A response to Hinojosa's "The Evidence-based paradox."

Jim Hinojosa (2013) wrote an interesting essay in the recent AJOT entitled "The evidence based paradox" which was published in "The Issue Is..." section.  I believe that this is an important article to read and discuss.I was a little concerned when I was reading the article because although he took some rather specific steps to tread cautiously and he did not go so far as an outright rejection of an evidence-based model there is still danger in propelling our thinking backward when you express the kinds of concerns that he expressed.Hinojosa outlines barriers to EBP including possible inapplicability of the established levels of evidence given the important qualitative and individualized nature of OT practice.  He correctly references the revised model that Tomlin and Borgetto (2011) presented that has already addressed this concern.  Tomlin and Borgetto (2011) proposed a model of a 'Research Pyramid' that includes and expresses a value for qualitative inquiry, so I am not sure why this is still identified as a barrier by Hinojosa.Hinojosa also criticizes systematic reviews for the potential of individualized bias and inclusion criteria errors but that is kind of like shooting fish in a barrel.  Of course there will be the potential for bias in nearly every endeavor; the potential should not preclude adoption of methods that are otherwise sound as long as we maintain the ability to study and examine and even criticize the reviews!  The point here is t...
Source: ABC Therapeutics Occupational Therapy Weblog - Category: Occupational Therapists Tags: evidence-based practice OT practice Source Type: blogs