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INTRODUCTION

QUESTIONS TO CONSIDER

  1. How will you determine if a study is applicable to your patient?

  2. How can you best implement treatment from a study?

CHAPTER-AT-A-GLANCE

This chapter will help you understand the appraisal of the following:

  • Applicability of research evidence to your patient(s)

  • Quality of research evidence related to treatment interventions

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High-quality studies produce valid results and can more confidently be applied to inform patient care. This chapter and Chapter 4 focus on the appraisal of intervention studies, supporting your knowledge and skill development for the third step of evidence based practice (EBP).

THE PROCESS OF STUDY APPRAISAL

The appraisal process is summarized in four parts. The first two parts are detailed in this chapter:

  1. Appraising a research study for its applicability

  2. Appraising a research study for its quality

The third part, appraising study results, and the fourth part, formulating a clinical bottom line, are detailed in Chapter 4.

Determining the Applicability of an Intervention Study

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Applicability refers to the process of evaluating a study and determining what specific people might benefit from the intervention. You may have a specific patient in mind when you search the literature, or you may have a more general question about types of patients with shared problems and what interventions are most effective for these types of patients. In both situations, you will examine the research you locate to determine if it applies to your patient or group of patients with a similar problem.

Using Research Evidence to Inform Care for Your Patients

The explanatory sections that follow are organized by questions to consider when appraising the applicability of an intervention study. You will apply each of these questions to June Wilson.

EVIDENCE IN PRACTICE June Wilson

You use PubMed to locate a randomized clinical trial (RCT) to ensure an evidence based approach to 17-year-old swimmer June Wilson’s treatment plan. Before you begin, you formulate the following searchable clinical question:

Searchable Clinical Question

For June Wilson, a 17-year-old swimmer with neck pain, is a combination of manual therapy and exercise effective for reducing pain and improving function?

After searching PubMed, you find an article that addresses a type of treatment and its effects on pain:

Walker MJ, Boyles RE, Young BA, et al. The effectiveness of manual physical therapy and exercise for mechanical neck pain: a randomized clinical trial. Spine. 2008;33:2371-2378.1

Use the questions outlined in this chapter to appraise the applicability of the intervention study.

QUESTION 1: Is the study’s purpose relevant to my clinical question?

You begin by determining if this study could apply to June. The article may be an example of excellent research with valuable results, but June is ...

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