Evaluación de la calidad clínica y metodológica de las guías de práctica clínica para el manejo fisioterapéutico del paciente con enfermedad respiratoria

Objective: To evaluate the design, structure and methodological quality of Clinical Practice Guidelines (CPG) for the management of respiratory patient through the AGREE II tool. Materials and methods: A total of 5 CPG were initially selected. The countries the CPGs come from are: The United States, England, Australia and Canada. They were published between 2003-2013. A technical document denominated as CPG, with reference to respiratory patients and physiotherapy management published in 2009 by Bott et al. «Guidelines for the physiotherapy management of the adult, medical, spontaneously breathing patient,» was independently assessed by 4 authors using the Spanish version of AGREE II tool. The concordance among evaluators was calculated with Kappa (k) coefficients. Results: Both structure and methodological quality of the CPG were satisfactory, with a score of 5-7 for most of the 23 items. The fields that obtained a lower score were applicability (31%), followed by rigor of elaboration with 56%. The higher scores were found in the fields of editorial independency (88%), objectives and scopes (83%) and clarity of presentation (71%). Global concordance among evaluators was moderate (?=0,57), this varying in accordance to the CPG evaluated between 0,33 and 0,88. Conclusions: Based on AGREE II scores, the application of the CPG published by Bott et al. is recommended for physiotherapeutic management of respiratory patients in Colombia. © 2013 Asociación Española de Fisioterapeutas

Evaluación de la calidad clínica y metodológica de las guías de práctica clínica para el manejo fisioterapéutico del paciente con enfermedad respiratoria

Objective: To evaluate the design, structure and methodological quality of Clinical Practice Guidelines (CPG) for the management of respiratory patient through the AGREE II tool. Materials and methods: A total of 5 CPG were initially selected. The countries the CPGs come from are: The United States, England, Australia and Canada. They were published between 2003-2013. A technical document denominated as CPG, with reference to respiratory patients and physiotherapy management published in 2009 by Bott et al. «Guidelines for the physiotherapy management of the adult, medical, spontaneously breathing patient,» was independently assessed by 4 authors using the Spanish version of AGREE II tool. The concordance among evaluators was calculated with Kappa (k) coefficients. Results: Both structure and methodological quality of the CPG were satisfactory, with a score of 5-7 for most of the 23 items. The fields that obtained a lower score were applicability (31%), followed by rigor of elaboration with 56%. The higher scores were found in the fields of editorial independency (88%), objectives and scopes (83%) and clarity of presentation (71%). Global concordance among evaluators was moderate (?=0,57), this varying in accordance to the CPG evaluated between 0,33 and 0,88. Conclusions: Based on AGREE II scores, the application of the CPG published by Bott et al. is recommended for physiotherapeutic management of respiratory patients in Colombia. © 2013 Asociación Española de Fisioterapeutas

Current state of research and main barriers to evidence-based practice in Colombian physical therapists

Introducción La práctica basada en la evidencia científica (PBE) se define como un proceso cuyo objetivo es la selección de los mejores argumentos científicos para la resolución de los problemas que se plantean en la práctica clínica. El propósito de este estudio fue evaluar el estado actual de la investigación y las principales barreras para la incorporación del uso de la PBE en fisioterapeutas colombianos. Materiales y métodos Estudio transversal, multicéntrico y descriptivo en 221 fisioterapeutas colombianos sin formación previa en PBE. Se aplicó una encuesta de 18 ítems divida en 3 apartados diferenciados: a) información de la titulación; b) aplicación de PBE, y c) áreas y líneas de desempeño profesional e investigativo. Adicionalmente, se reunieron datos de información sociodemográfica. Resultados El promedio de edad fue 26,6 ± 6,1 años; el 76% de los encuestados tenían titulación profesional y solo el 3,2% nivel de maestría. Un 43,4% de los encuestados buscan información en fuentes primarias y secundarias, mientras que el 28,5% respondió nunca hacerlo. El 55,7% usaban búsquedas mediante Altavista, Google, Hotbot y Lycos, y solo un 13% usaba Tesauros. El 48,9% respondía haber realizado estudios de tipo descriptivo, el 10,4% experimentales y el 3,2% de casos y controles. Un 10,9% de los encuestados desarrollaba proyectos en cuidado crítico, el 7,2% en enfermedad articular y el 4,5% en enfermedad neurológica. Conclusión El estudio confirma la escasa actividad científica y las barreras que limitan la inclusión de la PBE en profesionales de fisioterapia de Colombia. Múltiples estrategias de cambio serán necesarias para facilitar la inclusión de actividades encaminadas a la mejora de la competencia profesional en esta materia.Introduction Scientific evidence based practice (SEBP) is defined as a process whose objective is the selection of the best scientific arguments to solve the problems occurring in the clinical practice. This study has aimed to evaluate the current status of the investigation and the principal barriers existing for the Columbian physiotherapists to incorporate SEBP. Material and methods A cross-sectional, multicenter and descriptive study was performed in 221 Colombian physiotherapists with no previous training in SEBP. An 18-item survey divided into 3 differentiated sections was applied. These sections were: 1) degree information, 2) application of SEBP and 3) areas and lines of professional and investigational work. In addition, sociodemographic information data were collected. Results Average age was 26.6 ± 6.1 years; 76% of those surveyed had a professional degree and only 3.2% a master's degree. A total of 43.4% of those surveyed looked for information in primary and secondary sources while 28.5% stated they never did so. Searcy was performed in Altavista, Google, Hotbot, Lycos by 55.7% and only 13% used Tesauros. 48.9% stated they had carried out descriptive type studies, 10.4% experimental and 3.2% case-controls. Of those surveyed, 10.9% developed projected in critical care, 7.2% in articular disease and 4.5% in neurological disorder. Conclusion This study confirms the scarce scientific activity and barriers that limit including SEPB in physiotherapy professionals in Colombia. Multiple strategies Introduction Scientific evidence based practice (SEBP) is defined as a process whose objective is the selection of the best scientific arguments to solve the problems occurring in the clinical practice. This study has aimed to evaluate the current status of the investigation and the principal barriers existing for the Columbian physiotherapists to incorporate SEBP. Material and methods A cross-sectional, multicenter and descriptive study was performed in 221 Colombian physiotherapists with no previous training in SEBP. An 18-item survey divided into 3 differentiated sections was applied. These sections were: 1) degree information, 2) application of SEBP and 3) areas and lines of professional and investigational work. In addition, sociodemographic information data were collected. Results Average age was 26.6 ± 6.1 years; 76% of those surveyed had a professional degree and only 3.2% a master's degree. A total of 43.4% of those surveyed looked for information in primary and secondary sources while 28.5% stated they never did so. Searcy was performed in Altavista, Google, Hotbot, Lycos by 55.7% and only 13% used Tesauros. 48.9% stated they had carried out descriptive type studies, 10.4% experimental and 3.2% case-controls. Of those surveyed, 10.9% developed projected in critical care, 7.2% in articular disease and 4.5% in neurological disorder. Conclusion This study confirms the scarce scientific activity and barriers that limit including SEPB in physiotherapy professionals in Colombia. Multiple strategies of change will be necessary to facilitate the inclusion of activities aimed at the improvement of professional expertise in this material.of change will be necessary to facilitate the inclusion of activities aimed at the improvement of professional expertise in this material