A introduction to need for evidence informed practice

1. Evidence-informed Health
(Physiotherapy) Care
WHY AND WHAT IS IT
K Hariohm MPT
Professor in PT
MSAJ College of PT
ICEBNR

2. objective
1. What is evidence informed practice
2. What is the need for EIP
3. Learning the rudiments of of evidence
informed practice

3. IS MEDICINE A SCIENCE
What is science What is faith
“Knowledge covering general Faith is belief with strong
truths of the operation of conviction; firm belief in
general laws, esp. as obtained something for which there
and tested through scientific may be no tangible proof;
method [and] concerned with complete trust in or devotion
the physical world." to. Faith is the opposite of
doubt.

4. What is the first step in a scientific method
WHAT CONSTITUTES A SCIENTIFIC METHOD

5. MEDICINE IS SCIENCE
•Science starts with a problem or a
question
•Evidence based practice – no question or
no problem

6. REALLY DID THE APPLE FALL ON NEWTON
Formulate a question
No science without problem or question
EBP cannot happen if you don’t have a problem
Ask the right question Apple falls on Newton

7. 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 condition
2. Which is method of treatment is better
3. 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

8. OTHERWISE THE QUESTION HAS NO VALUE
Questions related to our patient care

9. WHEN AM I GOING TO FINISH LEARNING ALL THESE AND START
PRACTICING
Professional question

10. THE PRECIPITATE!
IF YOU'RE NOT PART OF THE SOLUTION, YOU'RE PART OF
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)

11. Can I take ideas and treatment on the face
DOES IT MEAN I NEED NOT LISTEN TO MY PROFESSOR
value of the expert

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

13. WHAT IF MY PEERS ARE ALL DUMB OR SUPER SMART
Discussion with peers
Remember they
can or may also
come to the
conclusion it is an
elephant.

14. We go and read
•What are we reading
•When was it published
•Was it referred properly
•Is there confirmation bias

15. 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 ?!

16. 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)

17. Why evidence informed practice
Well its how science is done
Makes the practice better- better outcomes
for your patient

18. How to practice EBM

19. Physiological sense

20. So how do I practice EBP or intelligently
1. Formulate a proper question
2. Search for answer
3. Critically look at the answer for “truth”
4. Put it into practice using you experience
and expertise
5. Re-evaluate