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.3 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.
4 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.3
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