3. Scientific Approach

What does the ADHA’s Strategic Plan focus on?

• Community

• Continuing Education

• Governance and Infrastructure

• Advocacy

Involves a combination of relevant components:

1. scientific evidence

2. professional judgement and expertise of the practicing DH

3. patient values and preferences

4. situational circumstances

Evidence-based decision making (EBDM)

What are the 6 A’s in the EBDM Process

1. Assess (the clinical issue)

2. Ask (the right research question)

3. Acquire (evidence from literature)

4. Appraise (the evidence critically)

5. Apply (with clinical expertise & patient’s context)

6. Audit (the outcome of evidence-based recommendation)

Process that includes identifying a clearly focused clinical question, considering what the patient believes is important, providing key search terms, and determining the type of evidence acquired to solve the problem

PICO Process

What does PICO stand for?

• Population

• Intervention

• Comparison

• Outcome

What are evidence sources that are Secondary studies? (pre-appraised, or filtered)

• Clinical practice guidelines

• Meta-analysis system reviews

What are Primary studies?

• Randomized controlled trial

• Cohort studies

• Case control studies

Original research studies (observational or experimental)

Primary research

Observes participants behaviors actions, or other exposures to disease-related factors. NO treatment is applied

Observational research

Looks backward to identify prior exposures in relation to an outcome

Retrospective

Outcomes observed forward in time and related to other factors

Prospective

Discovers the effects of a treatment in a controlled setting

Experimental research

Synthesis of the findings from individual research studies that answers the same question

Secondary research

Meticulous summary of ALL the available primary research in response to a research question

Systematic review

At the top of the hierarchy are _______________. A clinical practice guideline is secondary evidence that incorporates the best available scientific evidence to support a clinical practice

Clinical practice guidlines

Refers to the likelihood that the results were unlikely to have occurred by chance at a specified probability level and that the differences would still exist each time the experiment was repeated.

Statistical significance

Focuses on the practical importance of study results and is determined by the magnitude of change, relevance to patient outcomes, and impact on clinical decision-making rather than numerical comparisons alone.

Clinical significance

Which type of significance is shown by the p-value, which tells us how likely a result happened by chance? ex p<0.05

Statistical significance

What are the three guidelines to the critical analysis process

• reputable source

• evidence has been evaluated

• up-to-date