Opinions of speech-language-hearing pathologists and students on evidence-based practice: a systematic review.
Samara Fernandes da Silva Souza, Allya Francisca Marques Borges, Ramon Cipriano Pacheco de Araújo and 5 others
SLH pathologists across 21 countries generally value evidence-based practice but most reduce it to reading research papers, ignoring clinical experience and patient preferences.
The biggest barriers are lack of time, difficulty with statistics, and limited institutional support.
Key findings
1Most SLH pathologists have a partial understanding of EBP, reducing it to the use of scientific research alone. In three separate surveys, only 8%, 14%, and 28% of participants correctly identified all three components of EBP (research evidence, clinical experience, and patient preferences).
2Despite recognising the importance of research, most professionals rely predominantly on their own clinical experience (reported by up to 99.6% of respondents) and on the opinions of colleagues (up to 78.7%), rather than on high-level scientific databases such as Cochrane or SpeechBite.
3Lack of time is the most frequently cited barrier to EBP: 91% of school-based SLH pathologists in the US, 71.9% in Ireland, 62% in Iran, and 27.9% in Brazil reported it as an obstacle.
Still to come
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The review is a qualitative synthesis of 31 studies; no meta-analysis was performed, so findings cannot be pooled into a single effect estimate. The included studies themselves scored low on risk of bias (1–4 on a 0–6 scale; none reached the maximum), with recurring gaps in instrument validation, sample size justification, and reporting of non-respondents. Most included studies used self-report questionnaires, which are vulnerable to social desirability bias and self-selection (online distribution favours tech-comfortable, EBP-interested respondents). The review captures perceptions and attitudes, not the actual quality of clinical decisions made; a therapist who reports using EBP may not be doing so in a way that changes outcomes. Data extraction was assisted by an AI tool (NotebookLM), which, although verified by a reviewer, introduces a layer of automated processing that is not independently auditable. The 31 studies are heterogeneous in design, country, instrument, and sample, limiting the strength of cross-study comparisons.
Declared interests
No funding source is declared and no conflicts of interest are reported. The authors state 'nothing to declare' in both English and Portuguese.
The easy way to misread this
Do not read the consistently positive attitudes toward EBP as evidence that SLH pathologists are already practising it well. The review measures what people say they think, not what they do: the same professionals who rate EBP as important are the ones who report relying on personal experience (up to 99.6%) and colleague opinion (up to 78.7%) over research databases, and who score in the 8–28% range on correctly identifying what EBP actually requires. Attitude and practice are different things, and this review cannot close that gap.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →