Evidence Based Practice in the Clinic

Elena Noble, MPT | July 2013

"A young girl in an adaptive chair laughs and smilesUnlike a PT student immersed in research or a university professor who liberally assigns research papers, a practicing clinician may not have access to the stacks or online journal databases—the basis for evidence based practice (EBP). EBP combines the best available research with clinical expertise and the goals of the patient in order to deliver quality and effective medical and rehabilitation services.

Every therapist wants to provide evidence-based care for their clients. But staying current with the literature is tough for a practicing clinician. Why? Research takes time. Accessing full-text articles is costly and sometimes there are multiple and differing opinions on a given subject. For this reason, busy practicing clinicians should become familiar with the Clinical Practice Guidelines (CPGs).

What is a Clinical Practice Guideline?

Essentially, a CPG is a summary of all peer-reviewed and published literature on a topic. The research articles are analyzed by a panel of clinical experts who then apply the relevant findings to patient care. The result is a concise, research-based document called a “guideline.”  The guideline will provide best recommendations for practice (based on the literature) from evaluation through treatment.

Where do I find CPG’s?

Look in healthcare databases and refereed journals. One of the most comprehensive and organized collections I’ve found is the National Guideline Clearinghouse (NGC): The NGC is updated and added to by various organizations and experts as the research changes.  Although not specifically a physical therapy site, many of the NGC guidelines are relevant to the therapy field.

Another great database is PEDro (Physiotherapy Evidence Database) At this Australian site you can search a term and get an output of CPGs, randomized controlled trials, and systematic reviews that are all PT specific.

Although not every diagnosis or treatment scenario is included in a CPG yet, I have found the information at these sites to be of great value because it is accessible and applicable. Most importantly, it is  quick to find which makes it a great tool for clinicians with busy practices and heavy case loads.

If you know other sources of clinical research for busy practitioners, add your comments below.

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