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Speech Pathology & Audiology: Evidence-Based Practice

What is Evidence-Based Practice?

Evidence-based practice is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. That is, it integrates the best external evidence with individual clinical expertise and patients' choice.

Evidence-based practice involves 5 steps:

1. Ask a focused question to satisfy the health needs of a specific patient 

  • What is your clinical question? - use the P.I.C.O. model
  • What type of clinical question is this?
  • What is the best study design to answer this type of clinical question? Use the table to the right.

2. Find the best evidence by searching the literature

  • What is the highest level of literature to support the question?  See the pyramid to the right.
  • Where should you look for this material?  See the table to the right.

3.  Critically appraise the literature: testing for validity, clinical relevance, and applicability

  • What are the results of the study?

4. Apply the results in clinical practice

5. Evaluate the outcomes in your patient

Adapted from: the Centre for Evidence-Based Medicine and Sackett DL, Evidence based medicine: what it is and what it isn't. BMJ. 1996 Jan 13;312(7023):71-2.

Evidence Pyramid

Pyramid hierarchy of evidence from bottom up: background information/expert opinion; case studies; cohort studies; randomized controlled trials; critically-appraised individual articles [article synopses]; critically-appraised topics [evidence syntheses]; systematic reviews

EBP Toolkits