The Incubator #386 - 🟢 HOT TOPICS 2025 COVERAGE - When Has Enough Evidence Accumulated to Guide Practice (ft Dr. Ravi Patel)
10 snips
Dec 8, 2025 Dr. Ravi Patel dives into the clash between quality improvement and evidence-based medicine in NICUs. He advocates for prioritizing high-certainty interventions like antenatal steroids. The discussion highlights the importance of using GRADE to assess evidence certainty, guiding standardization versus individualization. Patel emphasizes re-energizing evidence generation to combat stalled improvements in common morbidities. Real-world examples like Eat Sleep Console illustrate the impact of evaluating new practices and involving families in shared decision-making.
AI Snips
Chapters
Transcript
Episode notes
Don't Standardize On Uncertain Practices
- Quality improvement and evidence-based medicine can clash when uncertain evidence leads to premature standardization.
- Standardizing low-certainty practices risks locking in the wrong approach and wasting limited NICU improvement capacity.
Prioritize High-Certainty Interventions
- Prioritize interventions with high certainty like antenatal steroids and delayed cord clamping for reliability efforts.
- Redirect limited QI capacity toward measures you know are effective rather than chasing many low-certainty protocols.
Use GRADE To Gauge Certainty
- Use evidence-certainty frameworks like GRADE to decide when to standardize care.
- High-certainty evidence warrants universal application while low-certainty findings should allow individualized decisions.