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Evidence-based practice


Evidence-based practice (EBP) is an interdisciplinary approach to clinical practice that has been gaining ground following its formal introduction in 1992. It started in medicine as evidence-based medicine (EBM) and spread to other fields such as audiology, speech-language pathology, dentistry, nursing, child life specialty, psychology, social work, education, library and information science. EBP is traditionally defined in terms of a "three legged stool" integrating three basic principles: (1) the best available research evidence bearing on whether and why a treatment works, (2) clinical expertise (clinical judgment and experience) to rapidly identify each patient's unique health state and diagnosis, their individual risks and benefits of potential interventions, and (3) client preferences and values

Evidence-based behavioral practice (EBBP) "entails making decisions about how to promote health or provide care by integrating the best available evidence with practitioner expertise and other resources, and with the characteristics, state, needs, values and preferences of those who will be affected. This is done in a manner that is compatible with the environmental and organizational context. Evidence is research findings derived from the systematic collection of data through observation and experiment and the formulation of questions and testing of hypotheses".

Empirically supported treatments (ESTs) in some clinical psychology settings are defined as "clearly specified psychological treatments shown to be efficacious in controlled research with a delineated population"

In recent years, EBP has been stressed by professional organizations such as the American Psychological Association, the American Occupational Therapy Association, the American Nurses Association, and the American Physical Therapy Association, which have also strongly recommended their members to carry out investigations to provide evidence supporting or rejecting the use of specific interventions. Equivalent recommendations apply to the Canadian equivalent of these associations. Pressure toward EBP has also come from public and private health insurance providers, which have sometimes refused coverage of practices lacking in systematic evidence of usefulness.


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