Transcript Research in the Health Sciences

Evidence Based Searching
Part 2
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
2
GoToWebinar Control Panel
3
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/)
Clinical Question using PICO
• P = Patient, Population or Problem
• I = Intervention, Prognostic Factor, or Exposure
• C = Comparison (if there is one)
• O = Outcome
Our clinical question
• Do BMI screenings in schools prevent
obesity in children?
PICO
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P = School age children
I = BMI testing in schools
C = Diet and/or Exercise
O = Obesity prevention
Unfiltered Resources
• MEDLINE with Full Text
• CINAHL Plus with Full Text
• PsycINFO
Types of Questions & Studies
Type of Question
Type of Study/Methodology
Therapy/Treatment
Randomized Controlled Trial
Systematic Review/Meta Analysis of RCT
Diagnosis
Controlled Trial
Systematic Review/ Meta Analysis of CT
Prognosis
Cohort Studies
Case Control
Case Series
Harm/Etiology
Cohort Studies
Prevention
Randomized Controlled Trial
Cohort Studies
Quality Improvement
Randomized Controlled Trial
Search Terms & Strategy
• Keywords/Subjects
– Obesity AND BMI AND schools
Limits: children and highest levels of evidence
What is a Systematic Review?
• Clearly formulated question
• Rigorous criteria for inclusion
– Usually clinical trials, but sometimes
observational studies
• Assessment guidelines
• Updated regularly
Benefits of Systematic Reviews
Refinement
Efficiency
Reliability
Precision
Reduction
Consistency
Power
Quantitative
Meta-Analysis
• A particular type of systematic review that
focuses on numerical results
• Combines results of several independent
studies to produce an estimate
• Aims to assist in making decisions about a
particular therapy
What is a Randomized Controlled Trial?
• A scientific experiment used in testing
safety and efficacy.
• RCTs commonly use a parallel group
design or crossover design.
• They are the highest level of evidence and
are combined to create systematic
reviews.
Let’s do some searching for evidence…
Publication Types
• MEDLINE
– Clinical trials (all)
– Controlled Clinical Trial
– Meta-Analysis
– Randomized Controlled Trial
Publication Types
• CINAHL
– Clinical Trials
– Practice Guidelines
– Systematic Review
Methodology
• PsycINFO
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Systematic Review
Meta-Analysis
Treatment Outcome/Clinical Trial
Qualitative study
Quantitative study
What is a Cohort Study?
• Longitudinal study (type of observational)
• Analyzes risk factors
• Follows groups that share a common
characteristic or experience.
Cohort Study
Study Type as Subject Heading
• MeSH in Medline
– MeSH = Medical Subject Headings
• CINAHL Headings
• Thesaurus in PsycINFO
MEDLINE – Clinical Queries
• Using the Clinical Queries limit
– Therapy (treatment or prevention/control)
– Diagnosis
– Prognosis
– Etiology (causation/harm)
– Clinical Prediction: risk assessment
3 Emphasis Categories
• Sensitivity
• Specificity
• Best Balance
CINAHL – Clinical Queries
• Clinical Queries
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Therapy
Prognosis
Review
Qualitative
Causation
• Check limits: Evidence-Based Practice
Questions?
Thank you!
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