Making reasonably informed decisions in Speech Language Pathology

Abstract

From Evidence-based medicine (EBM) to Evidence-based practice (EBP) established frameworks continue to emphasize the need that clinical decision should focus explicitly on scientific evidence, rather than on clinical intuition. Implementing the principles of evidence-based treatment can be an effective decision in the clinical rehabilitation of people with communication disorders. But how can we combine the realities of clinical practice in speech pathology with valid knowledge? The answer to this question is the aim of the present work. Methods This systematic review was designed to investigate how to combine the realities of clinical practice with the principles of EBP and what possible obstacles SLP clinicians need to overcome. Literature review was based on a search in PubMed/Medline database focused on the last ten years of published peer-reviewed papers. Results Despite the intentions of the EBP movement there seems to be a gap between clinical practice and research evidence. Clinicians cannot turn to technicians who just follow a recipe and on the other hand, clinicians cannot forget patient’s values and opinions. Recent literature saw EBP as too restrictive since EBPs seemed to exclude important sources of research and need to expand in a wider range of goals. There is a tendency from the overestimation of quantitative evidence to a more person-centered clinical education and practice. Conclusions There is a great need for the promotion and implementation of evidence-informed decisions. The clinical decision needs more flexibility and common sense instead of “recipes”.