The Quest for Evidence Flashcards
Questions regarding a patient’s problems and the best course of action to address them pertain to what 7 things?
1) The pathological, anatomical, or pathophysiological nature of the problem2) The medical and surgical management options3) The usefulness of tests and measures4) Which predictive factors will predict the pt’s future health status5) The benefits and risks of interventions6) The utility of clinical prediction rules7) The nature of the outcomes
What do background questions reflect?
A desire to understand the nature of the problem or need
Why must PTs ask background questions?
To better understand the patient’s situation better and plan accordingly
Why must PTs ask foreground questions?
To help them make decisions about the specific physical therapy management issues
4 Key Elements of Foreground Questions
1) Patient/client details such as age, gender, diagnosis, etc.2) A specific factor of interest such as diagnostic test, clinical measure, predictive factor, intervention, clinical prediction rule or outcome3) A basis for comparison with the specific factor of interest4) The consequence of interest for the factor of interest
Describe foreground questions about diagnostic tests
Usually focus on which tests will provide the most accurate and persuasive information in a timely manner with the least amount of risk, cost, or both
Describe foreground questions about clinical measures
Used to quantify and/or describe a pt’s impairments in body functions and structures as well as activity limitations and participation restrictions
Describe foreground questions about prognostic factors
These questions arise because therapists and pts want to know which pieces of information are most important to consider when predicting short and long term goals
Describe foreground questions about interventions
The goal of these questions is to identify which treatment approaches will provide a manner consistent with patient’s preferences and values
Describe foreground questions about clinical prediction rules
These questions focus on the accuracy of clinical predictions and the circumstances in which their performance is most useful
Describe foreground questions about outcomes and self-reported outcomes measures
These questions focus on the type of end points possible in response to a particular treatment of on the methods by which the end point can be measured
5 Steps to search for evidence once a question has been formulated
1) Determine the most useful database2) Identify Search Terms to Enter into the Database3) Use the database features to streamline the search4) Be prepared to reformulate the question5) Aim for the Highest Quality Evidence Available
5 Examples of Electronic Databases for EBPT
- PubMed- CINAHL- Cochrane Library- PEDro- APTA’s Hooked on Evidence
