At the same time, we must recognize that “outcomes” have multiple meanings and that ethical considerations encourage the continuous improvement of the quality of the evidence that is contained within the knowledge base. Treating the patient beneficently is understood as ensuring that the best possible therapy has addressed the overlap of personal and social values associated with stroke outcomes.
As efforts to grow the knowledge base continue, they must reflect the broadest acceptable consensus on the definitions for outcomes. If not, as clinicians value some outcomes and not others and as they simultaneously consider whether certain outcomes can be reasonably achieved, they will modify the rehabilitative process to operationalize their personal valuative decisions.There is a danger that evidence-based practice will be seen as something that is only practiced in academic centers. Even though academic centers have more resources to determine what proper evidence