Concealed allocation is therefore necessary to guard against investigators consciously or subconsciously introducing systematic differences in the groups. Readers of trial reports should take some reassurance from the use of concealed allocation, especially

when the method of concealment appears difficult to circumvent. “
“This Canadian website provides a collection of tools to help primary care clinicians identify, evaluate, and apply relevant evidence for better health care decision-making. While the content is designed for use in the field of medicine, there is plenty on this website that is relevant to physiotherapy practice, particularly in countries where physiotherapists are primary care practitioners, such as Australia and England. The need Epacadostat for a resource such as this EBM Toolkit arises from the exponential increase of internet-based clinical information that has occurred in recent decades. While it would selleckchem be wonderful if all such information were valid and reliable, it is widely recognised that the majority is not. The consequences of using biased evidence for clinical decision-making are serious: at best we make no difference to our patient’s health, but at worst we can cause harm. Therefore, to maintain

the highest standards of care and professionalism, it is essential that physiotherapists can locate, appraise, and apply high quality evidence in clinical practice. However, going through each of these steps to inform evidence-based practice can be time consuming and the primary barrier for physiotherapists is lack of time (Jette et al 2003). Therefore, well-designed websites such as the EBM Toolkit are invaluable

because they enable clinicians to find answers based on high quality evidence quickly. The EBM Toolkit website consists of the following sections: About EBM, Domains, Practice Guidelines, Systematic Reviews, Economic Analysis, Glossaries, JAMA Users Guide and Links. The most useful parts of the site for physiotherapists are Domains, Practice Guidelines and Systematic Reviews. All appraisal almost tools on the site have been adapted from the Users’ Guides series prepared by the Evidence Based Medicine Working Group and originally published in JAMA. The Domains section is sub-divided into therapy, diagnosis, prognosis, and harm. In each, there is a brief guide to appraise the validity and applicability of an individual research study (‘appraisal guide’). This guide serves as a useful reminder of the key criteria to evaluate how believable a study is, or to work out the size of a treatment effect, for example. My only gripe about this section is that only outcomes related to dichotomous measures (for example, re-injured or not re-injured) are considered, whereas physiotherapists are often interested in continuous outcomes (for example, pain on a 0–10 visual analogue scale) as well.