Two distinct models drive American speech-language pathologists' perspectives on evidence-based practice (EBP): the American Speech-Language-Hearing Association's (2004a, 2004b) and Dollaghan's (2007). Both derive from clinical practice, but their terms and definitions differ. These concepts, which we unify as clinical evidence, are an important part of EBP but lack consistent terminology and clear definitions in the literature. A recent scoping review (Fissel Brannick S, et al., Am J Speech Lang Pathol. 2022 Nov 16;31(6):2943-2958. doi: 10.1044/2022_AJSLP-22-00203) has undertaken to identify exactly how clinical evidence is described in the field.
This was a literature-search from 2005 to 2020, harvesting 78 articles. Across publications, vexingly, a single term was used to describe disparate concepts, and the same concept was given different terms, yet the concepts that authors described clustered into three categories: clinical opinion, clinical expertise, and practice-based evidence, with each described as distinct from research evidence, and separate from the process of clinical decision making. Clinical opinion and clinical expertise were intrinsic to the clinician. Clinical opinion was insufficient and biased, whereas clinical expertise was a positive multidimensional construct. Practice-based evidence was extrinsic to the local clinical data that clinicians generated. Good clinical decisions integrated multiple sources of evidence.
For a shared language among SLPs, there is still a need for clarification of terminology and associated definitions regarding clinical evidence.
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