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PHYSIOTHERAPY AND EVIDENCE BASED PRACTICE (DRIVERS (Clinician…
PHYSIOTHERAPY AND EVIDENCE BASED PRACTICE
DEFINTION
; Conscientious and judicious attempt to find best available evidence to assist treatment of the patient taking into consideration their specific situation, presentation and values
PROCESS
(5 Steps)
Critically appraise evidence
Data/stats
Sample Size
Strength/quality
Relevance
Integrate Evidence
Gather Evidence
Evaluate
Identify information needed / form clinical question
COMPONENTS
Patient Values
Research Evidence
Clinical Experience
Practical context
DRIVERS
Clinician accountability
Increased choices
Emerging techniques / technologies
Client expectations
Out of date evidence / interventions
CRITICAL APPRAISAL
Critical Appraisal Tools (CATs)
Checklists
PEDRO
CASP
Domain based
Cochrane
Quality of Evidence
Primary Research Designs
Cohorts
RCTs (control group, random allocation, blinding
Case series
Case Studies
Secondary research designs
Meta-Analysis
Systematic Reviews
Guidelines
Levels of Evidence
NHMRC levels
Oxford Levels
Validity
External (generalisability)
Internal
Threats
Bias
Reporting
Language
Author
Publication
Methodological
Allocation
Maturation
Attrition
Measurement
Placebo
Selection/sampling
Chance
Confounders
BARRIERS
Barriers
Varied research
Variable quality
Time constraints
Logistics
Access
Common databases accessed
Misinterpretation / drawing conclusions
Study limitations
Skill of clinician in EBP
Potential solutions
Courses
Ease of access
Start early
Redefinition evidence / resources
Facilitate involvement