Guide to Evidence-Based Physical Therapy Practice Book

Preface     ix
Acknowledgments     xiii
Principles of Evidence-Based Physical Therapy Practice     1
Evidence-Based Physical Therapy Practice     3
Introduction     5
Evidence-Based What?     6
Evidence-Based Physical Therapy Practice     7
Summary     13
What Is Evidence?     19
Introduction     21
General Characteristics of Desirable Evidence     21
Forms of Evidence     23
Hierarchies of Evidence     28
Summary     32
The Quest for Evidence: Getting Started     35
Introduction     36
Formulating Clinical Questions     36
Searching for Evidence     40
Electronic Database for Evidence-Based Physical Therapy Practice     44
U.S. National Library of Medicine-PubMed     44
Cumulative Index of Nursing and Allied Health Literature (CINAHL)     56
Cochrane Library     61
Physiotherapy Evidence Database (PEDro)     64
American Physical Therapy Association's Hooked on Evidence     68
Other Databases and Services     74
Summary     75
Elements of Evidence     79
Questions, Theories, and Hypotheses     81
Introduction     82
The Research Question     83
Background     84
Theories, Concepts, and Constructs     88
Hypotheses     91
Summary     93
Research Design     97
Introduction     100
General Features of Research Designs     101
Research Designs for Questions About Diagnosis and Measurement     105
Research Designs for Questions About Prognosis     106
Research Designs for Questions About Interventions     109
Research Designs for Questions About Outcomes     115
Secondary Analyses     118
Qualitative Studies     121
Summary     122
Research Subjects     127
Introduction     129
Subject Identification     130
Subject Selection     133
Subject Management Within the Study     138
Sample Size     141
Summary     141
Variables and Their Measurements     145
Introduction     148
Variables     148
Measurement     153
Measurement Reliability      156
Measurement Validity     160
Responsiveness to Change     164
Interpreting Change     165
Summary     166
Research Validity     169
Introduction     171
Research Validity     172
Threats to Research Validity of Intervention Studies     173
Threats to Research Validity in Diagnosis, Prognosis, and Outcomes Studies     183
The Role of Investigator Bias     184
Additional Solutions to Research Validity Threats     185
Threats to Construct Validity     187
External Validity     189
Summary     190
Unraveling Statistical Mysteries     193
Introduction     195
Descriptive Statistics     197
Parametric Statistics     206
Tests of Differences     207
Tests of Relationships     208
Nonparametric Statistics     213
Additional Statistics in Evidence-Based Physical Therapy     217
Statistical Importance     224
Clinical Relevance     226
Summary     227
Appraising the Evidence     233
Appraising Evidence About Diagnostic Tests     235
Introduction      237
Study Credibility     238
Study Results     241
The Meaning of Study Results     253
Evidence and the Patient/Client     254
Final Thoughts about Diagnosis in Physical Therapy     255
Summary     258
Appraising Evidence About Prognoses     261
Introduction     262
Elements of Prognosis     264
Study Credibility     265
Study Results     269
The Meaning of Study Results     273
Evidence and the Patient/Client     273
Summary     275
Appraising Evidence About Interventions     279
Introduction     281
Study Credibility     282
Additional Considerations     287
Study Results     289
The Meaning of Study Results     294
Evidence and the Patient/Client     295
Summary     304
Appraising Evidence About Outcomes     309
Introduction     312
Outcomes Research     312
Study Credibility     314
Study Results     319
The Meaning of Study Results     320
Evidence and the Patient/Client      320
Evidence About Outcome Measures     321
Important Clinimetric Properties     323
Study Results     328
The Meaning of Study Results     330
Evidence and the Patient/Client     331
Summary     331
Appraising Systematic Reviews and Practice Guidelines     337
Introduction     339
Systematic Reviews     339
Study Credibility     343
Study Results     348
The Meaning of Study Results     358
Evidence and the Patient/Client     360
Clinical Practice Guidelines     362
Is the Guideline Valid?     365
Is the Guideline Acceptable?     368
Summary     369
Evidence in Practice     375
Patient/Client Preferences and Values     377
Introduction     378
Patient-Centered Care     379
Preferences, Expectancies, and Values     384
Summary     390
Putting It All Together     393
Introduction     393
Clinical Case Examples Using Evidence     394
Using Physiologic Studies as Evidence     412
Evidence Hierarchies     421
Additional Evidence Appraisal Worksheets     427
Calculation of Confidence Intervals     449
Index     455