Evidence Based Practice (EBP)

ACRM members strive to apply the highest standards of both rigor and sensitivity to the evaluation of research evidence and its application in clinical practice in rehabilitation. To that end, the ACRM Clinical Practice Committee (CPC) provides the following collection of EBP resources.

Self Study Introduction to Evidenced Based Medicine Duke Medical Center Library
University of North Carolina at Chapel Hill Science Library
This tutorial is a good place to begin EBP self-study. Examples emphasize medical issues.

General Information Centre for Evidence Based Medicine Oxford University
The most comprehensive site for EBM. Download teaching materials in PPT. Bookmark this site!

Centre for Evidence Based Medicine University of Toronto
Offers valuable resources including chapters from Sackett's EBM book. Patient cases include EBP examples for nursing and therapy.
Bayesian Evidence Synthesis University of Sheffield, Health Economics and Decision Science

Reference Evidence-Based Medicine Glossary University of Toronto
Glossary of definitions for EBM terms with examples.
Levels of Evidence & Grades of Recommendations CAT: Critically Appraised Topic
Centre for Evidence-based Medicine, Oxford University
Summarizes levels of evidence with specific criteria for evaluating evidence.

Resources Organized by Steps in the EBP Process

Step 1. Identify Learning Issues and Formulate a Clinical Question

Educational Prescription Centre for Evidence-Based Medicine, Toronto Download a Word document to track learning issues and develop clinical questions.

Focusing Clinical Questions Centre for Evidence-Based Medicine, Oxford An example of the PICO format used to develop focused clinical questions.

Step 2. A) Conduct an Evidence Search Search for existing guidelines.

SUMSearch University of Kansas Medical Center This meta-search engine searches multiple databases and organizes results into existing guidelines, systematic reviews and primary literature.

National Guideline Clearinghouse Agency for Healthcare Research and Quality A definitive source with 182 guidelines indexed under rehabilitation, 40 on brain injury (including some that are not really guidelines, such as the NIH Consensus Conference summary), and 115 on stroke.

Rehabilitation Guidelines Universitéd'Ottawa
A database of web-based EBCPGs from recent scientific publications. Serves as a teaching and reference tool for students and rehabilitation specialists (occupational therapists, physiotherapists, audiologists, physiatrists, speech and language pathologists, etc.) to make informed decisions in choosing an effective intervention for their client.

AAN Practice Guidelines and Tools American Academy of Neurology
Clinical practice guidelines and related tools, including patient and physician summaries of selected guidelines.

Practice Guidelines of the ANCDS Academy of Neurologic Communication Disorders and Sciences

Step 2. B) If No Clinical Guidelines Exist Search for meta-analyses, systematic reviews and critically appraised topics.

The International Cochrane Collaboration A landmark international collaborative for systematic evidence reviews. Download a systematic review handbook and other materials. Free search of an abstract database, access to full systematic reviews with paid subscription. Reviews indexed in Medline/PubMed.

The Cochrane Collaboration US Cochrane Centre, Johns Hopkins Bloomberg School of Health La Biblioteca Cochrane Plus, Ministerio de Sanidad y Poltica Social

Agency for Healthcare Research and Quality
Reports and technology assessments based on rigorous, comprehensive syntheses and analyses of the scientific literature on topics relevant to clinical, social science/behavioral, economic, and other health care organization and delivery issues.

Database of Abstracts of Reviews of Effects (DARE) Centre for Reviews and Dissemination, The University of York
Includes systematic reviews related to rehabilitation. Register for email updates.

PEDro Centre for Evidence-Based Physiotherapy, George Institute for Global Health
Physiotherapy evidence database … for quality.

OT Seeker University of Queensland, School of Health and Rehabilitation Sciences
University of Sydney
A database that contains abstracts of systematic reviews and randomized controlled trials relevant to occupational therapy. Trials are critically appraised and rated to assist you to evaluate their validity and interpretability.

National Quality Measures Clearinghouse Agency for Healthcare Research and Quality
A public repository for evidence-based quality measures and measure sets.

Step 2. C) Conduct Primary Literature Search
If pre-digested literature is not available

PubMed National Library of Medicine
Free public access search engine. Use the ‘clinical queries' button to organize a search using EBP filters.

APA PsycNET™ American Psychological Association
Provides free and fee-based quick access to quality content in the field of psychology.

Step 3. Critically Appraise Evidence What is CAT?

About CAT: Critically Appraised Topic Centre for Evidence-Based Medicine, Oxford University Describes a process … (CATs).

CAT: Critically Appraised Topic Worksheets Centre for Evidence-Based Medicine, University of Toronto
Download worksheets to critically appraise evidence related to diagnosis, prognosis, therapy (intervention), harm, and systematic reviews.

CATMaker Centre for Evidence-Based Medicine, University of Oxford
A software tool to create Critically Appraised Topics (CATs) for key articles you encounter about therapy, diagnosis, prognosis, etiology/harm and systematic reviews of therapy.

For Specific Professions

Hooked on Evidence American Physical Therapy Association
APTA member-only access to a database of article extractions relevant to physical therapy.

American Occupational Therapy Association Member-only access to evidence-based literature on brain injury, multiple sclerosis, Parkinson's Disease, and stroke.

American Academy of Physical Medicine and Rehabilitation Practice Guidelines Resources

Guidelines Resource American Speech-Language-Hearing Association
Member-only resource area for guidelines.

Reviewed Jan 2011
Provided through the generosity and exceptional effort of the ACRM Clinical Practice Committee, especially Mary Slavin, PhD, PT; Mark Johnston, PhD; and Joseph Giacino, PhD.
Thank you.