Current Evidence Synthesis Tools for Physical Therapists

Pyramid from Alba DiCenso, Liz Bayley, R. Brian Haynes. Accessing preappraised evidence: fine-tuning the 5S model into a 6S model. Ann Intern Med.2009;151:JC3-2.

• Resources are sorted into where they fit in the pyramid - you may see some resources in more than one category. 
• If a resource is not marked as Pitt-only or members-only, it is freely accessible.

This guide was adapted from Resources for Evidence-Based Practice: The 6S Pyramid from McMaster University.

Meta-Search tools search all levels of the pyramid.

• ACCESSS (McMaster) is freely available with registration
• TRIP (Turning Research Into Practice) Database Plus

An evidence-based system is a up-to-date system that integrates all evidence about a clinical problem and that can be linked to a patient's medical record.

Summaries are regularly updated summaries of evidence related to a clinical topic or question. A Clinical Practice Guideline (CPG) is a common summary form.

• Evidence-Based Practice Resources from the the American Physical Therapy Association (APTA) includes physical therapy summaries and CPGs. Some relevant links include: APTA Clinical Practice Guidelines, CPGs from the APTA Academy of Orthopaedic Physical Therapy, CPGs from the APTA Academy of Neurologic Physical Therapy, and the APTA Academy of Pediatric Physical Therapy.
• The Rehabilitation Reference Center (APTA) provides current information and point-of-care resources in the fields of physical therapy, sports medicine, occupational therapy, and speech therapy. Highlights include Clinical Reviews and Practice Guidelines. Click "Enter the Rehabilitation Reference Center" under "Start Here".
• The freely accessible Physiotherapy Evidence Database (PEDro) includes clinical practice guidelines relevant to physical therapy. 

General Biomedical Resources

• ECRI Guidelines Trust
• UpToDate provides summaries of clinical topics written by experts, and is accessible with Pitt authentication. You can also download the mobile app. You must authenticate every 90 days.
• Evidence-Based Practice Centers (EPC) Reports from AHRQ contains reviews of relevant literature regarding topics pertaining to health care quality improvement.
• Register for free alerts from Evidence Alerts (no access to Plus).

Synopses of syntheses, summarize the information found in a single synthesis (for example, a summary of the evidence found in a systematic review). 

Rehab+ from McMaster (freely accessible with registraton) includes summaries of research articles and syntheses.

General Biomedical Resources

• Cochrane Clinical Answers provides readable, clinically focused summaries of relevant Cochrane Systematic Reviews.
• Cochrane Plain Language Summaries are publicly accessibly summaries of health evidence.

A synthesis is a collection and analysis of all of the available evidence (research studies) to answer a research question. Synthesis include systematic reviews, scoping reviews, and other review types. Data from syntheses can be statistically analyzed, including meta-analyses.

• The Physiotherapy Evidence Database (PEDro) includes systematic reviews relevant to physical therapy practice. 

General Biomedical Resources

• The Cochrane Database of Systematic Reviews indexes high-quality systematic reviews published by the Cochrane Collaboration.
• Use "Review" filters in article databases, such as the Systematic Review filter in PubMed, to limit retrieval to evidence syntheses.

A synopses of a single study refers to a readable summary of an original research article.

• The Physiotherapy Evidence Database (PEDro) includes clinical trials relevant to physical therapy practice. The clinical trials are summarized and rated for quality using the PEDro scale.

Single studies are the foundation of the of the EBM pyramid. Original research studies can be found in article databases such as PubMed (Medline). Many databases have special tools to help you filter results to answer a clinical query.

• PubMed (Medline) is a freely accessible biomedical article database. Authenticate with your Pitt credentials to easily access full text articles via the HSLS collection.
  • The Using PubMed in Evidence-Based Practice tutorial will walk you through using the database in support of EBM, such as how to use PubMed Clinical Queries.
• You can also access Medline (the same underlying articles in PubMed through Ovid Medline. The Ovid interface is only available with Pitt authentication.
• REHABDATA contains abstracts of research literature related to rehab and disability.
• CINAHL, available with Pitt authentication, allows you to search for nursing and allied health research articles.
  • Includes an Evidence-Based Practice limit.
• EMBASE, available with Pitt authentication, includes biomedical research with more of an international focus than Medline. The database contains substantial coverage of allied health topics.
• PsycINFO, available with Pitt authentication, allows you to search for psychiatry or psychology-related (including behavioral health) research articles.

• In addition to EBM summaries, the Rehabilitation Reference Center (APTA) includes background summaries of diseases and conditions, images of exercises, and research instruments.
• The Rehab Measures Database (from the Shirley Ryan Ability Lab) is a freely accessible database of rehabilitation measures and assessments.
• JAMAEvidence contains EBM educational resources and tools, such as critical appraisal checklists and calculators.
• The HSLS EBM Resource Guide is a general list of EBM resources (not specific to PT) available to Pitt users.