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Physical Therapy - Dallas

Physical therapy research guide for TWU Dallas students, faculty, and staff.

What Is Evidence-Based Practice?

There are a lot of different definitions regarding what evidence-based practice, or EBP, is, but 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's Five Steps to Evidence-Based Practice

Sackett defines the five steps to the EBP process as follows.

Graphic with the five steps for evidence-based medicine: Assess EBM process, ask a question, acquire evidence, critically appraise evidence, and apply evidence


Assess the situation: Can improvements be made to the current method of treatment for a patient?


Formulate a clear and detailed question using the PICO(t) format.


Consult your librarian for the best possible evidence from high quality, peer-reviewed sources


Evaluate the evidence for quality using critical appraisal tools 


Apply the information in combination with clinical experience and patient values

The Evidence-Based Practice Pyramid

The EBP pyramid is a visual representation that depicts the quality level of a particular type of evidence — the higher on the pyramid it features, the better the quality. Note: 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.

A graphic depicting the pyramid of evidence-based practice. Top to bottom (with highest quality at the top): Meta-analyses, systematic reviews, critically appraised literature and evidence-based practice guidelines, randomized controlled trials, non-randomized controlled trials, cohort studies, case series or studies, individual case reports, background information, expert opinions and non-EBM guidelines