Transcript Table of Contents – Part C • Other (Internet) Resources: – HINARI/PubMed’s Clinical Queries (Clinical Study Categories & Systematic Reviews citations) and ‘Type of.

Table of Contents – Part C
• Other (Internet) Resources:
– HINARI/PubMed’s Clinical Queries (Clinical Study
Categories & Systematic Reviews citations) and ‘Type
of Article’ Limits (Meta-Analysis, Randomized Control
Trial & Clinical Practice)
– Clinical Practice Guidelines
– BestBETS
– PubMed Health – clinical effective research
– Trip Database
– Evidence Updates - BMJ and McMaster University
– Knowledge Translation Learning Modules – Canadian
Institutes of Health Research
– Essential Health Links gateway – annotated links
• Summary
We now search for evidence-based articles using
PubMed. From the main HINARI webpage, go to
PubMed by clicking on Search inside HINARI fulltext using PubMed.
Remember you must login to HINARI to have
access to the full-text articles.
Open the Clinical Queries box. This search
tool assigns filters to keyword searches - to
locate articles on Clinical Studies, Systematic
Reviews and Medical Genetics.
Note: for these PubMed applications, all
individuals will have access to the free full text
articles. The examples are from
HINARI/PubMed searches and, for those
properly logged in, will also include access to
articles from HINARI participating publishers.
On the PubMed Clinical Queries page,
we have entered the type 2 diabetes
AND developing countries search.
The default search results for the Clinical Study
Categories are Category: Therapy and Scope: Broad.
Other options in the Category drop down menu are
Etiology, Diagnosis, Prognosis and Clinical Prediction
Guides. There are 142 articles for Therapy: Broad
and 20 articles for Systematic Reviews.
Note: you can go directly to PubMed Clinical Queries.
The direct link to PubMed Clinical Queries is
http://www.ncbi.nlm.nih.gov/pubmed/clinical
For the Scope option, we will enter Narrow
and for the same type 2 diabetes AND
developing countries search.
The Therapy (Category) and Narrow (Scope) type 2
diabetes AND developing countries search has resulted
in 11 citations. We now will click on the See all option
(bottom of the page).
Note that the results for Systematic Reviews and Medical
Genetics also are displayed.
We have displayed all 11 articles for this search
including 7 HINARI and 8 Free Full Text articles.
Remember - you can access the full-text articles by
clicking on these Filters or changing the display from
Summary to Abstract.
Note that the specific search is listed in the Search
box including the AND (Therapy/Narrow[filter]) for
clinical studies categories and systematic reviews.
After returning to the search results on the
Clinical Queries page, we have clicked on
the See all option for the systematic
reviews results. The type 2 diabetes AND
developing countries AND systematic [sb]
search resulted in 20 articles.
If you have a MY NCBI account, you can add Meta-analysis, Randomized
Control Trials and Systematic Reviews to your Filters. Go to Manage Filters,
click on Properties option and put each term in the Search with terms box.
When you save a PubMed search, you will be sent an email listing new
articles on the specific topic with these filters. Remember that you will need
to go to HINARI to get the full-text articles.
In this example, Free Full Text, HINARI, Meta-analysis and Systematic
Reviews are listed in Filters.
Another tools from PubMed is using the Filters option – see
left-column. We have checked the Meta-Analysis box in the
Article Types section and entered hypertension in the
PubMed Search box. The search Results number is 1239.
Note the Filters activated: Meta-Analysis line below the
Results number.
Filters can be activated from any search results page.
Remember to clear them before beginning other searches.
Now displayed are the results of a
hypertension search with the
Systematic Reviews Article Type filter
activated. The citations for this search
include 1158 Free Full text and 2368
HINARI articles.
Now displayed are the results of a
hypertension search with the
Randomized Controlled Trial Article
Type filter activated. The citations for
this search include 2862 Free Full text
and 6667 HINARI articles.
The final displayed search are the
results of a hypertension and
developing countries search with the
Meta-Analysis, Systematic Reviews and
Randomized Controlled Trial Article
Type filters activated. The citations for
this search total 64.
Definition Clinical Practice Guidelines
‘Clinical practice guidelines are statements
that include recommendations intended to
optimize patient care that are informed by
a systematic review of evidence and an
assessment of the benefits and harms of
alternative care options’
- National Guideline Clearinghouse, U.S. Department of Human
and Health Services www.guideline.gov/about/inclusioncriteria.aspx October 8, 2013
Overview of Guidelines
• Describe a range of generally accepted
approaches for the diagnosis, management, or
prevention of specific diseases or conditions
• Define practices that meet the needs of most
patients in most circumstances
• Are recommendations that are based on
evidence from a rigorous systematic review and
synthesis of the published medical literature
• Primarily for use by clinicians--physicians, nurses,
and other health professionals in clinical practice
Using the Filters option, we now will
activate the Practice Guideline Article
types filter and enter malaria treatment in
the PubMed Search box. You can click on
more than 1 box in the Article types
section.
The results of this search are 31 citations.
Note the Limits Activated: Practice
Guidelines text below the results line.
Remember that you must remove this
before beginning another PubMed search.
Examples of Clinical Practice
Guidelines documents from the
Kenya, South Africa and Uganda.
apps.who.int/medicinedocs/documents/s16427e/s16427e.pdf
Medecins Sans Frontieres
www.health.go.ug/docs/ucg_2010.pdf
www.kznhealth.gov.za/research/guideline2.pdf
Additional CPG resources
• National Guideline Clearinghouse (USA)
http://www.guideline.gov/
• Open Clinical: Clinical Practice Guidelines
http://www.openclinical.org/guidelines.html
• About Clinical Practice Guidelines
http://www.nhlbi.nih.gov/guidelines/about.htm#what
We have opened the initial issue –
April 2012 - of Systematic Reviews,
an open access journal published
by BioMed Central. This and
subsequent issues can be access
from the above url.
We have opened the BestBETS site
which contains numerous Best Evidence
Topics. Originally having a emergency
medicine focus, BETs for cardiology,
nursing and pediatrics now are included.
This slide discusses Best
Evidence Topic (BET) Format.
Each BET is analyzed with a 3
part question and answered with
a standardized Report Format.
We have opened the SEARCH BETs
option and completed a search for
cardiac arrest. Note the color coded
Status list for all the BETs.
This is an example of how each BETs
record is displayed including the Three
Part Question, Clinical Scenario,
Search Strategy Search Outcome
Relevant Paper(s) plus Comments.
A second option for accessing
the material is to Browse BET
Categories by Topic or Specialty.
A third option is to Search Critical
Appraisals which are one page
summaries of the evidence related
to a particular clinical question.
PubMed Health specializes in reviews of clinical
effective research – which finds answers to ‘What
Works’ in medicine and health care. It is based on
systematic reviews of clinical trials.
PubMed Health is a service provided by the National
Center for Biotechnology Information (NCBI) at the
U.S. National Library of Medicine (NLM).
From the Contents drop down menu, you can
access PubMed Health’s information in the
following categories: For consumers,
Executive summaries, Clinical guides and Full
text reviews. We will open the Executive
summaries option. Note also that PubMed
Health contains a Medical encyclopedia.
The Executive Summaries Results is
organized via an A-Z alphabetical listing.
This format also is used for the other
options in the Contents drop down menu.
We have entered HIV AND pregnancy in
the keyword search box.
For the HIV AND pregnancy search, there are 368
Results displayed in PubMed Health. The initial
display is in the Summary format. By clicking on the
title, the Abstract will be displayed.
The Refine your search option organizes the results
by the categories in Contents drop down menu.
Also note the Medical Encyclopedia links to key
concepts in the search results.
When available, PubMed Health contains
links to full-text documents. Displayed in
this slide are the titles from the H listing
for the Full Text Reviews. We will open
the HIV in Pregnant Women document.
The Full Text Review contains a
Structured Abstract and then links to the
various sections of the Review (next slide).
We have displayed the AIDS
(Acquired immune deficiency
syndrome) definition from the
A.D.A.M. Medical Encyclopedia.
Question for next two resources
• Both Trip Database and Evidence Updates are
aggregators that search various EBM tools for
results to keyword searches.
• The problem is that the results are often
resources that are fee-based and users are
asked for their username and password or
requested to pay a fee.
• Do you think these should be included or
excluded? Or should they just be mentioned
in the bibliography at the end?
Trip Database is a clinical search tool
for health professionals to identify
quality clinical evidence for clinical
practice. It allows simultaneous
searching of multiple sites which
speeds up the question answering
process.
Registration is required but free and
gives the users additional resources.
We have completed a search
for malaria AND bednets. The
results are displayed with, in
some cases, links to Full Text.
Preview goes to source – in this
case PubMed… We have
completed a search for malaria
AND bednets. The results are
displayed with, in some cases,
links to Full Text.
We have completed a search
for malaria AND bednets. The
results are displayed with, in
some cases, links to Full Text.
Access to the full-text article will
be if it is a free full text one or
your institution has access via
HINARI or a subscription.
For this search, we checked
4 boxes and now will Export
selected links as a CVS file.
The report is displayed as an Excel
spreadsheet with the title, url, publication
and date of each checked citation.
Access to full-text journal articles will
depend on whether they are free full text
articles or if your institution is eligible for
HINARI or has a subscription.
We have displayed
the Advanced Search
for the trip database.
EvidenceUPDATES contain a searchable
database, an email alerting system and links
to selected evidence-based resources.
Registration is required but free.
We have entered
chloroquine resistance in
the tool’s search box.
For this search there are 14 matches
that note the citation information plus
type of article (e.g. Review, Original).
Access to the full-text article again
will be if it is a free full text one or
your institution has access via
HINARI or a subscription.
EvidenceUPDATES contain options
to Download Citations including to
several commercial reference
manager softwares. We will
download to the Text File option.
In the Text File option, the
abstracts for the checked results
are listed in a Notepad file.
EvidenceUPDATES also contains an
Advanced Search option that initially is based
on disciplines, categories and populations.
From the drop down menu, subcategories for
each broad discipline will be displayed.
The Canadian Institutes of Health
Research web site contains four
Knowledge Translation Learning
Modules. Several of these online
courses are relevant for evidence
based practice and use of knowledge
to make informed health decisions.
The Essential Health Links gateway
contains annotated links to numerous
Evidence-Based Medicine resources
available on the Internet.
Additional Evidence-based Health Resources
• Bandolier Knowledge: Oxford University
http://www.medicine.ox.ac.uk/bandolier/knowledge.html
• The Campbell Library
http://www.campbellcollaboration.org/library.php
• DARE: Database of Abstracts of Reviews of Effects
http://www.crd.york.ac.uk/crdweb/
• Duke University Medical Center Library: EBM
http://www.mclibrary.duke.edu/subject/ebm?tab=contents
• EBM Librarian
https://sites.google.com/site/ebmlibrarian/
• McMaster PLUS collection
http://hiru.mcmaster.ca/hiru/HIRU_McMaster_PLUS
_projects.aspx
• National Guidelines Clearinghouse
http://www.guideline.gov/
• Nesbit Guide Evidence-Based Resources
http://www.urmc.rochester.edu/hslt/miner/digital_libr
ary/evidence_based_resources.cfm
Review –
5 Steps to evidence-based health care
• Step 1: Formulate your question - define
the population, the intervention, what
to compare this intervention to, as well
the outcome (PICO format)
• Step 2: Search for the evidence – find previous
studies or research conducted
• Step 3: Appraise the evidence - use a set of
criteria, evaluate the quality of the studies found
during the search; highest quality studies are
included in a systematic review
• Step 4: Put the evidence into practice - use
the evidence to improve practice (e.g.,
through the development of guidelines and
protocols that can be used in practice)
• Step 5: Monitor what has been done – to
ensure that it is effective; provide feedback for
the progress of performance
Dr. Frode Forland, Royal Tropical Institute (KIT)
www.elsevier.com/connect/5-steps-to-evidence-based-healthcare-in-africa October 8, 2013
Appendix 1
Appendix 1 – Contains four case studies for
developing Evidence-Based Practice curriculum:
experimental cancer research, EBP
curriculum for pharmacy students, health
literacy for pharmacy students and
outreach activity for early intervention
providers
Developed by:
Irena Bond, Library Manager
Associate Professor of Library and Learning Resources
Massachusetts College of Pharmacy and Health Sciences
Research Evidence
Practitioner’s Experience
Local Conditions
Patient/Community Preferences
& Values
This is the end of the Evidence-based Medicine for HINARI Users module.
The material initially was developed by: Gale G. Hannigan, PhD, MLS, MPH;
Professor & Medical Informatics Education Librarian, Texas A&M University.
Material revised and enhanced by Irena Bond, Library Manager, Associate
Professor of Library and Learning Resources, Massachusetts College of
Pharmacy and Health Sciences.
There is a workbook that accompanies this module. The workbook will take you
through a live session covering the topics included in this demonstration with
working examples.
Updated 2013 10