Transcript Research in the Health Sciences

Evidence Based Searching
Part 1
Kerry Sullivan, MLIS
Health Sciences Librarian
March 2011
• Your hosts
– Kerry Sullivan
– Michelle Hajder
QUESTIONS?
– We will have time for Q&A at the end of the session
– Expand the Questions window in the GoToWebinar
module (usually on the right) and type in your
questions for the presenters
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GoToWebinar Control Panel
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Overview
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Evidence in practice
Formulating the clinical question
Levels of evidence and quality
Resources for finding evidence
Evidence-Based Medicine (EBM) is
defined as: "The conscientious, explicit
and judicious use of current best evidence
in making decisions about the care of
individual patients.“
– Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., &
Richardson, W. S. (1996). Evidence based medicine: What it is and
what it isn't. British Medical Journal, 312(7023), 71-72.
The Institute of Medicine (IOM) defines “Evidence-Based
Practice" as a combination of the following three factors:
(1) best research evidence,
(2) best clinical experience, and
(3) consistent with patient values
– (IOM, 2001; http://www.iom.edu/)
1. Research
2. Clinician knowledge
3. Patient needs
Efficiency!
• Asking better questions
• Knowing where to look for evidence
• Quickly filtering out the noise
Formulating the Question
• Defining a clinical question by the specific
patient and problem lends itself to
effectively finding relevant evidence.
• EBP begins and ends with the patient.
Clinical Question Anatomy
PICO
PICO is a mnemonic that helps one
remember the key components of a well
focused question.
PICO
• P = Patient, Population or Problem
• I = Intervention, Prognostic Factor, or Exposure
• C = Comparison (if there is one)
• O = Outcome
You are a part of a health policy task force
working in conjunction with the public
school system to address student obesity
& related health risks. They are interested
in instituting a program that will raise
awareness of health risks for overweight
children and inquire about body mass
index testing for this purpose.
PICO
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P = School age children
I = BMI testing in schools
C = Diet and/or Exercise
O = Diabetes prevention
Our clinical question
Do BMI screenings in schools help prevent
obesity in children?
Library Guide
http://libraryguides.waldenu.edu/healthevidence
Filtered Resources
Highest Levels of Evidence
• Systematic Reviews / Meta-Analysis
• Critically Appraised Topics
• Critically Appraised Articles
Systematic Reviews
• Cochrane Database of Systematic Reviews
• Database of Abstracts of Reviews of Effects
• Joanna Briggs Institute
Systematic Reviews
What makes them so special?
Reliability!
• Address a clearly formulated question
• Sound methodology with strict guidelines
• Updated regularly with oversight
Critically Appraised Topics
Synthesized!
One page summaries of the evidence from
appropriate studies that answer a clinical
question and is regularly updated.
Critical Appraisal
• Evaluates the methodology (validity)
• Provides an interpretation of results
– relative risk reduction
– absolute risk reduction
– number needed to treat
Barratt, A., Wyer, P. C., Hatala, R., McGinn, T., Dans, A. L., Keitz, S., Moyer, V., et al. (2004).
Tips for learners of evidence-based medicine: 1. Relative risk reduction, absolute risk
reduction and number needed to treat. CMAJ, 171(4), 353-358.
Resources
– Joanna Briggs Institute Evidence Based
Resources
– Annual Reviews (Medicine, Public Health
Nutrition, etc)
– National Guideline Clearinghouse
• http://www.guideline.gov
– AHRQ Evidence Based Practice
• Agency for Healthcare Research & Quality
• http://www.ahrq.gov/
Critically Appraised Articles
• ACP Journal Club
• Bandolier
• Evidence Based Journal series
– Evidence-Based Medicine, Evidence-Based
Nursing, etc.
• Evidence Updates
• International Journal of Evidence-Based
Healthcare
Unfiltered Resources
• MEDLINE with Full Text
• CINAHL Plus with Full Text
• PsycINFO
Trip Database
Turning Research Into Practice
http://www.tripdatabase.com
Library Guide
http://libraryguides.waldenu.edu/healthevidence
Point-of-Care Products
• UpToDate
http://www.uptodate.com/
• Dynamed
http://www.ebscohost.com/dynamed
• FirstConsult
http://www.mdconsult.com
• eMedicine
http://www.emedicine.medscape.com
Questions?
Thank you!
ASK – A – LIBRARIAN
[email protected]
800-930-0914