Application of evidence (FS-10)

Focused symposium
Chair/speaker
Speakers
STRATEGIES TO IMPROVE THE APPLICATION OF EVIDENCE TO INDIVIDUAL PATIENTS

Elkins M1van der Wees P2Costa L3Craik R4Lamb S5 
1University of Sydney, Sydney Medical School, Sydney, Australia, 2Radboud University Medical Center, IQ Healthcare, Nijmegen, Netherlands, 3Universidade Cidade de São Paulo, São Paulo, Brazil, 4Arcadia University, Glenside, United States, 5University of Oxford, Oxford, United Kingdom

Learning objective 1: Understand the value of using high-quality clinical research to guide management of individual patients
Learning objective 2: Identify key challenges and solutions to evidence-based practice
Learning objective 3: Develop skills to address challenges to evidence-based practice
Description: Evidence-based practice is physical therapy informed by relevant, high-quality clinical research (1), which involves asking clinical questions, acquiring evidence, appraising the evidence, applying the evidence to clinical practice, and assessing effectiveness (2). While evidence-based practice is encouraged in physical therapy (3), physical therapists often experience challenges that can impede the use of evidence to guide clinical decision-making. These challenges include: navigating the large volume of published research; applying research on groups to individual patients; recognising when reporting of published evidence is misleading; developing skills in interpreting effect size and confidence intervals; and dealing with incomplete descriptions of the intervention (4). This symposium aims to develop participants' knowledge and skills in overcoming these challenges, thereby facilitating evidence-based practice. Specifically, the symposium will introduce a range of solutions to each of these challenges:
Strategies to assist in making sense of the large number of trials being published will include: use guidelines and systematic reviews instead of individual trials; follow living systematic reviews as these come online (5); make use of free services that efficiently direct you to high-quality evidence; and make use of free services that pre-appraise study quality.
Strategies to ensure that accurate results are received by clinicians and consumers will include: techniques to identify 'spin' in published research; what to look for beyond the abstract; directing consumers to plain-language summaries of high-quality evidence; get involved in post-publication peer review.
Strategies to maximise the use of 95% confidence intervals will include: understanding that confidence intervals provide more useful information than p-values; understanding the limitations in the methods used to estimate the smallest worthwhile effect (SWE) of an intervention; how to discern a patient's individual SWE, which may differ from the one used in the published research report; how to easily calculate a confidence interval from the data in the paper; and consider what the new study adds to the existing pool of evidence (6).
Strategies to assist in accessing complete descriptions of interventions will include: prefer journals that enforce use of reporting checklists; access the published protocol; and access electronic appendices.
Implications / Conclusions: Developing skills in recognising challenges inherent in evidence-based practice and learning how to apply solutions will improve physical therapists' ability to use high-quality clinical research to guide their management of individual patients. 
Key-words: 1. evidence-based practice 2. clinical research 3. 
Funding acknowledgements: Nil
Relevance to physical therapy globally: Evidence-based practice is physical therapy informed by relevant, high-quality clinical research. Physical therapists experience challenges that can impede the use of evidence to guide clinical decision-making. These challenges include: the large volume of published research; applying research on groups to individual patients; misleading reporting in published evidence; skills in interpreting effect size and confidence intervals; and incomplete descriptions of the intervention. This symposium will provide participants with strategies to overcome these challenges to evidence-based practice.
Target audience: Physical therapists looking to improve their skills in the application of published research evidence to their patients