Professional Practice, Evidence-Based Practice, and Research
What the candidate must know
Apply the evidence hierarchy: systematic reviews and randomized trials above cohort and case studies. Understand study design, bias, confidence intervals, and effect size. Know how to appraise validity, reliability, and clinical meaningfulness (MCID). Understand levels of evidence and grading. Know documentation standards and outcome measures (e.g., ODI, DASH, NPRS).
Traps
- Confusing statistical significance with clinical significance.
- Ignoring confidence intervals and relying on p-values alone.
- Overgeneralizing from a single study or low-level evidence.
- Misapplying reliability (consistency) as validity (accuracy).
Rule of thumb
Ask three questions of any study: Is it valid? What are the results (effect size, CI)? Will it help my patient (applicability, MCID)?
Worked example
A trial reports a statistically significant NPRS improvement of 0.8 points. Because that is below typical MCID thresholds for pain, the finding may not be clinically meaningful despite significance.