EBP
EBP, or evidence-based practice, is a highly valued process used by speech pathologists seeking the best clinical outcome for their clients. speechBITE aims to make this EBP process easier for clinicians by providing quick access to pre-appraised intervention research.
What is EBP?
What is EBP?
“Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” (Sackett et al, 1996)
Evidence-based practice (EBP) means using the best, research-proven assessments and treatments in our day-to-day client care and service delivery. This means each clinician undertakes to stay in touch with the research literature and to use it as a part of their clinical decision making. EBP also means weighing the value of each part of the research evidence with clinical data and informed client choice. In other words, we need to know what the research says, share this knowledge in an unbiased way with our clients, and with those clients make decisions about care based on our evaluation. To be accountable for our EBP we should record both the decisions made and the evidence we used. Following such decisions, an EBP clinician will also collect data to show that the clinical decision is helping address the client’s goals.
EBP relies on clinicians understanding and evaluating the available research evidence and their own practice. To evaluate all the evidence would be a time consuming process and therefore a systematic approach to interpreting the research is required. This might include being a member of a journal club, an EBP interest group or using speechBITE to evaluate the treatment literature.
Using EBP means giving the best possible care to our clients and letting go of old or ineffective practices when a different way is possible and shown to be effective. It means choosing client focussed service delivery and being able to explain why we should do it that way, rather than being compelled to use budget conscious service delivery because we can’t prove our treatments are effective.
What does the EBP process involve?
There are a number of EBP processes which have been developed to help clinicians implement EBP in the workplace and a number of EBP websites which explain the steps involved.
The most common procedure follows 6 steps:
- Formulate a clinical question
- Search the literature
- Sort, read and critique the literature
- Come to a “clinical bottom line”, in other words recommendations for day-to-day practice based only on the best available literature.
- Implement the recommendations, documenting them, any changes you choose to make and the outcomes of your intervention. In implementing the recommendations you apply the research to your clinical setting and client. You need to include your client and the service provider in this implementation process. In other words, apply the evidence to the situation in consultation with those who it will affect.
- Share the results of your EBP with others, ideally through writing them up.
Although traditionally EBP training emphasised accessing and appraising the research evidence, there has been a drive to increase clinician awareness of the three components of the EBP process (research evidence, clinical data and informed client choice). This has led to the term E3BP being introduced to reflect these three essential components (Dollaghan, 2007).
There are also a range of online EBP resources available to make the process easier, including already published systematic reviews, critically appraised papers (CAPs) and critically appraised topics (CATs).
How does speechBITE help in the EBP process?
speechBITE aims to reduce the time and challenges associated with accessing and appraising the research evidence in order to make EBP easier for all clinicians. We’ve done this by searching, indexing and rating the quality of 1000’s of treatment papers for you.
Links
EBP relevant to speech pathology
ASHA EBP technical report
ASHA’s guidelines for EBP in speech-language pathology and audiology.
Evidence-Based Practice Briefs
A publication that uses EBP principles to address specific clinical questions related to speech pathology practice.
ALTC report: Facilitating the Integration of Evidence Based Practice into Speech Pathology Curricula
Pages 75-84 of this report contain an extensive list of EBP resources relevant to speech pathology.
Evidence-Based Communication Assessment and Intervention
An international journal that provides appraisal of communication assessment and intervention studies, including expert commentary about the quality of the evidence as well as its practical implications.
EBP in healthcare
Stroke Engine
A website containing evidence-based information on the topic of stroke rehabilitation for health professionals, for people who have experienced a stroke and their families/friends.
JBI
An international research and development organisation focused on facilitating the implementation of EBP in healthcare.
BMJ Evidence-Based Medicine
Surveys a wide range of international medical journals applying strict criteria for the quality and validity of research. Practicing clinicians assess the clinical relevance of the best studies.
Centre for Evidence-Based Medicine (CEBM)
Provides valuable tools and downloads for EBP in health care.
Centre for Reviews and Dissemination (CRD)
CRD undertakes reviews of research about the effects of interventions used in health and social care. The centre maintains various databases, provides an enquiry service and disseminates results of research to NHS decision makers.
Agency for Healthcare Research and Quality (AHRQ)
AHRQ sponsors and conducts research that provides evidence-based information on health care outcomes, quality, cost, use and access.
Cochrane
Cochrane provides up to date information and systematic reviews on the effects of interventions across the healthcare field.
International Guideline Library at the Guidelines International Network
Search for guidelines in healthcare from all over the world.
Other searchable EBP databases
NeuroBITE
This database holds a large catalogue of studies on cognitive, behavioural and other treatments for psychological problems and issues occurring as a consequence of acquired brain impairment (ABI). NeuroBITE also provides methodological ratings for study types such as randomised controlled trials, non-randomised controlled trials and single case experimental studies.
PEDro
This database provides rapid access to the bibliographic details and abstracts of randomised controlled trials, systematic reviews and evidence-based clinical practice guidelines in physiotherapy. Trials on this database have been also been rated for methodological quality to help clinicians quickly discriminate between trials which are likely to be valid and interpretable and those which are not.
OTseeker
This database contains abstracts of systematic reviews and randomised controlled trials relevant to occupational therapy. Trials have also been critically appraised and rated to assist clinicians in evaluating their validity and interpretability.
Trip
Trip is a clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their health practice and/or care. As well as research evidence, Trip allows clinicians to search across other content types including images, videos, patient information
leaflets, educational courses and news.