Prelims Flashcards
What is Evidence-Based Practice?
Method of decision making and practice
Main Goal of EBP
Optimize the benefits gained from the high-quality data that we have gathered
EBP can be in the transformed into many fields such as?
○ Evidence-based medicine EBM
○ Evidence-based physical therapy EBPT
Method of clinical decision making and PT practice
Evidence-Based Physical Therapy
Evidence-Based Physical Therapy Integrates three important factors
○ Best available scientific research evidence
○ Clinical expertise
○ Patient’s unique values and circumstances
Components of the EBP triad
○ Best available scientific research evidence
○ Clinical expertise
○ Patient’s unique values and circumstances
Main Goal of EBPT
Optimize the benefits gained from therapy and therapeutic interventions
T or F
Characteristic of EBPT in the Philippines are:
● Low research evidence uptake
● Heavy reliance on potentially biased sources
TRUE
T or F
Characteristic of EBPT in the Philippines are:
● Effective professional education for practitioners to address barriers
● Intensive undergraduate education for students to ensure adequate preparation on being effective research evidence consumers
TRUE
Four Main Types of Clinical Research
Diagnosis
Prognosis
Intervention
Prevention
Includes examination and evaluation
Diagnosis
Likely course of a disease
Prognosis
therapy (Type of clinical research)
Intervention
○ Balance between doing good (beneficence) and doing no harm (non-maleficence)
○ Evidence on effectiveness of an intervention
○ A randomized clinical trial
Intervention
Evidence of factors that will aim for prevention of a
condition or prevent the further course of a condition
Prevention - “harm”
T or F
Youtube is a source that is considered a NON-SCIENTIFIC
TRUE
T or F
Meta-analyses is a source that is considered a NON-SCIENTIFIC
FALSE
it is a Scientific source
What is the top 3 strongest Scientific Evidence
- Meta-analyses & Systematic Review
- Randomized Controlled Trials
- Cohort Studies
What is the weakest scientific evidence?
- Case reports, Opinion papers, Letters
- Animal trials and invitro studies
- Cross-sectional studies
- Case-control; studies
Assess - again means that you have to?
Evaluate the effectiveness and efficacy of your efforts in step 0 through 4 and identify ways to improve them in the future
The Five Step EBP Process - The 5 A’s
Assess - step before you start
Ask
Acquire
Appraise
Apply
Assess - again
● Interpret the applicability of evidence to specific problems, given patient preferences and values
● Use clinical reasoning and engage patient in decision making
Apply
EBPT Process Determinants
- Knowledge about the patient’s condition in order to recognize what is unknown
- Knowledge on the evidence appraisal process
- Access to evidence
- Time to research for, appraise, and integrate evidence
● Systematically check best available evidence for
indications of validity, importance, and usefulness
● Apply the hierarchy of evidence
Appraise
● Gather important and convincing evidence from high-quality repositories of the health literature
● Locate most current evidence first
Acquire
● Construct clinical questions that facilitate an efficient search for evidence
● Formulate a well-built - relevant, viable, searchable - clinical question
Ask
● Learn how to recognize, classify, and prioritize important patient or policy problems
● Establish the clinical scenario
● Identify the knowledge need
Assess - step before you start
T or F
Lack of time, resources, skills, and access to research literature, supporting administrative policies, in-service training and authority in decision making is a benefit in EBPT
FALSE
It hinders the EBPT process
What needs to be done to stop the hinders the EBPT process?
Pre-professional preparation
Philosophical shift in the institution
Management support
Willingness to “consciously” challenge one’s assumptions and current state of knowledge
Acquire and practice the necessary skills
Any question that arises during your physical therapy practice that may be related to the client or patient, your practice, diagnosis, and/or diagnostic procedures, etc
Clinical Question
Clinical Questions Occur When?
There is a sense of uncertainty about the best course of action
○ I am not sure how to proceed?
○ What is the best way to proceed?
T or F
High-quality evidence could resolve some of the
uncertainties
TRUE
Where do clinical questions come from?
Professional Practice
Existing Public Research
Existing Theory
Professional Trends
○ “The bends” - decompression sickness DCS, or Caisson disease - occurs in scuba divers
○ Children with autism in O2 chamber, they become more cooperative
Professional Trends
Using a particular model and/or theory and comparing it to what actually happens in the real world
Existing Theory
○ More questions arise after reading a research article
○ Gaps are stated or found after reading a body of
knowledge
Existing Public Research
You encounter a patient and you and your colleagues are not 100% sure on how to proceed or treat
Professional Practice
“Bread and butter” of EBPT
Foreground Questions
Types of Clinical Questions
Background Questions
Foreground Questions
○ Questions that increase the understanding of the situation
○ Reflect the desire to understand the nature of a
patient’s problem or need
○ Often focused on the medical aspect of the situation rather than on the PT aspect
Background Questions
○ Help clinicians and their patients in making decisions about a specific PT management or a problem
○ Questions used to facilitate clinical decision-making
Foreground Questions
T or F
A good foreground questions has sufficient details to search for answer that are specific to the patient
about whom the question is asked
○ You have to put sufficient details because your details will help you later on in acquiring evidence
TRUE
Types of Foreground Questions
Questions About Interventions
Questions About Prognosis
Questions About Diagnosis
Questions About Outcomes
Questions About Experiences
Focus on which tests and measures provide the most accurate and precise information in a timely manner with the least amount of cost and/or risk
Questions About Diagnosis
How to write QAD
Specify the patient problem, the diagnostic test, diagnosis for which you are testing
PTD Framework
Patient or Problem - Test - Diagnosis
T or F
Writing question about outcomes have a format
FALSE
It has no format
PICO model
Patient - Intervention - Comparison - Outcome
PP Framework
Patient or Problem
PIOT Framework
Patient or Problem - Indicator - Outcome -Time Frame
