t a slogan. It is the designation of an approach to design activity. It is not a new concept at all. It is not the latest in a series of concepts, let alone the most recent concept to follow design thinking. While I agree with many of the issues in Klaus Krippendorff’s post, the kinds of design practice in the list he put forward are specific approaches to kinds of design activity — some overlap or intersect, some differ. For example, product design has not been replaced by emotional design — people still design products. Some approaches to product design consider emotional engagement, others do not. Many product designers also practice ergonomic design for some kinds of products. These three approaches to design activity exist in different ways. The terms are not slogans that succeeded one another. It is relatively easy to explain the concept of evidence-based practice. The Duke University Medical Centre Library offers a good online summary of evidence-based practice together with a guide and tutorial. According to the Duke guide, “the most common definition of Evidence-Based Practice (EBP) is from Dr. David Sackett. EBP is ‘the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.’ (Sackett D, 1996)." The guide explains evidence-based practice in detail. “EBP is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values. The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology. (Sackett D, 2002) "The evidence, by itself, does not make the decision, but it can help support the patient care process. The full integration of these three components into clinical decisions enhances the opportunity for optimal clinical outcomes and quality of life. The practice of EBP is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, and/or the etiology of disorders. "Evidence-Based Practice requires new skills of the clinician, including efficient literature searching, and the application of formal rules of evidence in evaluating the clinical literature.” The Duke guide provides a useful short summary of steps in the process of EBP (evidence-based practice). This is an approach to professional service in which : —snip— [1] ASSESS the patient — Start with the patient -- a clinical problem or question arises from the care of the patient [2] ASK the question — Construct a well built clinical question derived from the case [3] ACQUIRE the evidence — Select the appropriate resource(s) and conduct a search [4] APPRAISE the evidence — Appraise that evidence for its validity (closeness to the truth) and applicability (usefulness in clinical practice) [5] APPLY: talk with the patient — Return to the patient -- integrate that evidence with clinical expertise, patient preferences and apply it to practice [followed by] [6] Self-evaluation — Evaluate your performance with this patient —snip— You can read the full tutorial at URL: http://guides.mclibrary.duke.edu/ebmtutorial The term “evidence-based design” is not new to the PhD-Design list either. The term first appeared on the PhD-Design list in a post closing the on-line conference on Design in the University that took place on the list. I wrote this post on December 22, 2003. Here are the relevant paragraphs: —snip— In recent years, medical practice and nursing practice have developed an important new approach to professional practice known as "evidence-based medicine." According to Sackett, Rosenberg, Gray, Haynes, and Richardson (1996), "Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research." To me, this approach would serve well in the professional practice of design. The implications become clear when we read the description of what evidence based medicine means in clinical practice: "By individual clinical expertise we mean the proficiency and judgment that individual clinicians acquire through clinical experience and clinical practice. Increased expertise is reflected in many ways, but especially in more effective and efficient diagnosis and in the more thoughtful identification and compassionate use of individual patients' predicaments, rights, and preferences in making clinical decisions about their care. By best available external clinical evidence, we mean clinically relevant research, often from the basic sciences of medicine, but especially from patient centered clinical research into the accuracy and precision of diagnostic tests (including the clinical examination), the power of prognostic markers, and the efficacy and safety of therapeutic, rehabilitative, and preventive regimens. External clinical evidence both invalidates previously accepted diagnostic tests and treatments and replaces them with new ones that are more powerful, more accurate, more efficacious, and safer." That thread that never emerged here, and I would have liked to see it. One promise of locating a design school in a great university is developing a program that can support the field by training designers in the practice of "evidence-based design." —snip— Reference Sackett, David L, William M C Rosenberg, J A Muir Gray, R Brian Haynes, and W Scott Richardson. 1996. "Evidence-Based Medicine: What it is and what it isn't." (Based on an editorial from the British Medical Journal on 13th January 1996, BMJ 1996, 312: 71-2.) A copy of this article is available at URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2349778/ In my view, evidence-based practice is applicable to many forms of design activity. If we adapt Sackett’s definition to design, it makes perfect sense: Evidence-based design would be something like “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual client. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” Professional design practice is not the same thing as design research. What David has long said — and what Gjoko, Don and others say now, is that many forms of professional design practice would be well served if designers were to integrate professional expertise, client values, and the best research evidence in making design decisions. Once again, paraphrasing Sackett, this involves integrating a new repertoire of professional skills into the practice of design. Professional expertise refers to the practitioner’s accumulated experience, education, and professional skills. Research evidence may involve research of many kinds, including clinical research. What Sackett says about medicine applies very well: “The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology.” The client brings his or her own personal preferences and unique concerns, expectations, and values to the encounter. (For a discussion of the nature and differences among basic research, applied research, and clinical research, see: Friedman, Ken. 2003. “Theory construction in design research: criteria, approaches, and methods.” Design Studies 24 (2003), pp. 509–511. doi: 10.1016/S0142-694X(03)00039-5) There is no perfect way to do anything. I was quite pleased by David’s post, and pleased to see that the UK Design Council is making use of this concept. It is difficult to explain completely what might count as evidence — that’s a question in the philosophy of science, and it would take far more time to write a reasonable post than I can give to such an explanation. What is clear is that evidence-based practice differs both from traditional practice, guild practice, and purely intuitive practice. The Duke guide puts it well: “[3] ACQUIRE the evidence — Select the appropriate resource(s) and conduct a search. [4] APPRAISE the evidence — Appraise that evidence for its validity (closeness to the truth) and applicability (usefulness in clinical practice).” That works in design as well as it works in other professions. Is there room for intuition? Of course. Educated intuition arises from the experience of skilled professional practice. Is there room for human feelings and emotions? Yes. They are necessary, in human-centered design just as they are in human-centered medical practice: “[5] APPLY: talk with the patient — Return to the patient — integrate that evidence with clinical expertise, patient preferences and apply it to practice.” Inquiry into the nature of evidence is interesting and useful. I can't see how anyone can object to the concept of evidence-based practice of the kind that appears in the Duke guide. This gives us a richer repertoire of tools than we had in the past. The entire point of design research and research training in design is to enhance the repertoire of tools and skills that designers can apply to the work they do. And please, friends, it is not necessary to turn every responsible statement into a total concept. Do most design projects begin with questions of some kind? Yes. Do all design projects begin with questions? Of course not. Do most professional design projects begin with a problem that troubles a legitimate stakeholder? Of course. That’s why people with problems come to designers — they need help, and they seek professionals who are supposedly skilled at analysing problems to find creative and effective solutions. Should we always solve the problem every client brings us in exactly the form that they themselves present the problem? If course not. That’s why clients bring their problems to us — if they already understood the problem, as contrasted with the symptoms, they would be halfway toward a solution. And no, I do not want to get into a long argument about whether words such as “problem” or “solution” cover everything I mean. They don’t. I’m not trying to write a book on the philosophy of science applied to design here. I simply want to bring forward a reasonable argument for the value of evidence-based practice in design. Yours, Ken Ken Friedman, PhD, DSc (hc), FDRS | Editor-in-Chief | 设计 She Ji. The Journal of Design, Economics, and Innovation | Published by Tongji University in Cooperation with Elsevier | URL: http://www.journals.elsevier.com/she-ji-the-journal-of-design-economics-and-innovation/ Chair Professor of Design Innovation Studies | College of Design and Innovation | Tongji University | Shanghai, China ||| University Distinguished Professor | Centre for Design Innovation | Swinburne University of Technology | Melbourne, Australia -- ----------------------------------------------------------------- PhD-Design mailing list <[log in to unmask]> Discussion of PhD studies and related research in Design Subscribe or Unsubscribe at https://www.jiscmail.ac.uk/phd-design -----------------------------------------------------------------