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Chapter 15
Social Context:
Visualisation of Cooperation – EvidenceBased Medicine in Neurorehabilitation
Emilia Mikołajewska
Nicolaus Copernicus University, Poland
Tomasz Komendziński
Nicolaus Copernicus University, Poland
Dariusz Mikołajewski
Kazimierz Wielki University, Poland & Nicolaus Copernicus University, Poland
ABSTRACT
Evidence-based medicine (EBM) and Evidence-based practice (EBP) are sets of standards and procedures created to search, verify, and select up-to-date findings implemented by medical staff as a basis
for decision-making process in a daily clinical practice. Despite efforts of scientists and clinicians,
neurorehabiltiation is regarded as a difficult area for EBM/EBP practices due to huge diversity of
cases, clinical pictures, interventions, and scientific methodologies. More advanced tasks, including
application of brain-computer interfaces and neuroprosteheses, show the need for a new approach from
medical practitioners. This chapter presents challenges, barriers, and solutions in the aforementioned
area based on the personal experiences of the authors. Visualisation tools provide cognitive support
for social context, cooperation patterns, and data interpretation. Taking into consideration that social
issues may extend the visibility of the results and allow for easier dissemination of the results, the aim
was to show how visualisation helps identify cooperation networks and disseminate research results.
INTRODUCTION
Evidence Based Medicine (EBM) and Evidence Based Practice (EBP) are sets of standards and procedures created to search, verify and select up-to-date findings implemented by medical staff as a basis for
decision-making process in a daily clinical practice. Cause of emergence of EBM has been significant
increasing of data flow (e.g. easier access to electronical databases of medical articles). There become
DOI: 10.4018/978-1-5225-4990-1.ch015
Copyright © 2018, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited.
Social Context
hard to distinguish reliable and unreliable medical evidences. As a result - there was hard to develop
medical knowledge of the staff. The priority become selection and elimination unreliable findings at the
beginning. It was noticed, that rehabilitation methods should be as reliable as other methods in clinical
use. Concept Evidence Based Medicine licked into shape Evidence Based Practice (Bridges et al. 2007;
Dean-Baar & Pakieser-Reed 2004).
The following chapter presents challenges, barriers, and solutions in the aforementioned area based
on the personal experiences of the authors. Chapter begins from familiarizing of fundamentals of EBM/
EBP, including also debate with opponents. Paper contains also outcomes of the own research, their
useful visualizations, and results of practical implementation of EBM/EBP based on experience and
findings in Poland and abroad. Vizualization tools provide cognitive support for pattern recognition and
data interpretation toward usable information and knowledge (Osińska & Bala 2015, Osińska 2011). Our
aim was to show how visualisation helps identify co-operation networks and disseminate research results.
BACKROUND: EVIDENCE BASED MEDICINE IN
NEUROREHABILITATION – STATE OF THE ART
Neurological diseases are popular in main population and constitute one of the main cause of disability
in adult people. Interdisciplinary rehabilitation teams deal with neurologically disabled patients applying
the newest methods, drugs, and approaches to rehabilitation process (Członkowska & Sarzyńska-Długosz
2002). Rehabilitation should start as early as possible (Hömberg 2010). Integrative neurorehabilitation
science based on dedicated rehabilitation research focused on neurorehabilitation is necessary (Kwakkel
2009; Gillen 2010). Therapeutic procedures should be evidence-based and modified to find patienttailored solutions. General rules derived from neuroscience confirm their usefulness in designing new
therapeutic techniques in neurorehabilitation. (Hömberg 2010).
Searching and reading the research literature seem be essential activities for enhancing the use of
research and optimizing the quality of current clinical practice in neurorehabiltiation (figure 1). From
the other hand neurorehabilitation is regarded very hard area for EBM/EBP practices, especially due to
huge diversity of cases, their clinical pictures, interventions, and scientific methodologies. Thus neurorehabilitation may be perceived clinical area with lacking evidences (Grimmer-Somers et al. 2007; Iles
& Davidson 2006).
Enormous growth of knowledge in the neurosciences may cause significant progress in neurorehabilitation. EBM/EBP is a complex process that can be facilitated by the use of the Knowledge to Action
Process model. It provides a sequence of phases for researchers and clinicians to follow in order to optimize knowledge translation (KT) across various fields of practice. Thus our ultimate aim is creating
effective KT interventions to increase clinicians’ knowledge and use of EBM/EBP among for clinicians,
health care managers, and researchers (figure 2). Clinical application of the new tool/method, approach
requires research on its:
•
•
Reliability (interrater reliability, intrarater-reliability, test-retest reliability, etc.), i.e. measurement
error associated with an instrument,
Validity, i.e. extent to which an instrument measures itself in the absence of the “gold standard”
(including compartmental studies with other existing clinical scores and scales),
275
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