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Evidence-Based Practice Fact Sheet

Evidence-based Practice

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212 views

Evidence-Based Practice Fact Sheet

Evidence-based Practice

Uploaded by

mohamedwhatever
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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AMERICAN PHYSICAL THERAPY ASSOCIATION, SECTION ON PEDIATRICS

Evidence-based Practice in Pediatric Physical Therapy


What Is Evidence-based Practice?
Section on Pediatics

FACT SHEET

Evidence-based physical therapy practice has evolved from the move toward evidencebased medicine. Evidence-based medicine has been defined as the integration of best
research evidence with clinical expertise and patient values.1 In order for pediatric physical therapists to provide effective intervention we must become skilled at obtaining the
best evidence available to inform our practice. For more information on evidence-based
practice, please refer to Evidence-Based Medicine How to Practice and Teach EBM by
Sackett, et al,1 or visit the Center for Evidence-based Medicines Web site at www.cebm.
net/ebm_is_isnt.asp.
There are many options available to those interested in doing a search of the literature.
Most public libraries have librarians skilled in assisting beginners with learning to search
databases. Many universities offer courses or assistance from resource librarians in performing searches. Community colleges often have courses on using computers for database
searching. APTA has offered courses at national meetings as well as at state and regional
meetings. Also, if you would like to access the links we have provided in this document
electronically, see this document online at the Sections Web site (www.pediatricapta.org
under Resources & Listserveclick Brochures and Fact Sheets).
The five steps of evidence-based practice are:

1. Formulate your clinical question.

2. Obtain the evidence with literature searches.

3. Evaluate the evidence for validity and applicability.

4. Combine this evidence with clinical experience and your individual patients
situation to determine the best course of action.

5. Examine your performance.

S E C T I O N

O N

PEDIATRICS

AMERICAN PHYSICAL THERAPY ASSOCIATION

Section on Pediatrics
APTA
1111 North Fairfax Street
Alexandria, VA 22314-1488
Phone: 800/999-2782, ext. 3254
Fax: 703/706-8575
E-mail: [email protected]

www.pediatricapta.org

Step One: Formulate Your Clinical Question


There are several resources available to guide you in formulating a clinical question. A
couple of tutorials are available online at:

Duke/University of North Carolina, Chapel Hill, at www.hsl.unc.edu/services/tutorials/ebm/index.htm

Center For Evidence-based Medicine at www.cebm.net

You also may want to consult Sacketts text Evidence-Based Medicine How to
Practice and Teach EBM1

Step Two: Obtain the Evidence with Searches


There are many Web-based sources from which to obtain clinical research. A few
evidence-based sites are:

Cochrane reviews at www.cochrane.org/reviews. Cochrane reviews are metaanalyses of various topics.

TRIPdatabase (Turning Research into Practice) at www.tripdatabase.com. This
database takes a search and displays evidence-based links and meta-analyses, plus
individual articles dealing with therapy, diagnosis, etiology, and prognosis. These
links will send you to a PubMed site using the same search terms. It also provides a
search via PubMed for what it calls the big-four journals (Journal of the American
Medical Association, New England Journal of Medicine, The Lancet, and British

Section on Pediatics
Evidence-based
Practice in Pediatric
Physical Therapy

FACT SHEET

Medical Journal). Articles published in these big-four journals are among the most
highly regarded by medical practitioners and researchers because of their stringent
peer-review process for acceptance for publication.

PEDro (Physiotherapy Evidence resource) at www.pedro.fhs.usyd.edu.au/index.
html. This database contains reviewed studies and provides scoring of the level of
evidence (0-10) on the side of the reviewed study.

Current clinical trials at www.clinicaltrials.gov. This site describes current clinical
trials in a variety of health care disciplines.

National Organization for Rare Disorders at www.rarediseases.org.

APTA also has several resources to assist members with evidence-based practice.
Hooked on Evidence at www.apta.org/hookedonevidence/index.cfm. This site
has reviewed articles by therapists with commentary, although you need to be
very specific with the topic of your searches (for example, Down syndrome
and Downs syndrome get different results).
Evidence in Practice is a special section of Physical Therapy, APTAs peerreviewed journal. This section is both instructive and informative regarding how
to translate evidence into practice. There are a few pediatric-related articles
within the Evidence in Practice series that can be viewed at www.ptjournal.
org.
Open Door: APTAs Portal to Evidence-based Practice at www.apta.orgclick
on Research under the Areas of Interest navigation menu on the left hand
side of the page; then click on Open Door. This is a benefit to members and
provides access to a number of relevant journals, many with full-text articles.
The research journal collections include ProQuest Health and Medical Complete, ProQuest Nursing Journals, and CINAHL.
Pediatric Physical Therapy (Journal of the Section on Pediatrics of APTA) www.
pedpt.com/pt/re/pedpt/home.htm provides current full-text articles to members
and archived articles (after 2 years) free to non-Section members.
There also are other Web site resources that are pediatric-specific. Although most are
geared toward physicians, they often can provide useful information.

Pediatric Critical Care Medicine at pedsccm.org/EBJournal_Resources.php has a
wealth of Web resources and information on critical care.

National Institute of Child Health and Development at www.nichd.nih.gov/
cochrane has systematic reviews related to neonatology.

Evidence-based Pediatrics at www.evidbasedpediatrics.com has information
about general pediatrics.

Evidence-based Pediatrics at the University of Michigan at www.med.umich.
edu/pediatrics/ebm has helpful information, including several CATs or Critically
Appraised Topics related to pediatrics.

S E C T I O N

O N

PEDIATRICS

The largest and most frequently referenced online databases are:



Medline/PubMed (www.ncbi.nlm.nih.gov/entrez/query.fcgi) and Medline Plus
(www.nlm.nih.gov/medlineplus/healthtopics.html), which are a service of the
National Library of Medicine and include more than 15 million citations for biomedical articles back to the 1950s.

Ovid (www.ovid.com), which provides a searchable database of medical, scientific, and academic research information.

CINAHL (www.cinahl.com), which is commonly available at college campuses.

AMERICAN PHYSICAL THERAPY ASSOCIATION

These databases are, for the most part, free online ways of looking through clinical articles.
All of these databases can return a number of results during a search, but all offer ways of
either limiting or expanding the information gained. Many times there are self-tutorials,
including one on PubMed that show examples of how to search more effectively for the
information in the database. APTA members who do not have access databases like Ovid
and CINAHL may find many of the journals and articles searchable through APTAs Open
Door.

Step Three: Evaluate for Clinical Validity


Section on Pediatics
Evidence-based
Practice in Pediatric
Physical Therapy

FACT SHEET

Instructions for assessing the clinical validity of your article can be found at:

Duke//University of North Carolina, Chapel Hill, at www.hsl.unc.edu/services/
tutorials/ebm/index.htm

Center For Evidence-based Medicine at www.cebm.net

Step Four: Combine Evidence with Clinical Judgment


The next step is to consider your own clinical experience and judgment and that of your
colleagues. Ways to access other clinicians opinions include asking in your own clinic,
in pediatric study groups, and on the Section on Pediatrics listserve (at www.pediatricapta.
org under Resources & Listserve). Now combine the research evidence, your clinical
expertise, and the individual patients situation and formulate your answer as to how to
best perform (or, in some instances, not perform) the intervention for your patient.

Step Five: Examine Your Performance


After the intervention has been completed, evaluate your performance. Were you pleased
with your decision? Did the use of evidence-based practice help? Did the patient benefit
from the intervention? Did you find a way of more effectively locating the information?
You may even want to start your own database of effective interventions!

Summary
Evidence-based practice is an important part of our clinical practice as physical therapists.
Use of evidence-based practice is one of the primary goals of the Section on Pediatrics and
the American Physical Therapy Association. We encourage APTA members to continue to
use evidence-based practice and to contribute to APTAs Hooked on Evidence project, a
searchable database of article extractions relevant to the field of physical therapy.

Reference
S ackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB. Evidence-based Medicine:
How to Practice and Teach EBM. 2nd ed. Oxford: Churchill Livingstone; 2000.

Other Resources





American Physical Therapy Association www.apta.org


Section on Pediatrics, APTA www.pediatricapta.org
Center for Evidence-based Medicine www.cebm.net/ebm_is_isnt.asp
APTAs Hooked on Evidence www.apta.org/hookedonevidence/index.cfm
Evidence-based Pediatrics www.evidbasedpediatrics.com
Pediatric Physical Therapy www.pedpt.com/pt/re/pedpt/home.htm

For More Information


If you have additional questions, would like to order additional copies of this fact sheet,
or would like to join the Section on Pediatrics, please contact the Executive Office of the
Section on Pediatrics of the American Physical Therapy Association at:
S E C T I O N

O N

PEDIATRICS

AMERICAN PHYSICAL THERAPY ASSOCIATION

APTA Section on Pediatrics


1111 North Fairfax Street
Alexandria, VA 22314
800/999-2782, ext 3254
Fax: 703/706-8575
[email protected]
Or visit the Sections Web site at www.pediatricapta.org.
Copyright 2007. Developed by the Education Committee of the Section on Pediatrics, APTA, with special
thanks to expert contributors Robin Dole, PT, EdD, PCS; Robert Sieh, DPT; Sharon DeMuth, MS, DPT; and
Lana Svien, PhD, PT.

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