American Cleft Palate - Craniofacial Association

committed to team care…

Evidence-Based Practice

by Linda D. Vallino, PhD

Evidence-based practice (EBP) is a mechanism for providing quality care by utilizing the best available research and integrating it into clinical practice and patient preferences or values (Sackett, et al., 1997).  The essence of EBP is the link between the available scientific evidence and clinical practice to support relevant and effective treatment, and diagnoses, and to use as a basis for developing clinical guidelines. EBP involves six essential steps:  develop a clear clinical question, access the most relevant and best evidence, appraise the evidence, integrate the evidence to clinical practice, and evaluate the usefulness of this evidence in your clinical practice (Sackett et al., 2000) and disseminate findings (Schlosser, 2003).  An integral aspect of EBP is rating the quality or strength of the evidence using an evidence hierarchy ranking of levels of evidence from high to low depending on the study design.  Another aspect of EBP is that practice recommendations are graded (e.g., good, fair, poor or A, B, C) based on a level of evidence.  Based on the strength of the supporting evidence, practice recommendations can be made. 

References and Resources

ASHA   Introduction to Evidence-Based Practice.  http://www.asha.org/members/ebp/intro.htm

Center for Evidence Based Medicine. Levels of evidence and grades of recommendations. Center for Evidence Based Medicine website. 2001. http://www.cebm.net/levels_of_evidence.asp#levels Accessed 4-30-2007

Greenhalgh T.  How to read a paper:  the basics of evidence-based medicine.  London: BMJ Books, December 2001.

Guyatt, G. and Rennie, D. The evidence-based medicine working group Users' guides to the medical literature. Essentials of evidence-based clinical practice. Chicago: American Medical Association, 2002.

Straus, S. E., Richardson, W. S., Glasziou, P., Haynes, R. B. Evidence-based medicine: How to practice and teach EBM, Third Ed. Philadelphia: Elsevier Churchill Livingstone, 2005.

Vallino-Napoli, LD.  Evaluation and evidenced-based practice: research.  In: Cleft Palate Speech: Assessment, Analysis and Intervention.  S. Howard and A Lohmander (eds.).  Wiley- Publishers-Blackell, 2011.  317-358.