Heirarchy of Evidence for upload physiotherapy.pptx

EBP for physiotherapists

1. Heirarchy of Evidence PICO Question

2. Objective of the session Describe the 3 components of Evidence-Based Practice Explain the hierarchy of evidence and how to write a PICO question

3. Three components of EBP We must integrate the best research evidence, clinical expertise and patient values Optimal clinical decision making

4. The Gold standard PUBMED Developed by NIH Available through out the world Provided free of charge

5. EBP means using the best research evidence to optimize patient outcomes Identify the best clinical research evidence Describe a clinical question

6. Know where to find high quality research sources- Pubmed, Cochrane, CINAHL, Pedro Find the best information to address the question

7. Evidence pyramid check internet- can separate---metaanalysis and systematic review

8. Research methods Randomized Control Trial Looks at the difference between group of patients One group gets a specific therapy or intervention A second group doesn't receive the treatment or receives a placebo

9. Research methods RCT is the highest level of evidence

10. Research methods Systematic review is the next level in the evidence pyramid

11. Research methods Clinical practice guidelines are the highest level of evidence based research

12. Clinical practice guidelines Represent the best evidence based therapies, treatments and thinking in physical therapy Allows us to have increased confidence in the conclusions that we draw for the questions that we ask

13. Meta analysis Is powerful tool that looks at evidence by analyzing multiple RCTs and other studies

14. I am doing research to determine if cranio-cervical flexion training can help chronic neck pain patients to reduce pain and improve function. The type of study with the highest quality of evidence is a a. A cohort study b. A case study c. A systematic review d. An expert advice

15. EBP 5 Step Process Ask: Translation of uncertainty to an answerable question Acquire: systematic retrieval of best available evidence Appraise: Critical appraisal of evidence for validity, clinical relevance and applicability Apply : Application of results in practice Assess: Evaluation of performance

16. Asking a Background Question Unique Diagnosis presented Type 2 Diabetes mellitus What is DM Risk factors Signs and symptoms

17. PICO Question Foreground question The PICO process seeks to find the best question to ask

18. PICO P= Patient population I= Intervention C= Comparison Intervention O= Outcomes

19. 75 year old man with osteoarthritis presenting with pain, whether Strengthening exercise is effective to reduce pain

20. P = 70 yr old man with OA I = strengthening exercise C= No exercise O = pain (NPRS)

21. For a 70 year old man diagnosed with OA is strengthening exercise more effective in reducing compared to no exercise at all?

22. Test your understanding 65-year-old female patient diagnosed with bronchiectasis with complaints of increased sputum is active cycle of breathing technique more effective than conventional chest physiotherapy P = I = C= O=

23. Summary

24. References

25. Any questions