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Physical Therapy Information Resources: Evidence-Based Practice Information

The Evidence Based Process

  • Translate clinical case into a question
  • Formulate methodology
  • Evaluate and use the information

The Clinical Question

Consider significant aspects of the clinical situation and build a relevant question that is carefully phrased in order to facilitate the best answer as follows:

PICO: The EBM process begins with formulating an answerable question using the following standard structure:

PATIENT/PROBLEM

INTERVENTION

COMPARISON

OUTCOME

 

Searching PubMed for Best Evidence

Search by specific clinical study category or for systematic reviews in PubMed:

After running one of these searches, you may further refine your results using PubMed's Limits feature.

Results of searches on these pages are limited to specific clinical research areas. For comprehensive searches, use PubMed directly. offers several filters that retrieve specific types of studies as follows:

A Hierarchy of Strength of Evidence for Treatment Decisions

  • Systematic Reviews of Randomized Trials
  • Single Randomized Trial
  • Systematic Review of Observationaal Studies Addressing Patient-Important Outcomes
  • Single Observational Studies Addressing Patient-Important Outcomes
  • Physiologic Studies (e.G. studies of blood pressure, cardiac output, exercise capacity, bone density etc.)
  • Unsystematic Clinical Observations

What is Evidence Based Practice?

"Evidence-based practice is the integration of best research evidence with clinical expertise and patient values to facilitate clinical decidion-making."

- Sackett, D.L. Strauss. S. E. Richardson, W.S. et. al. Evidence-Based Medicine: How to Practice and Teach EBM. London: Churchill-Livingstone, 2000.

Evidence-based clinical practice is based upon the traditional process of evidence-based medicine (EBM), for which Dr. David Sackett offers one of the best definitions as "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual expertise with he best available external clinical evidence from systematic research."

Evidence-based practice is thus based on formal examination of evidence from clinical research and requires that the professional develop new skills such as effective searching of the literature and application of formal rules of evidence in evaluating the literature itself.

A. Kaji in The Annals of Emergency Medicine defined EBM as an information gathering skill based on knowledge of information resources, generating a clinical question, and application of best evidence to a patient situation. (Evidence-based medicine. A primer for the emergency medicine resident. Ann Emerg Med. 2002 Jan;39(1):77-80).

 

EBM Web Sites

Electronic Books on Evidence Based Practice

Pyramid of Evidence

Pyramid of EvidenceJan Glover, Dave Izzo, Karen Odato, and Lei Wang. Trustees of Dartmouth college and Yale university. 2006. EBM Page Generator. 26 March 2010. http://www.ebmpyramid.org/help.php

Subject Guide