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of Executives
Evidence-Based Management
An introduction
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October 26, Budapest
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 Where does it come from?
 What is it?
 Why do we need it?
 How does it look like in practice?
(An example)
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Evidence based management:
Where does it come from?
What field is this?
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 “there is a large research-user gap”
 “practitioners do not read academic journals”
 “the findings of research into what is an effective intervention
are not being translated into actual practice”
 “academics not practitioners are driving the research agenda”
 “the relevance, quality and applicability of research is
questionable”
 “practice is being driven more by fads and fashions than
research”
 “many practices are doing more harm than good”
Medicine: Founding fathers
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David Sackett
Gordon Guyatt
McMaster University Medical School, Canada
How it all started
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Problem I: too much information
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 More than 1 million articles in 40,000 medical journals per
year (= 1995; now probably more than 2 million). For a
specialist to keep up this means reading 25 articles every
day (for a GP more than 100!)
 Most of the new insights and treatment
methods don’t reach the target group
Problem I: too much information
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 HRM: 1,350 articles in 2010 (ABI/INFORM). For an HR
manager to keep up this means reading 3 to 4 articles
every day (for a ‘general’ manager more than 50!)
Problem II: persistent convictions
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if you’re
hyperventilating
breathe into a bag
Problem II: persistent convictions
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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
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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.
Hungarian Association
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David Sackett
 Half of what you learn in medical school will be
shown to be either dead wrong or out-of-date
within 5 years of your graduation; the trouble is that
nobody can tell you which half.
 The most important thing to learn is how to learn
on your own: search for the evidence!
 (Remember that your teachers are as full of bullshit
as your parents)
Evidence-Based Practice
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1991
Medicine
1998
Education
1999
Social care
2000
Nursing
2000
Criminal justice
????
Management?
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Evidence based management:
What is it?
Definition
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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.
Decision supports and practitioner expertise
Four sources
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Definition
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When making an important decision,
an evidence-based manager knows
whether there is scientific evidence
available to support this decision
(and how ‘strong’ the evidence is).
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Evidence-based management:
Why do we need it?
Four sources
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Trust me: 20 years of management experience!
Errors and Biases of Human Judgment
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Errors and Biases of Human Judgment
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Seeing order in randomness
Mental corner cutting
Misinterpretation of incomplete data
Halo effect
False consensus effect
Attribution error
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Group think

Self serving bias
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Sunk cost fallacy
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Cognitive dissonance reduction 
Confirmation bias
Authority bias
Small numbers fallacy
In-group bias
Recall bias
 Anchoring bias
 Inaccurate covariation detection
 Distortions due to plausibility
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“I’ve been studying intuition for 45 years, and I’m no better
than when I started. I make extreme predictions. I’m overconfident. I fall for every one of the biases.”
Errors and Biases of Human Judgment
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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!
Errors and Biases of Human Judgment
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stress & lifestyle
peptic ulcer
Oct 2005
Peptic ulcer – an infectious disease!
This year's Nobel Prize in Physiology or Medicine goes to Barry Marshall and Robin
Warren, who with tenacity and a prepared mind challenged prevailing dogmas. By
using technologies generally available (fibre endoscopy, silver staining of
histological sections and culture techniques for microaerophilic bacteria), they
made an irrefutable case that the bacterium Helicobacter pylori is causing disease.
By culturing the bacteria they made them amenable to scientific study.
In 1982, when this bacterium was discovered by Marshall and Warren, stress and
lifestyle were considered the major causes of peptic ulcer disease. It is now
firmly established that Helicobacter pylori
causes more then 90% of duodenal ulcers.
The link between Helicobacter pylori
infection and peptic ulcer disease has been
established through studies of human
volunteers, antibiotic treatment studies and
epidemiological studies.
Beliefs vs Evidence
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“What gets us into trouble is not what we
don't know,
it's what we know for sure that just isn't so.”
Mark Twain
True or false?
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1. Incompetent people benefit more from feedback than
highly competent people.
2. Task conflict improves work group performance while
relational conflict harms it.
3. Encouraging employees to participate in decision
making is more effective for improving organizational
performance than setting performance goals.
How evidence-based are we?
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HR Professionals' beliefs about effective human resource practices: correspondence
between research and practice, (Rynes et al, 2002, Sanders et al 2008)
 959 (US) + 626 (Dutch) HR professionals
 35 statements, based on an extensive body of evidence
 true / false / uncertain
On average: 35% - 57% correct
Evidence-based?
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 Competence management
 Excellent care
 Total Quality Management
 Flexible workspace / The New World of Work
 Knowledge Management
 Investors in People, Great Place To Work
 Balanced Score Card / INK
 Lean / Six Sigma / TOC
Evidence-based approach
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How ‘new’ is this question or problem?
Is there evidence from scientific research that
can help us find the most effective approach?
How ‘strong’ is this evidence?
Is the evidence applicable to my situation?
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Evidence based management:
How does it look like in practice?
The 5 steps of EBP
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1. Formulate a focused question (Ask)
2. Search for the best available evidence (Acquire)
3. Critically appraise the evidence (Appraise)
4. Integrate the evidence with your managerial
expertise and organisational concerns and apply
(Apply)
5. Monitor the outcome (Assess)
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1. Formulate a focused question
Asking the right question?
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 Does team-building work?
 Does the introduction of self-steering teams work?
 Does management development improve the performance
of managers?
 Does employee participation prevent resistance to change?
 Is 360 degree feedback effective?
Focused question?
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 Does team-building work?
 What is a ‘team’?
 What kind of team?
 In what contexts/ settings?
 What counts as ‘team-building’?
 What does ‘work’ mean?
 What outcomes are relevant?
 Over what time periods?
Answerable question: PICOC
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P = Population
I = Intervention or success factor
C = Comparison
O = Outcome
C = Context
Focused question: PICOC
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P = Population
I = Intervention or successfactor
C = Comparison
O = Outcome
C = Context
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Employee productivity?
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Job satisfaction?
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Return on investment?

Market share?

Organizational commitment?
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2. Finding the best available evidence
Where do we search?
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Hands on instruction
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3. Critical appraisal of studies
Making sense of evidence
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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?
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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Step 4: Turning evidence into
practice
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Applicable / 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
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Evidence-based practice:
 Focuses on the decision making process
 Uses research findings to increase the
likelihood of a positive outcome