Evidence Based Practice: Sports Medicine

The literature within the field of medicine is constantly changing (Akobeng, 2005). The practices utilized throughout the process need the integration of good quality publications with the considerations of professional expertise and values from the clients/patients. Although available evidence is essential, other factors need to be considered such as personal experiences, judgment, skills, and the unique practice of client/patient values (Akobeng, 2005). As professionals seek answers to their questions, researching applicable sources will make the process easier and increase the structures needed for evidence.

This article is focused on helping professionals understand the process of analyzing the quality of information from sources. Understanding the principles of evidence-based practices will allow professionals to make appropriate decisions based on current evidence that has gone through a systematic academic process. Evidence-based practices involve five essential steps to help build the foundations and framework for a professional’s path. Each step listed will help by incorporating tools that benefit critical thinking skills.

1. Formulating Clinical Questions

As professionals seek a known issue, the issue must be transitioned into an answerable question (Akobeng, 2005). The developed questions need to be clear and focused on the issue at hand (Akobeng, 2005). Sackett (2000) states the propose that questions need four essential components:

PICO:

1. Patient or Problem: Client/patient or issue in question

2. Intervention: Intervention, test, or exposure of interest

3. Comparison: Other invention comparisons (if applicable)

4. Outcome: Outcome or outcomes of interest

2. Searching for Evidence

Now it is time to search for relevant evidence that will help provide answers for the documented question(s). A variety of sources can be utilized during a search such as textbooks, journals, online electronic databases, and expert opinions (Akobeng, 2005). When searching for evidence, it is ideal for producing effective searches to maximize results in the shortest amount of time (Akobeng, 2005). If an individual is unaware of how to produce an effective search, it is recommended to enroll in basic training to enhance their searching skills (Akobeng, 2005). Other forms of learning can be used as well, such as communicating with a researcher that has a background in formal searches.

Recommendations:

1. General keywords that are appropriate to the question.

2. Select a database that is available, updated regularly, and one is familiar with.

3. When the keywords and database have been solidified, search.

3. Evidence Appraisal

Now that the evidence has been collected, it is time to appraise the evidence for validity and usefulness (Akobeng, 2005). A variety of databases will have an abundance of research but understanding the validity, importance, and applicability of each article is variable (Akobeng, 2005). At this step, it is ideal to understand the basics of research and how a study is developed. This step is known to take some time but appraising the literature is needed to move forward.

Statistical Analysis:

If a study utilized a quantitative research design, it would contain some form of statistics, analysis, and interpretation (Greenwood & Freeman, 2015). Statistical analysis can be a complex process that should be reviewed for inappropriate statistics (Greenwood & Freeman, 2015).

When it comes to statistical analysis and interpretation, two useful questions can be utilized:

1. Are the statistical results appropriate to the research question?

2. Is the interpretation of the results correctly acknowledged?

There are a variety of approaches to statistical analysis (Greenwood & Freeman, 2015). That’s why it is important to understand the process of statistical analysis during the appraisal step, as searching if the methods are valid or invalid (Greenwood & Freeman, 2015). If further review is needed, consulting a statistician within the appropriate discipline may be useful during this process. As mentioned, statistics can be a complex process, so reaching out to professionals with a greater grasp of the concepts may be needed.

4. Evidence Application

After coming to terms with the fact that the evidence collected is valid and important, next is deciding if it is deemed worthy of applying to the clients/patient or population (Akobeng, 2005). As mentioned at the beginning of this article, it is important to consider the client's/patient's personal values when moving forward. Communication is key in this step, as professionals need to inform the clients/patients of what will be next. It is critical to educate clients/patients about the upcoming plan of action. If it is new for the client/patient, give them an update about what they can expect and how you plan to address the intervention (or program). Many factors can hinder this step; the scope of practice of the professional, the cost of the intervention, and the availability of the appropriate resources (Akobeng, 2005).

5. Performance Evaluation

Like any form of practice, a regular evaluation is needed to decide if further actions are needed. Does any of the steps need to be revisited? Evaluate how the intervention strategy is forming and make the appropriate adjustments. Is it heading toward the correct path, or does it need to be modified? If it needs modifications, time to revisit the drawing board. A new question might emerge after the performance evaluation, and a new search is needed. As an individual revisits the drawing board, the information learned will only enhance and benefit one's career or process.

The formation of Evidence-Based Practice is focused on improving the quality of interventions so that clients/patients can head toward a progressive outcome. As a professional within a field that is constantly changing and upgrading, it is essential to review the literature that may advance the interventions for clients or patients. Of course, before applying the researcher’s findings from the study, assessing the quality of the methods is very important (Zeng et al., 2015). As a professional, internal and external validity can help enhance the quality of the research (Zeng et al., 2015). According to Zeng et al. (2015), internal validity is influenced by selection bias, performance bias, attrition, and other restrictions noticed during the research process. The study's external validity can help provide support in allowing professionals to apply the findings to their clients/patients or populations.

As professionals under the sports medicine umbrella (allied healthcare professionals, strength and conditioning specialists, exercise physiologists, personal trainers, etc.), updating interventions with supported research is critical. As the field of sports medicine continues to upgrade, current professionals will be able to provide high-quality interventions that will help improve strength, power, injury healing, recovery, prevention mechanisms, and more!

Reference:

• Akobeng, A. K. (2005). Understanding randomized controlled trials. Archives of disease in childhood, 90(8), 840-844. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16040885

• Greenwood, D. C., & Freeman, J. V. (2015). How to spot a statistical problem: advice for a non-statistical reviewer. BMC medicine, 13, 270-270. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26521808

• Sackett, D. L. (2000). Evidence-based medicine: how to practice and teach EBM. Edinburgh; New York: Churchill Livingstone.

• Zeng, X., Zhang, Y., Kwong, J. S. W., Zhang, C., Li, S., Sun, F., . . . Du, L. (2015). The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review. Journal of Evidence-Based Medicine, 8(1), 2-10. Retrieved from https://doi.org/10.1111/jebm.12141.