What is Evidence-Based Practice (EBP)?

By Pam Marshalla

The term Evidence-Based Practice (EBP) has been giving practicing SLP’s a lot of trouble recently. This is because some professionals have mistakenly assumed that an evidence-based practice requires that practicing therapists restrict their methods to only those that have been researched in a laboratory. This is a false interpretation of the EBP. The EBP actually integrates information from three sources: LAB, CLINIC, and CLIENT.

Let’s review four references that explain this:

1. According to Carol Dollaghan (The handbook for evidence-based practice in communication disorders, 2007, Baltimore: Brook), the EBP is the conscientious, explicit, and judicious integration of best available evidence from three areas:

  • External evidence from systematic research (LAB)
  • Internal evidence from clinical practice (CLINIC)
  • Evidence concerning the preferences of a fully-informed patient (CLIENT)

2. According to the American Speech-Language-Hearing Association (ASHA), the EBP integrates information from these same three areas:

  • Current Best Evidence (LAB)
  • Clinical Expertise (CLINIC)
  • Client/Patient Values (CLIENT)

3. According to Laura Justice who is editor of the American Journal of Speech-Language Pathology (“Evidence-Based Terminology” AJSLP, 17, 4, November 2008), some people are confusing the term EBP with the term “empirically validated treatments,” which is a treatment that has been validated by empirical research. She wrote:

“…one’s use of an empirically validated treatment is not the same as engaging in EBP” (p. 324).

Using EBP, the clinician:

“systematically gathers and integrates information (i.e., evidence) from a variety of resources, including scientific evidence [LAB], prior knowledge [CLINIC], and client preferences [CLIENT], to arrive at a decision” (p. 324).

4. The originators of the concept of the EBP are Sacket et al (Sacket, D., & Richardson, W.S., & Rosenberg, W., & Haynes, R.B. (1997) Evidence-Based Medicine: How to Practice and Teach EBM. Edinburgh: Churchill Livingstone). They wrote:

“Evidence-based medicine is not ‘cook book’ medicine … It requires a bottom-up approach that integrates the best external evidence [LAB] with individual clinical expertise [CLINIC] and patient choice [CLIENT] … External clinical evidence [i.e., research] can inform, but can never replace, individual clinical expertise” (p. 3-4).

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