Searching for the Evidence Workshop with Diana Blackwood & Sandra Pullman 15 th February 2008
Session outcomes zEnhanced awareness of the range of useful EB information sources for health professionals zIncreased expertise in searching the mountains of websites and publications to find the best evidence.
EBP – what it really is Evidence-based practice (EBP) is an approach to decision-making that integrates the best available evidence with clinical expertise and patient values. Taken from Monash University, Medicine Nursing & Health Sciences
What is the best way to … zmanage fever in a child? zpromote leg ulcer healing in a diabetic? zprevent DVTs in post-op patients? zassist elderly people to remember to take their medications at home? zscreen for prostate cancer? zhelp people stop smoking?
5 steps of EBP decision making Taken from Monash University, Medicine Nursing & Health Sciences
Levels of evidence zSystematic reviews, or meta-analysis of multiple controlled studies zIndividual experimental study zIndividual quasi-experimental study zSystematic review of multiple non-experimental studies zIndividual non-experimental study (includes qualitative) zCase report, or systematically obtained, verifiable quality/programme evaluation data zRespected authorities/Expert committees z“Someone told me about it” Adapted from Clinical Practice Model Resource Centre
How do I start? zSecondary sources - expert summaries e.g. Cochrane Library, Joanna Briggs, clinical practice guidelines, NICE, NICS, CATbank, Bandolier, Best Evidence & other commentary journals, Dynamed, Nursing Reference Center, BMJ Clinical Evidence zPrimary sources - journal literature e.g. Medline, CINAHL,PsycINFO, AMED. ScienceDirect, Social Work Abstracts, Proquest, Embase. zFree resources on the web for busy practitioners e.g. special tools like TRIP, SUMsearch, Google the Evidence (SCHARR), PEDRO plus many resource lists, tutorials
z Remember these are mostly full text reviews z Not all have subject headings zTry restricting your search words to title, keywords & abstract zFor a “mini” search, limit from PubMed Medline via the tag X[jour] Tips for the Cochrane Library
Joanna Briggs Institute
Searching via “Connect”
zlimit by publication type e.g. RCT, Clinical Trial, Meta-analysis zuse study design subject headings zuse expert strategies/filters (see your handouts for CINAHL & MEDLINE) ztry the Clinical Queries filter in PubMed Hot search tips for databases
Examples of “expert” EBP filters for Medline zDIAGNOSIS (sensitivity or predictive value).tw. zCAUSE (risk or cohort).tw. or case-control studies/ zTHERAPY clinical trial.pt. or (double blind$ or placebo$).tw. zPROGNOSIS exp cohort studies/ or prognosis/ or survival analysis/ N.B. available via automatic filtering on PubMed
Clinical queries link at PubMed -
Tools for the busy practitioner zTRIP ( Turning Research into Practice ) y zGoogle the Evidence ( SCHARR ) yhttp://tinyurl.com/2poh3a zEvidence Australia ( Royal Melbourne Hospital ) yhttp://mh1.mh.org.au/library/eds/ea.htmhttp://mh1.mh.org.au/library/eds/ea.htm zSUMSearch zCATbank yhttp://cebm.jr2.ox.ac.uk/docs/catbank.html
zMany free EBM tutorials and sites on the Web zSee your handout for a list of resources zAsk a librarian for help More information?