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"Evidence-based practice is the integration of best research evidence with clinical expertise and patient values to facilitate clinical decidion-making."
- Sackett, D.L. Strauss. S. E. Richardson, W.S. et. al. Evidence-Based Medicine: How to Practice and Teach EBM. London: Churchill-Livingstone, 2000.
While evidence-based clinical practice applied to occupational therapy is relatively new, it is based upon the traditional process of evidence-based medicine (EBM), for which Dr. David Sackett offers one of the best definitions as "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual expertise with he best available external clinical evidence from systematic research."
Evidence-based practice is thus based on formal examination of evidence from clinical research and requires that the professional develop new skills such as effective searching of the literature and application of formal rules of evidence in evaluating the literature itself.
A. Kaji in The Annals of Emergency Medicine defined EBM as an information gathering skill based on knowledge of information resources, generating a clinical question, and application of best evidence to a patient situation. (Evidence-based medicine. A primer for the emergency medicine resident. Ann Emerg Med. 2002 Jan;39(1):77-80).
Pyramid of Evidence
The Evidence-Based Medicine Pyramid! Posted on 29th April 2014 by Danny Minkow, https://s4be.cochrane.org/blog/2014/04/29/the-evidence-based-medicine-pyramid/
Level I
Experimental study, randomized controlled trial (RCT)
Systematic review of RCTs, with or without meta-analysis
Level II
Quasi-experimental Study
Systematic review of a combination of RCTs and quasi-experimental, or quasi-experimental studies only, with or without meta-analysis.
Level III
Non-experimental study
Systematic review of a combination of RCTs, quasi-experimental and non-experimental, or non-experimental studies only, with or without meta-analysis.
Qualitative study or systematic review, with or without meta-analysis
Level IV
Opinion of respected authorities and/or nationally recognized expert committees/consensus panels based on scientific evidence.
Includes:
- Clinical practice guidelines
- Consensus panels
Level V
Based on experiential and non-research evidence.
Includes:
- Literature reviews
- Quality improvement, program or financial evaluation
- Case reports
- Opinion of nationally recognized expert(s) based on experiential evidence
From Johns Hopkins nursing evidence-based practice : Models and Guidelines
Dang, D., & Dearholt, S.L. (2018). Johns Hopkins nursing evidence-based practice : Model & guidelines (3rd ed). Sigma Theta Tau International.
Providing full text for more of the most used journals in the CINAHL index than any other database - with no embargo. It covers more than 50 nursing specialties and includes quick lessons, evidence-based care sheets, CEU models and research instruments.
From The National Institute on Disability and Rehabilitation Research. Provides objective information about assistive technology products and rehabilitation equipment available from domestic and international sources. ABLEDATA does not sell any products, but can locate companies.
National Rehabilitation Information Center
Project of the National Institute on Disability and Rehabilitation Research, gathers over 70,000 resources, using a simple search interface. Includes full-text documents and reports available through REHABDATA.
Latest news, professional information and job postings, blogs, forums and organizations of interest to occupational therapists.
McMaster Occupational Therapy Evidence-based Practice Group
Focuses on research to critically review evidence regarding occupational therapy interventions and to develop tools for evidence-based occupational therapy practice. Describes importance of evidence based practive and provides Summary of OT EBP Projects.