WHY AND WHAT IS IT

Evidence-informed Health (Physiotherapy) Care

K Hariohm MPTProfessor in PT

MSAJ College of PTICEBNR

objective

1. What is evidence informed practice2. What is the need for EIP3. Learning the rudiments of of evidence

informed practice

IS MED

ICINE A SCIEN

CEWhat is science

“Knowledge covering general truths of the operation of general laws, esp. as obtained and tested through scientific method [and] concerned with the physical world."

What is faith

Faith is belief with strong conviction; firm belief in something for which there may be no tangible proof; complete trust in or devotion to. Faith is the opposite of doubt.

WHAT CONSTITUTES A SCIENTIFIC METHOD

What is the first step in a scientific method

MED

ICINE IS SCIEN

CE

•Science starts with a problem or a question

•Evidence based practice – no question or no problem

REALLY DID

THE APPLE FALL O

N N

EWTO

NFormulate a question

Ask the right question Apple falls on Newton

No science without problem or questionEBP cannot happen if you don’t have a problem

What are the question in physio-therapeutic science

Question should be related to our patient care.1. Which treatment to follow for a particular

patient or condition2. Which is method of treatment is better3. Which test to perform to help in diagnosis 4. Can it lead to worsening of the patient

(harm).5. Will my patient achieve a goal can he/she

achieve

OTH

ERWISE TH

E QU

ESTION

HAS N

O VALU

E Questions related to our patient care

WH

EN AM

I GO

ING

TO FIN

ISH LEARN

ING

ALL THESE AN

D

START PRACTICING

Professional question

IF YOU

'RE NO

T PART OF TH

E SOLU

TION

, YOU

'RE PART OF TH

E PRECIPITATE!

Next step -Find solution

• Who do we usually ask-• Expert• Teacher• Social media- peers

• Refer what? • Books• Journal (really)

• Infer from • Physiological and other rationale• discuss and infer (peer discussion)

DO

ES IT MEAN

I NEED

NO

T LISTEN TO

MY PRO

FESSOR

Can I take ideas and treatment on the face value of the expert

Don't go “according to Mr. ” to every treatment method and statement

WH

AT IF MY PEERS ARE ALL D

UM

B OR SU

PER SMART

Discussion with peers

Remember they can or may also come to the conclusion it is an elephant.

We go and read

•What are we reading•When was it published•Was it referred properly•Is there confirmation bias

Remember medicine is science

•It has to be proved•Is there a physiological validity for what is said •Experimented•Repeatability•Ideal homogeneity in the answer ?!

What is evidence based practice

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. (From BMJ 1996;312:71-72)

Why evidence informed practice

Well its how science is doneMakes the practice better- better outcomes for your patient

How to practice EBM

Physiological sense

So how do I practice EBP or intelligently

1. Formulate a proper question 2. Search for answer3. Critically look at the answer for “truth”4. Put it into practice using you experience

and expertise 5. Re-evaluate