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Research Pyramid: a new evidence-based practice model for occupational therapy.

George Tomlin¹, Bernhard Borgetto

¹University of Puget Sound, 1500 North Warner Street, CMB 1070, Tacoma, WA 98416, USA. tomlin@pugetsound.edu

The American Journal of Occupational Therapy : Official Publication of the American Occupational Therapy Association

|April 12, 2011

Summary

The current evidence-based practice model is insufficient for occupational therapy. A new Research Pyramid model better integrates diverse research evidence, including qualitative studies, to support clinical reasoning and practice decisions.

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Area of Science:

Occupational Therapy
Evidence-Based Practice
Research Methodology

Background:

The existing single-hierarchy model for evidence levels inadequately represents the full spectrum of valuable research in occupational therapy.
This limitation hinders the effective implementation of evidence-based practice within the profession.

Purpose of the Study:

To present a modified and expanded Research Pyramid model for occupational therapy.
To address the shortcomings of the current evidence hierarchy by incorporating diverse research types and validity criteria.

Main Methods:

The proposed model separates internal and external validity criteria for evidence levels.
It explicitly integrates evidence from qualitative research studies.
The model retains the crucial concept of research rigor.

Main Results:

A pyramidal evidence model, termed the Research Pyramid, has been developed.
This model aligns with revised evidence-based medicine principles and occupational therapy's clinical reasoning modes.
It offers a framework for ordering evidence according to the profession's epistemology.

Conclusions:

The Research Pyramid provides a more comprehensive approach to evidence-based practice in occupational therapy.
It aims to guide occupational therapy research, meta-synthesis, and integration into clinical decision-making.
This model represents an initial effort to align evidence ordering with the profession's foundational knowledge.