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Kinesiology

Evidence-based practice for Kinesiologists

Professional kinesiologists need to make evidence-based decisions to ensure they are using the most appropriate and effective treatments for their patients.

"Evidence-based health care is the conscientious use of current best evidence in making decisions about the care of individual patients or the delivery of health services." -- Cochrane Collaboration via HLWIKI Canada 

In addition to relying on your own clinical expertise, and incorporating patient values and preferences, this approach prioritizes selecting and critically appraising evidence from empirical studies.

Levels of evidence

  • As you proceed up the pyramid:
    • the rigour of scientific method increases
    • bias decreases
    • we can be more confident in validity and generalizability of study results

 

Evidence synthesis: 6S Pyramid

  • Also known as knowledge synthesis

  • Evidence that is:

  • Synthesized from a large set of data/single studies

  • Summarized

  • Critically appraised

When selecting evidence, always work down from the highest point of the pyramid and only move to the next stage if evidence is not available at the higher stage.

 

Best bets from the pyramid: search tools

Summary level:

  • regularly updated clinical guidelines or textbooks that integrate evidence-based information about specific clinical problems
  • Sources:
    • NICE Clinical Guidelines – National Institute for Health and Clinical Evidence, U.K.:
      • Use Evidence Search and keywords for your condition and profession/approach
    • SuperSearch and other databases:
      • Search for "clinical practice guideline*” AND keywords for your condition e.g. arthritis AND your profession e.g. kinesiology
    • CINAHL > Evidence-Based Care Sheets
      • Browse alphabetically or search for keywords for your condition e.g. osteoporosis

Synopses of syntheses:

  • summaries of systematic reviews
  • Sources:
    • EPPI Centre Knowledge Library -- find key messages on health and social science topics; messages are based on evidence from several reviews (syntheses). Browse by topic

Syntheses: 

  • usually refers to a systematic review
  • Systematic reviews:
    • Undertake a systematic, structured review of all empirical evidence on a specific research question
    • Use explicit, pre-defined criteria to include and exclude studies
    • Incorporate search strategies which are systematic, free of bias and reproducible
    • are NOT “review articles”
  • Sources:
    • Cochrane Database of Systematic Reviews – EBM Reviews
      • Find full-text systematic reviews of the effects of health care interventions. Prepared by the Cochrane Collaboration, an international network committed to preparing, maintaining, and disseminating health-related systematic reviews.
    • Evidence-Based Medical Reviews
      • Find systematic reviews and other evidence-based literature useful for clinical research. Includes Cochrane Database of Systematic Reviews, American College of Physicians Journal Club, and Database of Abstracts of Reviews of Effectiveness
    • EPC Evidence Reports: from Evidence-Based Practice Centres, U.S. Agency for Healthcare Research and Quality

Synopses of single studies:

Single studies:

  • Focus on a specific research question.
  • Considered the lowest level of evidence
  • May be the only type of research available on your topic
  • Single studies can be accessed via article databases e.g.
    • SportDISCUS – exercise science
    • CINAHL – nursing and allied health, incl. OT/PT, etc.
    • Proquest Nursing and Allied Health -- nursing and allied health, incl. OT/PT, etc.
    • MEDLINE – biomedical; access via PubMed, OVID, Web of Science Complete
    • Web of Science – multi-disciplinary
  • Search tip: Look for filters that allow you to search by study design e.g. systematic review, RCT
Single Studies: Clinical Queries
  • PubMed Clinical queries – available on PubMed landing page
  • CINAHL – Clinical queries available as search filter e.g. therapy
  • OVID MEDLINE -- Clinical queries available as search filter e.g. therapy

Access subject databases via the Find Articles tab of this research guide

Meta-Search Tools

  • These tools search across multiple levels of evidence
  • While the search tools are free to access, the literature within may only be available to subscribers
    • If you find a useful article you can't access, search for the citation in a Library database to retrieve it
  • Epistemonikos -- multilingual database of systematic reviews & primary studies
    • Basic or advanced search
  • TRIP – Turning Research into Practice
    • Searches & ranks multiple levels of evidence
    • Basic or PICO search
    • Free or Pro versions
    • Search tips

PEDro – database of randomized trials, systematic reviews and clinical practice guidelines in physiotherapy

 

Search tips

  • Generate keywords and synonyms for your topic
  • Use advanced searching techniques:
    • OR – retrieves articles with ANY of your keywords
    • AND – retrieves articles with ALL of your keywords
  • “exact phrase” searching
  • Truncation e.g. teen* retrieves teen, teenager, teenaged