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J Orthop Sports Phys Ther. 2008 Aug;38(8):476-84. doi: 10.2519/jospt.2008.2722. Epub 2008 Aug 1.

A primer on selected aspects of evidence-based practice relating to questions of treatment. Part 1: asking questions, finding evidence, and determining validity.

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Department of Physical Therapy, Franklin Pierce University, Concord, NH 03301, USA.


The process of evidence-based practice (EBP) guides clinicians in the integration of individual clinical expertise, patient values and expectations, and the best available evidence. Becoming proficient with this process takes time and consistent practice, but should ultimately lead to improved patient outcomes. The EBP process entails 5 steps: (1) formulating an appropriate question, (2) performing an efficient literature search, (3) critically appraising the best available evidence, (4) applying the best evidence to clinical practice, and (5) assessing outcomes of care. This first commentary in a 2-part series will review principles relating to steps 1, 2, and 3 of this 5-step model. The purpose of this commentary is to provide a perspective to assist clinicians in formulating foreground questions, searching for the best available evidence, and determining validity of results in studies of interventions for orthopaedic and sports physical therapy.

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