Finding Relevant Evidence Kristin Sanchez Health Sciences Librarian UTEP Library 915-747-5066 gksanchez@utep.edu

What is Evidence Based Practice? Finding, Critically Appraising, and using the Current Best Evidence to make decisions regarding the care of individual patients.

Why is Evidence Based Practice Important? More than 6,000 new scientific articles published daily. Difficult to keep up with recent advances. Practice is rapidly outdated. Clinicians may only rely on the studies that they have read, expert opinion or tradition. Staff shortages make efficiency critical. EBP reduces costs, both financially and physically, to patients.

How Can Evidence Based Practice Help? Evidence based practice is an alternative to the unscientific method in which information transfer is currently occurring. Provides a method to assess and critique medical research. Avenue for better care and “burnout” reduction among staff.

What type of resources can I use? Use the following types of studies: Stronger types of evidence: Systematic Review – An extensive literature review that utilizes a systematic way of conducting a literature search and finding valid evidence. Valid studies are then combined and analyzed and the evidence reported. Meta Analysis - A systematic review that statistically analyzes all of the results as if they were one study. Randomized Controlled Trials – Participants are randomly placed into either an intervention or control group.

Step 2: Find the Evidence (cont.) Weaker types of evidence: Cohort Studies – From a large population, follows patients who have a specific condition or receive a particular treatment over time and compared with another group that has not been affected by the condition or treatment studies. (susceptible to bias, lack of control, etc…) Case Control Studies – Compare people who are at risk and have the disease against those who are at risk and do not have the disease. Case Series/Case Report – Reports on multiple cases (case series) or a single case (case report) and the outcome.

Step 2: Find the Evidence (cont.) Begin with Systematic Reviews, Meta-Analysis and Randomized Controlled trials - provide strong levels of evidence. Proceed with Cohort, Case control and then Case reports. Evidence-Based Clinical Practice Guidelines also provide specific practice recommendations.

Where can I find these types of studies? Journals Journals are published more quickly than books, therefore, they will have the most recent information available. (Brockopp, pg. 139) Web Resources There are numerous reliable web resources published on the web by organizations, government agencies, and educational institutions.

Databases to search for Evidence Based Practice: Cochrane Library – Contains systematic reviews that are full-text and updated regularly and provides citations for randomized controlled trials. Easy to search. Good place to start CINAHL (1982-Present) – Access to over 3,000 journals from 17 Nursing and Allied Health disciplines. Limits include: Evidence based practice, practice guidelines, systematic reviews, clinical trial case study, etc…

Databases to search for Evidence Based Practice: PsycINFO (1887-Present) – 98% of this database is peer-reviewed. Access to over 2200 periodicals. Limits: Clinical Case Studies, Meta-Analysis, Clinical Trials. PubMed (1950’s-Present) - Covers of 18 million citations from the 1950’s to present. Limits: Systematic reviews, Clinical Trial, Meta-Analysis, Practice Guideline, Randomized Controlled Trial, Case Reports, Clinical Trials, Controlled Clinical Trials

Evidence Based Websites: AHRQ – Agency for Healthcare Research and Quality http://www.ahrq.gov/ National Guideline Clearinghouse – http://www.guideline.gov/ SUM Search- http://sumsearch.uthscsa.edu/ TRIP Database- http://www.tripdatabase.com/index.html