Evidence-based Physiotherapy

ByB.Nelson

Outline of Presentation

• What is Evidence –Based Healthcare and its importance

• Labels used across health care professions• What is evidence based practice ? • What is evidence based physiotherapy

practice• What evidence is needed?• Steps in EBPT

What is needed ?

• Reliable, objective, high-quality information• Tools for critical evaluation of evidence

Evidence-based across professions

• Use of evidence in the clinical decision making is used extensively across health care professions

• APTA states that by 2020 PTs will be utilising evidence based clinical decisions

• APTA created “ Hooked on evidence” a database for research articles on physiotherapy interventions

• Evidence in health care referred to by a variety of labels

• Evidence based medicine• Evidence based practice• Evidence based healthcare

What is evidence-based practice

• Integrating the clinical expertise with the best clinical evidence from systematic research

• Clinical decision making is moving away from reliance on knowledge gained from authority or tradition

Evidence based physiotherapy practice(EBPT)

• Is a thoughtful clinical decision making about physiotherapy management of a patient/client that integrates the “best available evidence with clinical judgment” and the patient /client preferences and values and that further considers the larger social context in which physiotherapy services are provided ,to optimise patient outcomes and quality of life.

What evidence is needed

• Best technique• Prognosis• Choice of intervention• outcome

Best technique

• Evidence may assist in selecting the best technique to correctly identify, quantify and classify the patient’s problems ,a result that will enhance the efficiency and effectiveness of service delivery

Prognosis

• Evidence may identify the salient factors which may produce the most accurate prediction

Choice of intervention

• Do good (beneficence)• Do no harm (non- maleficence)

• Evidence may assist in the therapist and patient by providing information about effectiveness and harm

Outcome

• Evidence may assist the therapist in determining the possible outcomes and which measurement tool can detect change in a consistent manner

Process of EBPT practice

• Depends on some factors:• PT requires sufficient knowledge about the

patient/client’s condition in order to recognise what is unknown

• PTs need access to evidence• PTs need time to search for ,appraise and

integrate the evidence into practice

• EBPT practice requires practice like any other skill

• PTs should use evidence to inform their decision making during the patient management process

What constitutes evidence?

• Published research articles• Clinical guidelines• Patient records• Recall of prior patient

• Best available clinical evidence

Suggested readings

• Guide to Evidence based Physical Therapy Practice by Dianne A.Jewell

• Understanding Evidence-Based Healthcare: A Foundation for Action by Musa Mayer, MS, MFA (Johns Hopkins Bloomberg School of Public Health)

• www. wcpt.org