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

Abstract

This paper reviews concepts of evidence-based practice (EBP), and provides 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. A complementary model of practice-based evidence (PBE) is offered to encourage clinical scientists to design, implement, and evaluate our own clinical practices with high quality evidence. Two models for conducting PBE are described: 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.