3 Essential Elements
EVIDENCE derived through rigorous scientific research.
EXPERTISE derived from the healthcare practitioner's clinical experience.
PATIENT preferences concerning personal healthcare decisions.
What Is EBP?
A way of providing health care that is guided by a thoughtful integration of the best available scientific knowledge with clinical expertise. This approach allows the practitioner to critically assess research data, clinical guidelines, and other information resources in order to correctly identify the clinical problem, apply the most high-quality intervention, and re-evaluate the outcome for future improvement. (PubMed MeSH)
A way of providing nursing care that is guided by the integration of the best available scientific knowledge with nursing expertise. This approach requires nurses to critically assess relevant scientific data or research evidence, and to implement high-quality interventions for their nursing practice. (PubMed MeSH)
Evidence-Based Physical Therapy
Evidence-based physical therapy practice is “open and thoughtful clinical decision-making” about the physical therapy management of a patient/client that integrates the “best available evidence with clinical judgement” and the patient/client’s preferences and values, and that further considers the larger social context in which physical therapy services are provided, to optimize patient/client outcomes and quality of life. (from Guide to Evidence-Based Physical Therapy Practice by Dianne V. Jewell c2008)
An approach or process of practicing oral health care that requires the judicious integration of systematic assessments of clinical relevant scientific evidence, relating to the patient's oral and medical condition and history, with the dentist's clinical expertise and the patient's treatment needs and preferences. (from J Am Dent Assoc 134: 689, 2003)
An approach of practicing medicine with the goal to improve and evaluate patient care. It requires the judicious integration of best research evidence with the patient's values to make decisions about medical care. This method is to help physicians make proper diagnosis, devise best testing plan, choose best treatment and methods of disease prevention, as well as develop guidelines for large groups of patients with the same disease. (from JAMA 296 (9), 2006)
Evidence-based Librarianship (EBL) is a means to improve the profession of librarianship by asking questions as well as finding, critically appraising, and incorporating research evidence from library science (and other disciplines) into daily practice. It also involves encouraging librarians to conduct high quality qualitative and quantitative research. (from Crumley E, Koufogiannakis D. Developing evidence based librarianship in Canada: six aspects for consideration. Hypothesis 2001;15:9-10.
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Building a P I C O Question
Levels of Evidence
EB Practitioners must determine the strength of the evidence they find in the literature. Systems for rating the strength of evidence vary widely.
Locate the Evidence
Evidence in literature can be found anywhere, but it is best to start in Library Databases.
Viva La Evidence
by James McCormack (4min 19sec)
Locating Evidence using P I C O Question
Locating evidence in literature depends upon asking an effective research question. Use the PICO mnemonic to build that question.
P I C O
P -- patient, population, participant
I -- intervention, therapy
C -- comparison (not always required)
O -- outcome
4 Types of PICO Questions
In children with respiratory infection, is the respiratory rate as effective as chest x-ray in detecting pneumonia?
In premature infants (compared to full-term infants), what is the lifetime prevalence of hearing deficit?
In patients with recurrent infection, do antibiotics, compared to no treatment, reduce recurrence rate?
In post-menopausal women, does hormone replacement therapy increase the risk of breast cancer?
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