Occupational Therapy - Dallas

There are a lot of different definitions regarding what EBP is, simply put it is a combination of:

• scientific research
• clinical expertise 
• patient preferences.

Evidence based practice combines hard objective research with clinician expertise and patient preference creating a holistic method of treatment greater than the sum of its parts. As new scientific studies discover better treatments, this model represents an evolving and ever improving way to improve practice methods and approaches to patient care.

Sackett defines the 5 steps to the EBP process as follows. His full article on the subject may be viewed here: https://pubmed.ncbi.nlm.nih.gov/8555924/

1. Assess
   Assess the situation, can improvements be made to the current method of treatment for a patient?
2. Ask
   Formulate a clear and detailed question using the PICO(t) format.
3. Acquire
   Consult your librarian for the best possible evidence from high quality, peer-reviewed sources
4. Appraise
   Evaluate the evidence for quality using critical appraisal tools 
5. Apply
   Apply the information in combination with clinical experience and patient values

The EBP pyramid is a visualized representation that depicts the quality level of a particular type of evidence--the higher on the pyramid it features the better the quality. One word of warning to the wise though, people are fallible and even though a systematic review or meta-analysis may feature at the top of the pyramid--if it is poorly researched and written a well executed lower level of evidence can prove better.

In order to get the best answers it is important to ask the right questions!!!

The universally accepted way to do this in healthcare is to use the PICO(t) acronym.

PICOT can be used to answer a variety of different types of question: