American Speech-Language-Hearing Association

Instructions for Nomination

As part of its efforts to facilitate the integration of scientific evidence into everyday clinical decisionmaking, ASHA's National Center for Evidence-Based Practice in Communication Disorders (N-CEP) undertakes a series of evidence-based systematic reviews (EBSRs). EBSRs are a formal synthesis of the evidence underlying an area of clinical practice, typically related to either a treatment or diagnostic question. The availability of EBSRs lessens the burden on clinicians to identify, review and synthesize the findings from multiple studies, which is often not practical given the demands on clinicians' time.

The basis of an EBSR is a well-designed clinical question. For topics related to treatment, the clinical question should specify the population, intervention, and outcome that you want to know more about. For topics related to screening or diagnosis, the clinical questions should define the diagnostic tool, the underlying status/condition, as well as the population of interest. For topics related to prevention, the clinical questions should define the population, the preventive action, and the condition or status to be prevented. Please complete a separate nomination form for each clinical question. Related clinical questions may be bundled and combined into a single EBSR.

Instructions for Nominating Clinical Questions

To nominate a clinical question, complete the appropriate form specifying the population, intervention or diagnostic tool, and the outcome or status/condition according to the parameters outlined below.

Population

Thought will need to be given as to how to define the population(s) in which you are interested. It is important to clearly define the population for each clinical question. For example, a population of interest might be preschoolers with autism spectrum disorders or adults with stroke-induced aphasia. If you think that the evidence may be different for some subsets of a population (e.g., acute aphasia versus chronic aphasia), or if you're not sure but would want to know whether the evidence differed, then you would need to submit a separate clinical question for each population. As a general guideline, be as specific as possible, as it is much easier to later combine questions than to sub-divide them if we are unsure as to where and how to make the divisions.

Intervention/Diagnostic Tool/Preventive Action

Again, you will need to clearly define the intervention or diagnostic tool you are interested in examining. These should be specific interventions, diagnostic tools or preventive action (e.g., focused stimulation, otoacoustic emission testing, dysphagia screening, etc.) or variations in treatment schedule/dosage (e.g., daily vs. weekly treatment).

Outcome or Status/Condition

Finally you will want to identify the effect of the intervention/diagnostic tool on a targeted outcome or condition. Similar to the previously mentioned Population and Intervention categories, Outcomes or Status/Condition can be defined broadly (e.g., measures of language impairment, presence/absence of hearing loss) or more narrowly (e.g., performance on the Western Aphasia Battery, identification of mild sensorineural hearing loss).

Examples of Key Elements of a Clinical Question

Population: Preschoolers with autism spectrum disorder
Intervention: Focused stimulation
Outcome: Functional expressive language skills

Population: Adults with stroke-induced chronic aphasia
Intervention: Promoting Aphasic Communicative Effectiveness (PACE)
Outcome: Discourse analysis

Population: Infants less than 3 months
Diagnostic Tool(s): Otoacoustic emission testing
Status/Condition: Hearing loss identification

Defining these elements is not an exact science and is dependent upon your professional judgment. NCEP staff will be glad to work with you on defining the elements that you have in mind. Contact N-CEP Associate Directors Tracy Schooling (tschooling@asha.org; 301-296-8741) or Tobi Frymark (tfrymark@asha.org; 301-296-8736).

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