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Evidence-Based Practice
Evidence-based practice (EBP) has been defined by each field that employs it. There are common elements to the various definitions that include the judicious use of the best research evidence (i.e., highest quality, most current) in order to improve the health and safety of patients while reducing overall costs and variation in health outcomes. High quality best evidence is combined with professional expertise and the values, preferences, and expectations of the person under treatment or the population under consideration.
The emphases can be slightly different in different fields. While in clinical areas (Dentistry, Medicine, Nursing, and Pharmacy) the focus is on the patient, in Kinesiology, the focus is on the athlete and in Public Health, on a population.
In fields other than medicine, evidence-based practice focuses on the clinical experience and research evidence produced by nurses, allied health professionals, movement scientists, athletic trainers,and population health researchers.
You might find these additional definitions helpful:
- Professional expertise is the culmination of:
- the provider's experience treating and providing care or
- research and experience in population studies
- Values, preferences, and expectations are the ideas and beliefs about the body, healing, and return to activities of daily living/work/athletic participation. These ideas and beliefs can be confounded by comorbidities.
- Use of best research evidence includes using a systematic method to find, review, synthesize, and apply the highest quality research to a person's or population's issue(s).
There are several reasons EBP has become important in caring for patients, athletes, and for guiding decisions affecting populations.
- EBP provides a basis for decision making that reduces uncertainties introduced by any single study.
- It can reduce costs by focusing in on treatments with known outcomes.
- It adds new knowledge to the field under study so that researchers and clinicians are not continually asking the same questions about which treatments are effective and safe.
- EBP prioritizes the needs of the person in considering treatment.
What does evidence-based research look like? Here are some examples of questions researchers pursued to understand what the evidence shows and how to apply it to people. Click on the titles to be taken to the the articles. A snippet from the abstract is included below each title.
"Understanding Cannabis-Based Therapeutics in Sports Medicine"
"With increased use of cannabis-based products by the public for both recreational and medical use, sports medicine clinicians should be informed of historical context, current legal considerations, and existing evidence with regard to efficacy, safety, and risks in the athletic community."
"Bedrails and Falls in Nursing Homes: A Systematic Review"
"Some healthcare providers believe bedrails prevent falls, while others think they are ineffective and dangerous. A systematic review was conducted to address: 'For older adults living in nursing homes, does more or less bedrail use reduce the incidence of falls?'"
"The objective of this study was to review randomized controlled trials (RCTs), which included a wearable activity tracker in an intervention to promote physical activity among cardiac rehabilitation (CR) participants, and to conduct a meta-analysis for the outcomes of step counts and aerobic capacity (V˙o2max)."
Evidence-Based Practice Process
The process of evidence-based practice can be represented in various ways, differing somewhat by discipline, but it always begins with the person or population of interest: a patient, client, athlete, or a population, such as a group of adolescents in Detroit. The A's represent the steps that you take in the process, such as ASK a question, ACQUIRE information, APPRAISE information, APPLY the information, ASSESS the outcomes.
The EBP process begins and ends with the person or population.
- ASK a focused question. Is there a new intervention that is more effective than the one currently used? Which practice works well and what could be improved? Why should the intervention change?
- ACQUIRE the current evidence by conducting a literature search that will be guided by your research question.
- APPRAISE the literature: sort, read, and critique peer-reviewed literature.
- APPLY what you find in your decision-making process, remembering to integrate the evidence you've found with your expertise and the expressed preferences, values, expectations of the person or population.
- ASSESS the outcomes for the person or population by reviewing data and documenting your approach, including changes. Evaluate and summarize the outcome(s), then make evidence-based recommendations for day-to-day practice or policy.