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College of Health Professions Evidence Based Practice Portal - 2022 draft revision

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This page covers the fourth of the five As -- applying the evidence you have acquired and appraised as is needed to answer your clinical question and/or called for by your patient's situation or circumstances.  How the evidence is applied will change on a case-by-case basis, but there are four areas in particular which should be considered when applying evidence -- diagnosis, prognosis, harm, and therapy.  Drawing from content presented in the University of Minnesota Libraries EBP tutorial, each is discussed in turn in the tabs to the right.

Helge V. Keitel. (2012, Jul. 12). On Call 24/7. Retrieved from https://www.flickr.com/photos/17088227@N00/21236578204.
Used under the Creative Commons License.

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This page is licensed under a Creative Commons license.

Lab technician
Here are some questions to ask when determining what of the literature you have appraised to apply to a diagnosis stemming from your clinical question:
 
  • Is the test affordable, accurate, and available in my practice?
  • Can I estimate the pre-test probability of ailment in my patient?
  • Is it possible that the results of the test (post-test probability) may affect the therapy or treatment I recommend?
  • What is the cost (financial and otherwise) and relative value of alternate tests?

 

 

 

U.S. Army Southern European Task Force, Africa. (2010, Sept. 14). Tropical Medicine Course 2010. Retrieved from
https://www.flickr.com/photos/usarmyafrica/5056988349. Used under the Creative Commons License.

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Text on this page is Adapted from the University of Minnesota Libraries EBP tutorial, and is licensed under a Creative Commons license.

Nurse with skullAdapted from the University of Minnesota Libraries EBP tutorial, here are some questions to ask when determining what of the literature you have appraised to apply to a prognosis stemming from your clinical question:
 
  • Is my patient similar to other patients in the study group?
  • How strong is the evidence behind the prognostic factor?
  • Given how long your patient has had the condition, does this change his/her/their prognosis?
  • Were the outcomes patient-oriented or condition-oriented?
  • What is the prognosis on related outcomes? (e.g., disability and quality of life as well as mortality)
 
The Accent. (2009, Apr. 14). Nursing. Retrieved from
https://www.flickr.com/photos/theaccent/3775405209. Used under the Creative Commons License.

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Text on this page is Adapted from the University of Minnesota Libraries EBP tutorial, and is licensed under a Creative Commons license.

Nursing studentAdapted from the University of Minnesota Libraries EBP tutorial, here are some questions to ask when determining what of the literature you have appraised to apply to considerations of harm stemming from your clinical question:
 
  • Can the study results be applied to my patient?
  • How large is the risk that was identified in the study?
  • How does the risk of the treatment compare with its potential benefits?
  • Are there alternative therapies with a lower risk of harm?
  • How do the potential harms align with the case and preferences of my patient?

 

 

University of Missouri System. (2006, May 5). Nursing Student. Retrieved from
https://www.flickr.com/photos/umsystem/4901380521. Used under the Creative Commons License.

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Text on this page is Adapted from the University of Minnesota Libraries EBP tutorial, and is licensed under a Creative Commons license.

StudentThe University of Minnesota Libraries EBP tutorial poses the following questions to ask when determining what of the literature you have appraised to apply to a therapy that may provide an answer to your clinical question:
 
  • Is my patient similar enough to those in the study that the results would be valid?
  • According to the study results, how much would my patient benefit from the treatment?
  • Were the results clinically significant (tangible and valuable to the patient) or just statistically significant?
  • Is the treatment available at my practice?
  • Does the treatment reflect my patients needs, values, and situation?
  • What s the quality of life with this treatment as compared to others?
 
 
 
 
Lilly Tranh. (2009, Sept. 29). Happy Student. Retrieved from
https://www.flickr.com/photos/43217299@N07/3994863259. Used under the Creative Commons License.

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Text on this page is Adapted from the University of Minnesota Libraries EBP tutorial, and is licensed under a Creative Commons license.

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