Critically Appraising Systematic Reviews in the Field of Speech-Language Pathology: A How-to Guide for Clinician Readers

2021 ◽  
pp. 1-13
Author(s):  
Cara Donohue ◽  
Giselle Carnaby ◽  
Kendrea L. (Focht) Garand
Keyword(s):  
Systematic Reviews ◽  
Evidence Based Practice ◽  
Research Work ◽  
Future Research ◽  
Clinical Settings ◽  
Evidence Based ◽  
Speech Language Pathology ◽  
Speech Language Pathologists ◽  
High Quality Research ◽  
Language Pathology

Purpose This tutorial will provide speech-language pathologists with foundational knowledge about systematic reviews and their importance in everyday practice. It will also assist clinicians in developing critical appraisal skills so that current research can be translated judiciously to clinical environments for patient care. Systematic reviews are often regarded as the highest level of research evidence for implementing best evidence-based practice, because they synthesize research findings from multiple high-quality research studies, identify methodological weaknesses and biases from the studies included, and assist in illuminating areas for future research work based on current gaps in the literature. While systematic reviews can provide comprehensive knowledge to inform clinical practice, few speech-language pathologists receive training on appraising and applying the findings from systematic reviews appropriately within clinical settings. Conclusion Clinicians within the field of speech-language pathology can use the framework provided in this tutorial to evaluate systematic reviews as a preliminary step for determining appropriate assessment and treatment methods for implementing evidence-based practice within clinical settings.

scholarly journals Patient-Reported Outcomes and Evidence-Based Practice in Speech-Language Pathology

2020 ◽  
Vol 29 (1) ◽  
pp. 357-370
Author(s):  
Matthew L. Cohen ◽  
William D. Hula
Keyword(s):  
Psychosocial Functioning ◽  
Patient Reported Outcomes ◽  
Evidence Based Practice ◽  
Communication Disorders ◽  
Future Research ◽  
Evidence Based ◽  
Speech Language Pathology ◽  
Patient’S Perspective ◽  
Patient Reported ◽  
Language Pathology

Purpose The patient's perspective of their health is a core component of evidence-based practice (EBP) and person-centered care. Patient-reported outcomes (PROs), captured with PRO measures (PROMs), are the main way of formally soliciting and measuring the patient's perspective. Currently, however, PROs play a relatively small role in mainstream speech-language pathology practice. The purpose of this article is to raise important questions about how PROs could be applied to EBP in speech-language pathology for individuals with communication disorders and to propose preliminary approaches to address some of these questions. Method Based on a narrative review of the literature, this article introduces relevant terminology and broadly describes PRO applications in other health care fields. The article also raises questions related to PRO-informed clinical practice in speech-language pathology. To address some of these questions, the article explores previous research to provide suggestions for clinical administration, interpretation, and future research. Conclusion More routine measurement of subjective health constructs via PROMs—for example, constructs such as effort, participation, self-efficacy, and psychosocial functioning—may improve EBP. More routine use of PROMs could significantly expand the information that is available to clinicians about individual clients and add to the evidence base for the profession of speech-language pathology. However, careful consideration and more research are needed on how to capture and interpret PROs from individuals with cognitive and language disorders.

scholarly journals Evidence-Based Practice in Speech-Language Pathology: Where Are We Now?

2021 ◽  
Vol 30 (1) ◽  
pp. 186-198
Author(s):  
Tamar Greenwell ◽  
Bridget Walsh
Keyword(s):  
Clinical Practice ◽  
Graduate School ◽  
Evidence Based Practice ◽  
Perceived Barriers ◽  
Evidence Based ◽  
Speech Language Pathology ◽  
Clinical Practices ◽  
Speech Language Pathologists ◽  
Career Training ◽  
Language Pathology

Purpose In 2004, American Speech-Language-Hearing Association established its position statement on evidence-based practice (EBP). Since 2008, the Council on Academic Accreditation has required accredited graduate education programs in speech-language pathology to incorporate research methodology and EBP principles into their curricula and clinical practicums. Over the past 15 years, access to EBP resources and employer-led EBP training opportunities have increased. The purpose of this study is to provide an update of how increased exposure to EBP principles affects reported use of EBP and perceived barriers to providing EBP in clinical decision making. Method Three hundred seventeen speech-language pathologists completed an online questionnaire querying their perceptions about EBP, use of EBP in clinical practice, and perceived barriers to incorporating EBP. Participants' responses were analyzed using descriptive and inferential statistics. We used multiple linear regression to examine whether years of practice, degree, EBP exposure during graduate program and clinical fellowship (CF), EBP career training, and average barrier score predicted EBP use. Results Exposure to EBP in graduate school and during the CF, perception of barriers, and EBP career training significantly predicted the use of EBP in clinical practice. Speech-language pathologists identified the three major components of EBP: client preferences, external evidence, and clinical experience as the most frequently turned to sources of EBP. Inadequate time for research and workload/caseload size remain the most significant barriers to EBP implementation. Respondents who indicated time was a barrier were more likely to cite other barriers to implementing EBP. An increase in EBP career training was associated with a decrease in the perception of time as a barrier. Conclusions These findings suggest that explicit training in graduate school and during the CF lays a foundation for EBP principles that is shaped through continued learning opportunities. We documented positive attitudes toward EBP and consistent application of the three components of EBP in clinical practice. Nevertheless, long-standing barriers remain. We suggest that accessible, time-saving resources, a consistent process for posing and answering clinical questions, and on the job support and guidance from employers/organizations are essential to implementing clinical practices that are evidence based. The implications of our findings and suggestions for future research to bridge the research-to-practice gap are discussed.

scholarly journals Evidence-based Practice in Speech Language Pathology: Scaling Up

2008 ◽  
Vol 55 (1) ◽  
pp. 7-12
Author(s):  
Laura M. Justice
Keyword(s):  
United States ◽  
Systematic Reviews ◽  
Best Practice ◽  
Evidence Based Practice ◽  
Scaling Up ◽  
The United States ◽  
Evidence Based ◽  
Speech Language Pathology ◽  
Language Pathology ◽  
Meta Analyses

Evidence-based practice is a process to which clinical professionals adhere when making decisions concerning the assessment or treatment o f a given condition. Within the field of speech-language pathology, it is increasingly advocated as best practice. As our profession seeks to transform itself from one that is primarily craft-based to one that relies on evidence-based processes, it must develop and implement a series of structures that will foster this transformation. This article describes three specific structures that are increasingly available within the field of speech-language pathology in the United States to guide transformation of the profession: systematic reviews and meta-analyses, treatment studies, and clearing houses. Without these structural supports, it is unlikely that evidence-based practice can be scaled u pin a way that has positive impacts on practice.

Current Issues: Evidence-Based Practice for the Real World: Thoughts on Clinical Education in Communication Disorders

2010 ◽  
Vol 20 (3) ◽  
pp. 100-105 ◽  
Author(s):  
Anne K. Bothe
Keyword(s):  
Clinical Education ◽  
Real World ◽  
Evidence Based Practice ◽  
Communication Disorders ◽  
University Faculty ◽  
Evidence Based ◽  
Speech Language Pathology ◽  
Basic Principles ◽  
The Real ◽  
Language Pathology

This article presents some streamlined and intentionally oversimplified ideas about educating future communication disorders professionals to use some of the most basic principles of evidence-based practice. Working from a popular five-step approach, modifications are suggested that may make the ideas more accessible, and therefore more useful, for university faculty, other supervisors, and future professionals in speech-language pathology, audiology, and related fields.

Evidence-Based Practice & Practice-Based Evidence Applied to Adult, Medical Speech-Language Pathology

2013 ◽  
Vol 18 (1) ◽  
pp. 14-26 ◽  
Author(s):  
Rik Lemoncello ◽  
Bryan Ness
Keyword(s):  
Evidence Based Practice ◽  
Single Case ◽  
Quality Data ◽  
Evidence Based ◽  
Speech Language Pathology ◽  
Clinical Practices ◽  
High Quality ◽  
Randomized Controlled Clinical Trials ◽  
Relative Paucity ◽  
Language Pathology

In this paper, we review concepts of evidence-based practice (EBP), and provide a discussion of the current limitations of EBP in terms of a relative paucity of efficacy evidence and the limitations of applying findings from randomized controlled clinical trials to individual clinical decisions. We will offer a complementary model of practice-based evidence (PBE) to encourage clinical scientists to design, implement, and evaluate our own clinical practices with high-quality evidence. We will describe two models for conducting PBE: the multiple baseline single-case experimental design and a clinical case study enhanced with generalization and control data probes. Gathering, analyzing, and sharing high-quality data can offer additional support through PBE to support EBP in speech-language pathology. It is our hope that these EBP and PBE strategies will empower clinical scientists to persevere in the quest for best practices.

Adopting a Conceptual Validity Framework for Testing in Speech-Language Pathology

2021 ◽  
pp. 1-15
Author(s):  
Olivia Daub ◽  
Barbara Jane Cunningham ◽  
Marlene P. Bagatto ◽  
Andrew M. Johnson ◽  
Elaine Y. Kwok ◽  
...  
Keyword(s):  
Educational Research ◽  
American Educational Research Association ◽  
Psychological Testing ◽  
Evidence Based ◽  
Research Association ◽  
Speech Language Pathology ◽  
Speech Language Pathologists ◽  
Major Barrier ◽  
Language Pathology ◽  
Test Use

Purpose Limited evidence-based guidelines for test selection continue to result in inconsistency in test use and interpretation in speech-language pathology. A major barrier is the lack of explicit and consistent adoption of a validity framework by our field. In this viewpoint, we argue that adopting the conceptual validity framework in the Standards for Educational and Psychological Testing (American Educational Research Association et al., 2014) would support both the development of more meaningful and feasible clinical tests and more appropriate use and interpretation of tests in speech-language pathology. Method We describe and evaluate the Standards for Educational and Psychological Testing (American Educational Research Association et al., 2014) validity framework and consider its relevance to speech-language pathology. We describe how the validity framework could be integrated into clinical practice and include examples of how it could be applied to support common clinical decisions. We evaluate the costs and benefits of adopting this framework, from the perspectives of speech-language pathologists, clients, and test developers. Results The Standards' validity framework clarifies complex validity issues by shifting the focus of validity from tests to the decisions speech-language pathologists make based on test results. By focusing on decisions, the framework requires critical evaluation of test use, rather than evaluating tests against sets of criteria. Adopting this framework has the potential for appreciable improvement in the way tests are used and valued across our profession. Conclusions Speech-language pathologists, test developers, and clients will benefit from improved evidence-based assessment practices. It is recommended that regulators, test developers, professional associations, universities, and researchers adopt the framework and endorse it as best practice moving forward. This viewpoint proposes a series of first steps toward supporting uptake of the framework into research and practice.

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