How to Proceed When Evidence-based Practice Is Required But Very Little Evidence Available?
SOURCE: Chiropractic & Manual Therapies 2013 (Jul 10); 21 (1): 24 ~ FULL TEXT
Charlotte Leboeuf-Yde, Olivier Lanlo and Bruce F Walker
The Spine Research Centre,
Hospital Lillebaelt, and Institute for Regional Health Research,
University of Southern Denmark,
BACKGROUND: All clinicians of today know that scientific evidence is the base on which clinical practice should rest. However, this is not always easy, in particular in those disciplines, where the evidence is scarce. Although the last decades have brought an impressive production of research that is of interest to chiropractors, there are still many areas such as diagnosis, prognosis, choice of treatment, and management that have not been subjected to extensive scrutiny.
DISCUSSION: In this paper we argue that a simple system consisting of three questions will help clinicians deal with some of the complexities of clinical practice, in particular what to do when clear clinical evidence is lacking. Question 1 asks: are there objectively tested facts to support the concept? Question 2: are the concepts that form the basis for this clinical act or decision based on scientifically acceptable concepts? And question three; is the concept based on long-term and widely accepted experience? This method that we call the “Traffic Light System” can be applied to most clinical processes.
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