Evidenced-based or clickbait?

Written by Thomas Jorno

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by Nicholas L Blonski , SPT

Sipping a cup of coffee,  I reach for my phone and begin scrolling through Instagram.   It’s then that I come across a post with giant red font making the declaration of  “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 whether 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 edged sword. On one side, we are able to constantly learn new ways to treat our patients at any point of the day. On the other side  is the chance we are taking techniques or approaches into our practice, not because they are evidenced based,  but because the most popular physical therapy social media handles are tell us that this new approach is the truth.  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, 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. However, let’s be honest, most of us don’t take the time to do a full literaturary review on every PT related social media posting that we see. Another strategy is to look at 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 Levels of Evidence score, by everyone should follow these three simple rules to help make a quick appraisal of the referenced articles:

  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. Taking the time to see if this matches your clinical experience can go a long way, because while you may not be confident of it, you probably know more than you think you do.
  3. Lastly, looking at the study design and the results. If the study design is poor and the results are poor, then you can reasonably assume this it’s unwise to put this information to practice.  

It is also important to not automatically be sold on changing how you practice based off of  research you read on Instagram without regard to the quality of the evidence. Remember 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 avoid being blindly led down a path on a treatment technique or philosophy that maybe only works for a specific population or, worse yet, be be detrimental to the patient.

Making the effort to be an educated reader of new research on social media will allow you to better recognize the value of information and responsibly apply it to your tool box as a therapist. By not blindly follow trends 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/