Implementing evidence in clinical practice: the ‘therapies’ dilemma

Evidence-based practice involves the application of the best available evidence, often from research findings, into the clinical setting to ensure best practice. This paper discusses some of the issues faced by allied health therapists when attempting to integrate research evidence into their own clinical practice. Of particular concern in allied health research are the methodological flaws, which may seriously affect the capacity of the allied health therapist to use the evidence in their clinical practice. Single therapy intervention research, or research based on an occasion of service does not replicate the model of clinical reasoning that underpins the clinical process, nor the notion of an episode of care that characterizes the allied health therapies. Other issues such as the relevance of outcome measures used in allied health research to potential stakeholders, and the differences between therapy diagnostic criteria and research diagnostic criteria used will also adversely affect the capacity for therapists to use the research evidence. It is imperative that research paradigms begin to address the therapy paradigms, allowing research evidence to reflect the real-world situation. Allied health therapists must take a pro-active stance in the process, through undertaking organized reflective practice and forging links with researchers. Barriers associated with the implementation of evidence-based practice in the allied health professions may be reduced with the publishing of relevant clinically directed research.