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Physical Therapy : Evidence Based Practice & PICO

EBP Tutorials & Worksheets

Evidence Pyramid

Image of the Melnyk model of levels of evidence

Source: https://library.downstate.edu/EBM2/2100.htm

Evidence Based Practice (EBP)

Source: https://www.amsn.org/practice-resources/evidence-based-practice

Evidence based practice (EBP) is the conscientious use of current best evidence in making decisions about patient care (Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000).

It is a problem solving approach to clinical practice and administrative issues that integrates:

  • A systematic search for and critical appraisal of the most relevant evidence to answer a burning clinical question
  • One's own clinical expertise
  • Patient preferences and values (Melnyk & Fineout-Overholt, 2014)

Clinical Question and Suggested Research Design(s)

  • All Clinical Questions-Systematic review, meta-analysis
  • Therapy-Randomized controlled trial (RCT), meta-analysis. Also: cohort study, case-control study, case series
  • Etiology-Randomized controlled trial (RCT), meta-analysis, cohort study. Also: case-control study, case series
  • Diagnosis-Randomized controlled trial (RCT). Also: cohort study
  • Prevention-Randomized controlled trial (RCT), meta-analysis. Also: prospective study, cohort study, case-control study, case series
  • Prognosis-Cohort study. Also: case-control study, case series
  • Meaning-Qualitative study
  • Quality Improvement-Randomized controlled trial (RCT). Also: qualitative study
  • Cost-Economic evaluation

PICO

Having difficulty figuring out good keywords to use to search for information? Use the PICO mnemonic to help get started on brainstorming possible keywords for searching:

P(patient, population, problem)- age, sex, setting, ethnicity, condition,disease, type of patient, or population

I(intervention)- treatment, medications, education, diagnostic tests or best practice(s)

C(comparison with other interventions or current practice)- may not be applicable if your question is looking for best practice.

O(outcome)- stated in measurable terms, expected outcomes based on the intervention identified, such as decrease in fall rate, decrease in length of stay, increase in patient satisfaction

Source: Dearholt S, Dang D, Sigma Theta Tau I, Institute for Johns Hopkins N. Johns Hopkins Evidence-Based Practice Model And Guidelines, Second Edition [e-book]. Indianapolis, IN: Sigma Theta Tau International; 2012. Available from: eBook Collection (EBSCOhost), Ipswich, MA. Accessed August 28, 2017.

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