Evidence Hierarchy Pyramid

It is essential that when using evidence-based practice guidelines to choose a treatment, that variety of research methods are applied so that the best relevant data can be produced. Such methods include qualitative/quantitative research, randomised controlled trials and systematic reviews. Both qualitative and quantative methods produce valuable data. Quantative research produces numeric evidence that is necessary for practice and can be measured and qualitative research produces descriptive data about the subject by using patients views etc. which can also be applied to clinical practice (Broeder et al, 2010)
Evidence hierarchy pyramid is used to determine which research method produces the strongest evidence at the highest level (Level I)

An example of a Quantative study is by (Hill. J, 2007) who conducted a study on patient knowledge and misconceptions of Osteoarthritis with 83 patients with the condition using a 16 Multiple-Choice Questionnaire. The results found there was a high number of patients who were knowledgeable about the symptoms of Osteoarthritis and exercises. However, 34% of the patients did not know NSAIDs should be taken with food or after. 70% of the patients were not aware that Analgesics should be taken when pain starts to increase. Overall, it was concluded that the questionnaire was easy to read, reliable, effective and reproducible as quantative data was produced. It is quick to complete and the results could be used in clinics or GPs.

A Qualitative study was conducted by (J Denise et al, 2008) on fatigue using 160 individuals with hip/knee OA in a focus group. Participants completed a questionnaire about their fatigue in much written detail. The findings showed that majority of the patients reported they experience significant fatigue. Using a Qualitative data allows clinicians to enhance their understanding of fatigue in more detail as the findings are real life participant

The guidelines generate the latest high-quality evidence which can very helpful to Physiotherapists as it will allow them to provide the best quality of care to the patients and improve the quality of their clinical decision making. However, guideline recommendations can be misleading, misinterpreted or wrong for some patients. It is important to evaluate the evidence and see if it is compatible with the patient the treatment is being provided for before selecting the recommended treatment. Furthermore, guideline evidence can be difficult to scrutinise for limitations as this requires a lot of time, resources and skills which is not available for all clinicians. Overall, if used correctly and appropriately Evidence-Based guidelines can be an effective process when Physiotherapists are choosing a treatment for a