Ethical and evidence-based practice in brain injury rehabilitation.

James F. Malec

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The ultimate goal of evidence-based medicine (EBM) is to develop a scientific basis for choosing interventions that will benefit individuals with defined characteristics under specified conditions. By referencing practice recommendations to the strength of the scientific evidence gleaned from systematic reviews, EBM avoids the influence of professional biases. The randomised controlled trial (RCT) has come to be considered the gold standard for EBM methodology. Strengths as well as risks and weaknesses of RCT-focused EBM are reviewed. EBM is also linked to the medical model in which the target of the intervention is a disorder within the individual patient. Some interventions in brain injury rehabilitation may be more appropriately studied within a social model of disability in which the target of intervention is the individual's environment or social system. While the pursuit of a scientific basis for practice is clearly an ethical mandate, defining ethical practice in the absence of strong evidence and in the presence of competing methodologies is elusive. Balancing these considerations, the ethical practice of brain injury rehabilitation requires an awareness not only of the scientific evidence for an intervention but also of current best practices recommended by professional traditions and consensus, the practice situation, and the individual's current and evolving situation, needs and preferences.

Original languageEnglish
Pages (from-to)790-806
Number of pages17
JournalNeuropsychological Rehabilitation
Volume19
Issue number6
DOIs
StatePublished - Dec 2009

Fingerprint

Evidence-Based Practice
Evidence-Based Medicine
Brain Injuries
Rehabilitation
Randomized Controlled Trials
Social Environment
Practice Guidelines
Evidence-based Practice
Evidence-based Medicine
Brain Injury
Randomized Controlled Trial
Methodology
Scientific Evidence

ASJC Scopus subject areas

  • Applied Psychology
  • Neuropsychology and Physiological Psychology
  • Rehabilitation

Cite this

Ethical and evidence-based practice in brain injury rehabilitation. / Malec, James F.

In: Neuropsychological Rehabilitation, Vol. 19, No. 6, 12.2009, p. 790-806.

Research output: Contribution to journalArticle

@article{fdf2948a79a84bd19d9004f817a5a6e2,
title = "Ethical and evidence-based practice in brain injury rehabilitation.",
abstract = "The ultimate goal of evidence-based medicine (EBM) is to develop a scientific basis for choosing interventions that will benefit individuals with defined characteristics under specified conditions. By referencing practice recommendations to the strength of the scientific evidence gleaned from systematic reviews, EBM avoids the influence of professional biases. The randomised controlled trial (RCT) has come to be considered the gold standard for EBM methodology. Strengths as well as risks and weaknesses of RCT-focused EBM are reviewed. EBM is also linked to the medical model in which the target of the intervention is a disorder within the individual patient. Some interventions in brain injury rehabilitation may be more appropriately studied within a social model of disability in which the target of intervention is the individual's environment or social system. While the pursuit of a scientific basis for practice is clearly an ethical mandate, defining ethical practice in the absence of strong evidence and in the presence of competing methodologies is elusive. Balancing these considerations, the ethical practice of brain injury rehabilitation requires an awareness not only of the scientific evidence for an intervention but also of current best practices recommended by professional traditions and consensus, the practice situation, and the individual's current and evolving situation, needs and preferences.",
author = "Malec, {James F.}",
year = "2009",
month = "12",
doi = "10.1080/09602010903031203",
language = "English",
volume = "19",
pages = "790--806",
journal = "Neuropsychological Rehabilitation",
issn = "0960-2011",
publisher = "Psychology Press Ltd",
number = "6",

}

TY - JOUR

T1 - Ethical and evidence-based practice in brain injury rehabilitation.

AU - Malec, James F.

PY - 2009/12

Y1 - 2009/12

N2 - The ultimate goal of evidence-based medicine (EBM) is to develop a scientific basis for choosing interventions that will benefit individuals with defined characteristics under specified conditions. By referencing practice recommendations to the strength of the scientific evidence gleaned from systematic reviews, EBM avoids the influence of professional biases. The randomised controlled trial (RCT) has come to be considered the gold standard for EBM methodology. Strengths as well as risks and weaknesses of RCT-focused EBM are reviewed. EBM is also linked to the medical model in which the target of the intervention is a disorder within the individual patient. Some interventions in brain injury rehabilitation may be more appropriately studied within a social model of disability in which the target of intervention is the individual's environment or social system. While the pursuit of a scientific basis for practice is clearly an ethical mandate, defining ethical practice in the absence of strong evidence and in the presence of competing methodologies is elusive. Balancing these considerations, the ethical practice of brain injury rehabilitation requires an awareness not only of the scientific evidence for an intervention but also of current best practices recommended by professional traditions and consensus, the practice situation, and the individual's current and evolving situation, needs and preferences.

AB - The ultimate goal of evidence-based medicine (EBM) is to develop a scientific basis for choosing interventions that will benefit individuals with defined characteristics under specified conditions. By referencing practice recommendations to the strength of the scientific evidence gleaned from systematic reviews, EBM avoids the influence of professional biases. The randomised controlled trial (RCT) has come to be considered the gold standard for EBM methodology. Strengths as well as risks and weaknesses of RCT-focused EBM are reviewed. EBM is also linked to the medical model in which the target of the intervention is a disorder within the individual patient. Some interventions in brain injury rehabilitation may be more appropriately studied within a social model of disability in which the target of intervention is the individual's environment or social system. While the pursuit of a scientific basis for practice is clearly an ethical mandate, defining ethical practice in the absence of strong evidence and in the presence of competing methodologies is elusive. Balancing these considerations, the ethical practice of brain injury rehabilitation requires an awareness not only of the scientific evidence for an intervention but also of current best practices recommended by professional traditions and consensus, the practice situation, and the individual's current and evolving situation, needs and preferences.

UR - http://www.scopus.com/inward/record.url?scp=77953150980&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953150980&partnerID=8YFLogxK

U2 - 10.1080/09602010903031203

DO - 10.1080/09602010903031203

M3 - Article

C2 - 19626559

AN - SCOPUS:77953150980

VL - 19

SP - 790

EP - 806

JO - Neuropsychological Rehabilitation

JF - Neuropsychological Rehabilitation

SN - 0960-2011

IS - 6

ER -