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Evidence Based Practice


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A presentation educating the viewer on evidence based practice and how it can effect your clinical decisions.

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Evidence Based Practice

  1. 1. Evidence-based practice<br />
  2. 2. Learning objectives<br /><ul><li>Explain the fundamental elements in evidence-based practice
  3. 3. Identify the different steps of evidence-based practice
  4. 4. Describe the difference between effectiveness and efficacy studies
  5. 5. After completing this presentation you will be able to:</li></li></ul><li>It’s all about decisions in the selection and fitting process…….<br />Case: <br />Ethel Tibbet is 75 years old and lives alone. She has bilateral moderate presbycusis. She has worn hearing aids for 10 years. She has a hard time following conversation, which is increasingly annoying for her family. Her family wants to know if the ”new” hearing aids will help Mrs. Tribett more ……… (ref: Cox et al, 2004)<br />What should be the clinical recommendation and decisions?? <br />
  6. 6. Decision-making……<br />Hearing aid choice<br />Widex’ focus is on providing the best possible starting point for making the clinical decisions involved in helping the client. <br />We follow evidence-based practice (EBP) that links best available evidence with patient choice and individual clinical judgment <br />(ref: Thorne, P.R 2002)<br />Hearing aid choice<br />Decision - making<br />
  7. 7. Traditional vs. EBP<br />Differences<br />To determine what treatment to use for a particular patient…<br />Traditional approach: <br />……clinicians rely on their past experience or their knowledge of hearing disorders, check in a textbook, or ask an expert for advice.<br />EBP approach: <br />....the choice of treatment for an individual should be based<br />whenever possible on specifically relevant current data.<br />
  8. 8. Do we have evidence to …<br />…answer any of these questions: <br />Is adaptive directional technology better than fixed polar pattern?<br />Does digital noise reduction provide patient benefit? <br />Can a hearing aid help tinnitus patients?<br />Are low knee-points better than high?<br />Is frequency transposition better than frequency compression?<br />
  9. 9. Evidence-based practice<br />Basic principle<br />Evidence-based practice tackles one problem and one patient at a time…..<br />
  10. 10. Evidence-based practice<br />Approach<br />There is a widely accepted five-step agenda for tackling each problem….<br />(ref: Cox et al . 2004)<br />
  11. 11. Evidence-based practice<br />
  12. 12. Efficacy…..<br />Evidence measured under laboratory or ideal conditions<br />The efficacy of a treatment is how well it can work given the best possible scenario. <br />
  13. 13. Efficacy…..<br />Example:<br />Comparison between an adaptive directional microphone system and an omnidirectional microphone in an anechoic room.<br />Speech<br />Noise<br />
  14. 14. Effectiveness…..<br />Evidence measured in the ”real world”<br />The effectiveness of a treatment is how well it works in the real world. <br />
  15. 15. Effectiveness…..<br />Example<br />Comparison between an adaptive directional microphone and an omnidirectional microphone in real life situations.<br />Questionnaire<br />
  16. 16. Treatment efficacy vs. effectiveness<br />Most important treatment<br />A treatment with acceptable efficacy is not necessarily effective in the real world with real patients……<br />…….In the final analysis, treatment effectiveness is more important than treatment efficacy for evidence-based practice.<br />
  17. 17. Evidence-based practice <br />What to remember from this presentation<br />