research module 1

evidence based practice

integration of best research evidence with PTs clinical expertise and patient’s unique values and circumstances

EBP framework

clinical question → clinical decision making through evidence based practice → patient management

sources of evidence

research, clinical expert, patient evidence

research evidence pyramid(lowest→highest evidence)

textbooks/narrative reviews→case studies→case series→ case-control studies → cohort studies → RCTs → systematic reviews

systematic review

get a bunch of articles related to topic then use guidelines to decrease number of studies

systematic review and meta analysis steps

focused RQ → systematic search for all relevant studies → systematic appraisal of all relevant studies → integration of results in meta-analysis when possible → study results provide new interpretation of available literature

EBP steps

PICO question → search for best research evidence → appraise the quality of it → integrate the evidence with info about the pt and clinical expertise → reflect on process to improve

Clinical Practice Guidelines

comprehensive and systematic compilation of research evidence for specific clinical questions(may not be patient specific and may be outdated)

ethics

system of moral principles; rules of conduct recognized in respect to a particular group

fine line between PT practice and research

objective of research is NOT to treat and has a standardized intervention

personal autonomy

self determination based on adequate understanding; informed consent

beneficence

obligation to attend to the well-being of individuals; maximize possible benefits and minimize risk/harm

justice

fairness in distribution of both burdens & benefits of research

informed consent

information element(disclosure of info and subject’s comprehension); consent element(voluntariness and competence to consent)

Institutional review board(IRB)

approve, deny, require modifications based on scientific merit, risk to the subjects, competence of investigators, feasibility, risk/benefit ratio and principle of human subject protection