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Evidence-Based Practice: An Overview

Evidence-Based Practice: An Overview. “How do you know that what you do and how you do it really works?”. Holm, 2000. Why Evidence-Based Practice?. “All delivery systems expect increased accountability from their service providers, including occupational therapy practitioners”

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Evidence-Based Practice: An Overview

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  1. Evidence-Based Practice: An Overview

  2. “How do you know that what you do and how you do it really works?” Holm, 2000

  3. Why Evidence-Based Practice? • “All delivery systems expect increased accountability from their service providers, including occupational therapy practitioners” • Fawcett & Strickland, 1998

  4. What is Evidence-Based Practice (EBP)? • “Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research” • Sackett et al, 1996

  5. The Myth and the Reality EBP already exists EBP is impossible to put into place EBP is cookie cutter medicine EBP is a cost cutting mechanism Many practitioners take little or not time to review current medical findings Even extremely busy practitioners can initiate EBP EBP requires extensive clinical expertise EBP emphasizes the best available clinical evidence for each client’s situation. Aimee Roberts. 2002

  6. Levels of Evidence • I - Strong evidence from at least one systematic review of multiple well-designed randomized controlled trials • II-Strong evidence from at least one properly designed randomized controlled trial of appropriate size • III- Evidence from well-designed trials without randomization, single group, pre-post, cohort, time series, or matched case controlled studies • IV-Evidence from well-designed nonexperimental studies from more than one center or research group • V-Opinions of respected authorities, based on clinical evidence, descriptive studies, or reports of committees.

  7. The Issues • Does randomized controlled studies really provide “true” evidence? • Do we only want “evidence” to be our practice? What about emerging practice? (balance between ideas and evidence) • Evidence should inform practice…..practice can not be solely based on evidence.

  8. How do we do Evidence-Based Practice? • “Health care is an imperfect science that requires both overarching clinical guidelines and individual judgment in equal parts” • Law, 2001

  9. Occupational Therapy and EBP • We have a history of using evidence to guide our practice Oral tradition Our own beliefs and values Client preferences Assessment data The opinions of experts Research evidence Holm, 2000

  10. Questions for Discussion……. • As clinicians, how can we use evidence on the limited time we have available? • Do we only want “evidence” to be our practice? What about emerging practice? (balance between ideas and evidence)

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