Evidenced-based or clickbait?

Written by Thomas Jorno

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by Nicholas L Blonski , SPT

Two hours after the second exam of the week finishes I am finally catching my breath in our campus coffee shop sipping a warm cup of coffee watching the leaves fall outside. As most millennials I reach for my phone and begin scrolling through instagram, when I came across a post with big red font exclaiming “Busted” over a stock photo of a PT palpating a sacrum. I tap on the more in the comments and read that they are busting the myth that the SI joint moves.

Regardless of our individual opinions on if the SI joint moves or not the truth is that the abundance of information available instantly to physical therapists via social media is a double ended sword. On one end of that sword we are able to constantly learn new ways to treat our patients at any point of the day. On the other end of that sword though is the chance we are taking techniques or approaches into our practice that are not evidenced based just because the most popular physical therapy social media handles are tell us that this new approach is the truth. So the dilemma becomes how do we make sure what we are reading on social media is evidenced based and not just clickbait?

One strategy is to take the time to appraise each article’s that the posts reference by looking at the outcome measures, methodology, participants used, how the results are presented, and if the article uses reliable and valid tests and measures, so on and so on. However, let’s be honest most of us don’t take the time to do a full literature review on every PT related social media posting that we see. So another strategy is to look on each article and see if it has a PEDro (Physiotherapy Evidence Database) score or an Oxford Centre for evidence-based medicine levels of evidence score.

These scores will allow you to see how reliable and valid the studies referenced in the posting truly are. It will also grade based on the hierarchy of evidence based literature with systematic reviews being the highest level, followed by RCT and so on down to expert opinions, you can find the links below to both of these resources for quick access. Along with using either the PEDro scale or the Oxford Centre for evidence-based medicine level of evidence score following three simple rules that Cook C. J Man Manip Therapy. 2012(2) came up with can help take a quick appraisal of the referenced articles a long way.

  1. Figure out if the study can be reproduced. If a study is able to be replicated by an independent researcher who is using a similar population, similar amounts of control, and a similar analyses then you have a positive check towards being a reliable study.
  2. Making sure to trust your gut. If it looks too good to be true then it probably is too good to be true. Taking the time to see if this matches your clinical experience can go a long way, because I know you don’t believe it but you probably know more than you think you know.
  3. Lastly, looking at the study design and the results. If the study design is poor and the results are poor, then you can assume this information is probably not the best information to pull into your practice.

It is also important to not automatically be sold on changing how you practice just based off of some research you read on Instagram regardless of the evidence. Remembering the importance of the three pillars to being an evidenced-based clinician: Best research evidence, Clinical Expertise, & Patient Values & Preference. By remembering these three pillars it will allow you to not be blindly led down a path on a treatment technique or philosophy that maybe only works for a specific population, or that could be detrimental to the patient that seems to fit this studies target population.

Taking an opportunity to be an educated reader of new research postings on social media will allow you to take the information for what it is and apply it to your tool box as a physical therapist. By not blindly follow what the most popular instagram account tells you is the best way and instead being strong evidence based therapist we are able to improve our practice and provide the best treatment for our patients.

 References for the PEDRO scale and the Oxford scale
   
 PEDro Scale
 https://www.pedro.org.au/english/downloads/pedro-scale/

 Oxford Centre for evidence-based medicine levels of evidence score
 https://www.cebm.net/2009/06/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/