Evidence-Based Practice: A Process for Practical Implementation. Leonard Gibbs, University of Wisconsin—Eau Claire & Stanley McCracken, University of Chicago. Agenda.
Evidence-Based Practice: A Process for Practical Implementation
Leonard Gibbs, University of Wisconsin—Eau Claire & Stanley McCracken, University of Chicago
Forces Making Evidence-Based Practice Possible
Internet Access and Speed
New Search Methods Based on Well-Built Questions
Clinical state and circumstances
Client Preferences and actions
Haynes, Devereaux, and Guyatt, 2002
1) Use of Multidisciplinary / Interdisciplinary / Cross disciplinary / Transdisciplinary / Interprofessional team: Yes / No
2) Study on an individual or group: Yes / No
3) There is some evidence that the author(s) used an Evidence Based Practice Process at the individual client/patient level:
Akobeng, A. K. (2005). Evidence in practice. Archives of Disease in Childhood, 90(8), 849-852.
A 60 year old white male is in his doctor’s office reviewing laboratory test results with his doctor. The patient’s grandfather died of prostate cancer; his mother died of breast cancer; his father died of esophageal cancer, and his sister has breast cancer. His doctor says: “Your PSA is up a bit (.8 to 1.9 in 20 months), but we will have to watch it.”
Question: For a sixty year old with a family history of cancer, with a PSA of .8 moving to 1.9 in 20 months, what is the probability that he has prostate cancer?
Posing Well-Built, Answerable, Practice Questions
Gibbs, L. E. (2003). Evidence-based practice for the helping professions: A practical guide with integrated multimedia. Pacific Grove, CA: Brooks/Cole.
a)Comparing an intervention to no intervention
b) Comparing two interventions
c) What is the best intervention?
a) Comparing an assessment instrument/ procedure to no assessment
b) Comparing two assessment instruments/ procedures
c) What is the best assessment instrument/ procedure?
a) Summarizing characteristics (how much, how many, what percentage, what is the average?)
b) Asking about relationships between variables
a) Require narrative responses
b) Suggest in-depth explorations, little known phenomena (how would they describe, what is the process, how do they experience?)
This format from Gibbs (2003) follows Sackett, D. L., Richardson, W. S., Rosenberg, W. & Haynes, R. B.(1997). Evidence-based medicine: How to practice and teach EBM. New York: Churchill Livingstone.