Decision-Making in Evidence-Based Practice in Rehabilitation Medicine: Proposing a Fourth Factor.

American Journal of Physical Medicine & Rehabilitation
Christoph Gutenbrunner, Boya Nugraha

Abstract

According to the Sackett's model, evidence-based decision-making in medicine includes the clinical judgment, scientific evidence, and the patient's values and preferences. In rehabilitation medicine, it is well established that according to the International Classification of Functioning, Disability and Health model, contextual factors (environmental and personal factors) influence a person's individual level of functioning. This article argues that component of the health system (eg, health insurance coverage, availability of services, treatments, and assistive devices) and the service organization (eg, spectrum and training level of health professionals, availability of diagnostic, and treatment devices) have relevant influence on the decision-making in the individual case. For that reason, it is proposed to add the health system and service organization as a fourth factor to the model of evidence-based decision-making. Taking the influence of it into consideration and to describe it clearly will improve transparency of the decision-making process and the acceptance of health care users. This fourth factor is also relevant for other medical fields. However, the proposed factor and its components need to be discussed and furth...Continue Reading

References

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Dec 21, 2017·Journal of Rehabilitation Medicine·Cecilie RøeChristoph Gutenbrunner
Feb 7, 2018·Electronic Physician·Marzieh ShirazikhahFarahnaz Mohammadi Shahboulaghi
Mar 27, 2018·Journal of Rehabilitation Medicine·Boya NugrahaChristoph Gutenbrunner
Mar 31, 2018·European Journal of Physical and Rehabilitation Medicine·Sumadi L AnwarBoya Nugraha
Jun 16, 2018·American Journal of Physical Medicine & Rehabilitation·Sumadi Lukman AnwarBoya Nugraha
Nov 14, 2019·Journal of Rehabilitation Medicine·Christoph GutenbrunnerCarlotte Kiekens

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Citations

Jul 31, 2021·International Journal of Speech-language Pathology·Liza Bergström, Julie Ay Cichero
Aug 22, 2021·Pediatric Physical Therapy : the Official Publication of the Section on Pediatrics of the American Physical Therapy Association·Chantal CamdenChristoph Gutenbrunner

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