Postgraduate Course
One or two things about
Evidence-Based Management
Pitstop Evidence-Based HR, VOV lerend netwerk,
Gent, 27 september 2012
Postgraduate Course
Evidence-Based Management?
VOV leden, n= 86
Evidence-Based Practice
Postgraduate Course
1991
Medicine
1998
Education
1999
Social care, public policy
2000
Nursing
2000
Criminal justice
????
Management?
Definition
Postgraduate Course
Evidence-based management means making decisions
about the management of employees, teams or
organizations through the conscientious, explicit and
judicious use of four sources of information:
1.
The best available scientific evidence
2.
Organizational facts, metrics and characteristics
3.
Stakeholders’ values and concerns
4.
Practitioner expertise and judgment
Four sources
Postgraduate Course
Four sources
Postgraduate Course
Postgraduate Course
Trust me: 20 years of management experience!
Bounded rationality
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Bounded rationality
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Het feilbare brein
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Seeing order in randomness
Mental corner cutting
Misinterpretation of incomplete data
Halo effect
False consensus effect
Group think
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Self serving bias
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Sunk cost fallacy
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Cognitive dissonance reduction 
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Confirmation bias
Authority bias
Small numbers fallacy
In-group bias
Recall bias
Anchoring bias
Inaccurate covariation detection
Distortions due to plausibility
Postgraduate Course
if you’re
hyperventilating
breathe into a bag
Postgraduate Course
elderly people who have
an irregular heartbeat are
much more likely to die of
coronary disease
give them a drug that
reduces the
number of
irregular beats
How 40,000 cardiologists can be wrong
Postgraduate Course
In the early 1980s newly introduced antiarrhythmic drugs were found to be highly
successful at suppressing arrhythmias.
Not until a RCT was performed was it realized
that, although these drugs suppressed
arrhythmias, they actually increased mortality.
The CAST trial revealed Excess mortality of
56/1000.
By the time the results of this trial were
published, at least 100,000 such patients had
been taking these drugs.
Errors and Biases of Human Judgment
Postgraduate Course
Doctors and managers hold many erroneous beliefs,
not because they are ignorant or stupid, but because
they seem to be the most sensible conclusion
consistent with their own professional experience!
available evidence.
Problem II: false information
Postgraduate Course
 Half of what you learn will be shown to be either dead
wrong or out-of-date within 7 years of your graduation;
the trouble is that nobody can tell you which half
 Sackett: remember that your teachers are full of crap,
just like your parents.
Evidence-based?
Postgraduate Course
1. Incompetent people benefit more from feedback than
highly competent people.
2. Task conflict improves work group performance while
relational conflict harms it.
3. Being intelligent is a disadvantage for performing low
skilled jobs.
Evidence-based?
Postgraduate Course
 Competentie management
 Excellente zorg
 Kwaliteits management
 Het nieuwe werken
 Kennis management
 Magnet, Investors in People
 Plain Tree, Healing Environment
 Balanced Score Card / INK
 Lean / Six Sigma / TOC
Postgraduate Course
Don’t be a parrot!
Think critically about experience,
question your assumptions, and
challenge what you think you know.
(Show me the evidence!)
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5-step approach
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1. Formulate a focused question
2. Searching for the best available evidence
3. Critical appraisal
4. Turning evidence into practice
5. Monitor the outcome
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Step 3: Critical appraisal of studies
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Best available evidence?
Research designs
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What is the BEST car?
Research designs
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Which design for which question?
Twee type vragen
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Effect
vs
Non-effect
Type vraag: effect
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Werkt het?
Werkt het beter dan ....?
Effect
Heeft het een effect op ....?
Wat zijn de succesfactoren voor ....?
Wat is nodig om het te laten werken?
Type: non-effect
Postgraduate Course
Needs:
Wat hebben mensen nodig, waar hebben ze
behoefte aan?
Attitude:
Wat denken of vinden mensen van ...?
Experience:
Wat zijn de ervaringen van mensen met ...?
Prevalence:
Hoeveel mensen / organisaties ....?
Procedure:
Hoe kunnen we .... implementeren?
Explanation:
Waarom werkt het?
Economics:
Hoeveel kost het (tijd en geld)?
Which design for which question?
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Explanation
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Best research design?
Best available?
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What is evidence?
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 Evidence is not the same as ‘proof’ or ‘hard facts’
 Evidence can be
- so strong that no one doubts its correctness, or
- so weak that it is hardly convincing at all
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The best available evidence =
Studies with the highest internal validity
Studies with the highest external validity
Internal validity
Postgraduate Course
internal validity = indicates to what extent the
results of the research may be biased and is
thus a comment on the degree to which
alternative explanations for the outcome found
are possible (confounding).
Confounding
Postgraduate Course
Confounding is the idea that a 3rd variable can distort or
confuse (or confound..) a relationship between two other
variables. For instance, when factor X causes disease Y,
that relationship could be confounded by factor C that is
associated with both factor X and disease Y. C would be
an alternative explanation for the relationship observed
between X and Y.
What are the confounders?
Postgraduate Course
1.
Shoe size & quality of handwriting
2.
Body length & body weight
3.
Number of storks & birth rate
4.
Smoking youngsters & better lung function
Reverse causation
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?
Charismatic leaders
Successful companies
Levels of internal validity
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1. Were there enough subjects in the study?
2. Was a control group used?
3. Were the subjects randomly assigned?
4. Was a pretest used?
5. Was the study started prior to the intervention or event?
6. Was the outcome measured in an objective and reliable way?
6x yes
= very high (A)
5x yes
= high (A)
4-3x yes
= limited (B)
2x yes
= low (C)
1-0x yes
= very low (D)
Levels of internal validity
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Levels of internal validity
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It is shown that …
It is likely that …
There are signs
that …
Experts are of the
opinion that …
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Best available evidence:
external validity
External validity: generalizability
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Always ask yourself to what extent the evidence
is generalizable to your situation:
Ecological validity: Is your organization so different from
those in the study that its results may be difficult to apply?
Population validity: Is your population so different from
those in the study that its results may be difficult to apply?
Generalizability
Postgraduate Course
Keep in mind:
What works in one narrowly defined setting
might not work in another,
but some psychological principles
are generalizable to all human beings.
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Step 4:
Turning evidence into practice
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Feasible?
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 organizational facts and characteristics
 cultural aspects
 stakeholders’ values and concerns
 political aspects
 financial aspects /cost-effectiveness / ROI
 priorities
 change readiness / resistance to change
 implementation capacity
 timing
Tot slot:
Postgraduate Course
Focus on the decision making process!
(not the outcome)