Evidence-based practice - implementation level and attitude among physical, occupational, and speech and language therapists in Germany: status quo.

INTRODUCTION: Evidence-based practice (EBP) is an important component of clinical practice in public health. Its implementation involves interpreting scientific studies and then applying this knowledge to clinical decision-making. In Germany, the therapy professions are often trained in non-academic medical schools, and only a small number of therapists are university graduates. AIMS: This study assessed the current status of EBP among physiotherapists, occupational therapists, and speech and language therapists and to determine whether academization influences the implementation of EBP in Germany. METHODS: To assess the EBP implementation level and therapists' attitudes toward EBP, a cross-sectional study was conducted using the German version of the Evidence-Based Practice Inventory (EBPI), which consists of five dimensions: attitude; subjective norm; perceived behavioral control; decision-making; and intention and behavior. The structural validity and internal consistency of the EBPI survey were also tested. RESULTS: Of the 2,412 responses, only 557 were eligible. There were statistically significant differences between academically educated vs. non-academically educated therapists in four of the five EBPI dimensions. Furthermore, four of the five dimensions had sufficient unidimensionality and internal consistency. CONCLUSION: There are differences between academically educated and non-academically educated therapists regarding EBP knowledge, attitudes, and implementation. Academically educated therapists are more likely to use EBP than non-academically educated therapists. There are still barriers to clinical application that need to be addressed. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A195.

Psychometric properties of questionnaires to assess evidence-based practice among occupational, physical and speech therapists: A systematic review.

INTRODUCTION: Evidence-based practice (EBP) is an important aspect of healthcare work, but the clinical implementation is complex. To be able to facilitate EBP implementation, valid measurement of the "EBP status quo" is essential. Therefore, we aimed to identify valid tools for EBP status assessment among occupational, physical and speech therapists in Germany. METHODS: The databases PubMed, Cochrane Library, PsycINFO, and CINAHL were systematically searched from August 2011 until July 2022. Methodological quality and evidence level were scored by two independent raters via: i) the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist, ii) updated criteria for good measurement properties, and iii) modified GRADE criteria. RESULTS: Overall, 57 reports describing the development or validation of 31 EBP questionnaires were included. Six questionnaires showed "sufficient" evidence for content validity, three questionnaires showed "sufficient" evidence for reliability, two questionnaires showed "sufficient" evidence for structural validity as well as internal consistency, and nine questionnaires showed "sufficient" evidence for construct validity. Most questionnaires demonstrated moderate or low-quality evidence for the psychometric properties tested. DISCUSSION: Overall, the present review found a lack of sufficient evidence on the psychometric properties of most questionnaires. The Evidence-Based Practice Inventory (EBPI), the Evidence-based Practice Confidence (EPIC) scale and the Health Sciences-Evidence-Based Practice (HS-EBP) questionnaire were the only questionnaires with "sufficient" content validity and, in addition, "sufficient" reliability or "sufficient" internal consistency. CONCLUSION: Although a lack of high-quality psychometric properties of EBP tools became apparent, the EBPI, the EPIC scale and the HS-EBP questionnaire currently appear to be the best validated tools to assess EBP behavior/attitude and implementation in occupational, physical and speech therapists.

Measuring facial symmetry: a perception-based approach using 3D shape and color.

OBJECTIVE: Facial symmetry is an important factor affecting esthetics. Thus, its restoration is an essential task in maxillofacial surgery. The aim of this study is to develop an objective measure of facial asymmetry by a novel approach where both the shape and the color are taken into account and to validate its correlation with perception. METHODS: Optical three-dimensional (3D) face scans of 30 healthy adults are performed. Face-specific asymmetry indices are calculated by quantifying color differences as well as spatial distances between 3D data of a face and its mirrored copy. Subjective ratings of symmetry and attractiveness of the faces by 100 subjects are used to validate these indices. RESULTS: The symmetry ratings show significant correlations with color and geometric asymmetry indices. The attractiveness ratings correlate only weakly with both indices. However, the product of the indices exhibits significant correlations with both attractiveness and symmetry ratings. CONCLUSION: The presented combined asymmetry index comprising shape and coloring turned out to reflect subjective perception of both facial symmetry and attractiveness. It thus promises to be a valid objective measure for facial esthetics, which could contribute, e.g., to the evaluation of surgical methods as well as to the design of craniofacial prostheses.