1. NICE Evidence search workshop
Reference slide set with teaching notes July 2017

2. Workshop aim and learning outcomes
to know when and how to use NICE Evidence search
Learning outcomes:
be able to use Evidence search more effectively and understand its scope
identify some of the more useful filters to refine your search results
know how to search and browse CKS, NICE Pathways and the BNF/BNFc

3. What is NICE Evidence Search ?
A search engine linking to high quality medicine, health and social care information sources
covers commonly-searched conditions
care of patients/service users
It is NOT:
a search engine for primary research articles (NOT a PubMed/Medline equivalent)
a source of information on the underlying science of healthcare
Ask the participants what they think NICE Evidence Search is?
Q: What’s the difference between NICE Evidence and any other search engine such as Google?
A: NICE Evidence only includes results from high quality sources, so you can trust that you will find good quality information that’s relevant to your search terms. It cuts out all the other stuff – personal opinions or experiences, blogs, poor quality resources – so that you don’t have to spend time wading through it all.
From process manual “Much of the evidence in Evidence Search is high quality ‘secondary evidence’ that has consolidated or synthesised information from ‘primary evidence’. As a result, the service is ideal for users who want answers to questions without having to analyse or critically appraise the primary research themselves.”
Remember: NICE Evidence is applicable to patient or client care. It does not include details of the underlying science such as chemistry, anatomy, physiology...
Note students have commented on its “simplicity and breadth” – i.e how easy it is to search and how broad ranging it is.

4. More on NICE Evidence Search:
Separate from, but complements, bibliographic databases such as BNI, CINAHL, and PubMed /Medline,
Easily accessible - no need for registration
For health and social care professionals
A developing resource
It brings together selected content from multiple high quality web sources
The technology powering the search engine allows the full text of individual documents from numerous web sources to be searched very quickly.
It then displays a page of search results that are prioritised in 2 ways:
quality
relevance
Higher quality evidence comes higher up your search results – so you’ll find guidance documents at the top of your list of results.
The technology looks for where your search terms come in each document – if they’re in the title of a document, that document will appear higher in your results that if they’re in the last paragraph of the last page of a document.
The site is aimed at health and social care professionals, and contains information of most use to you in your working life – guidance, care pathways, good quality patient information, etc. As it’s open access, patients or clients can use NICE Evidence Search, but it isn’t primarily a source of information for the public. In the first instance, we would direct them to use NHS Choices.
Evidence Search is a developing resource: there are changes and developments with the technology, as well as an on-going programme of user research to ensure that the site meets the needs of those people it’s aimed at. What you see on the site today will not be the same in 6 months time.

5. What’s in NICE Evidence Search?
Guidance and policy
Secondary evidence
(Selected) primary research
Ongoing trials
Practice based information
Information for the public
Medicines current awareness
Evidence types: top level categories - see final slide screen dump and evidence type definitions leaflet. It’s one of the student champion resources in the zip file.
Guidance and Policy
Secondary Evidence
Primary Research – selected
Ongoing Trials
Medicines Current Awareness
Practice Based Information
Implementation Support
Information for the Public

6. Over 275,000 resources from more than 800 sources

7. Evidence Search sources
Information from a wide range of trusted, high quality health and social care sources
Selected information for the public
Current lists of included sources search/evidence-search-content
Sources are searched by an automated and/or manual process
The NICE Accreditation Mark is displayed next to the name of guidance producers whose processes have been accredited. You can filter by accredited sources.
Only patient information that has been awarded the Information Standard is on Evidence Search.
The Information Standard is an independent certification scheme that is commissioned by NHS England.
NICE Accredited Explain that the purpose of NICE accreditation is to help users identify the most trusted sources of guidance and advice that have been developed using critically evaluated high-quality processes. An independent Accreditation Advisory Committee makes accreditation recommendations on behalf of NICE and that patients and carers are involved as lay members of the Accreditation Advisory Committee. Note: Only accredited guidance and advice is used to develop NICE quality standards. You can use a Filter to limit to only accredited guidance. See the slide on filters or page down the list of filters on the left hand side of the NICE Evidence search results page.

8. When to use Evidence search
To find high quality consolidated sources of evidence relating directly to patient care
including guidelines, systematic reviews and medicines information
When you need a quick answer
NB. Whatever evidence you find, you need to critically appraise and make sure it is relevant.
Critical Appraisal
Is the evidence relevant to your patient or service user / does it help answer your specific question/s?
For in depth Critical Appraisal see the CASP Checklists

9. Evidence search www.evidence.nhs.uk
What is available
Key browsable NICE procured resources. NB All are NICE Evidence Search sources too.
Clinical Knowledge Summaries
British National Formulary – updated every month
British National Formulary for Children – updated every month
Note :Evidence Uncertainties (UK DUETs) also searchable and browsable separately too.
NEW – direct link to NICE Pathways + quick way back to NICE Guideline pages.
The Journals and Databases
links to the NHS Athens resources and some freely available resources. The link is outlined in red will continue to be accessible via the Evidence Services toolbar. Key resources include:
HDAS (Healthcare Databases Advanced Search)- NHS Athens password required
e-books – NHS Athens password required
Journals – NHS Athens password required
Cochrane Library – no password required
Updated August 2015

10. NICE Evidence search workshop
How NICE Evidence search works + searching tips

11. Simple searching Search terms: Refine your search
problem or population
e.g. dementia
Refine your search
filters
additional search terms

12. Results Screen Filters Main results
The main results screen for a simple topic search is likely to retrieve a large number of results. But, what can be helpful is that the most relevant results appear at the top of the search screen. For common health conditions an accredited guidance overview from Clinical Knowledge Summaries may appear first. If you need to narrow your search, you may want to use the filters on the left hand side of the screen.
For evidence relating to the care of your patients, clients, service users we suggest that you apply the Types of Information filters in the following order:
Guidance - listed under Guidance and Policy
Evidence Summaries listed under Secondary Evidence
Systematic Reviews listed under Secondary Evidence
For carer / patient / client/ service user information, filter by Types of Information / Patient Information You can also filter by source if you have a preferred source e.g. BASH, Cochrane, DUETs, Patient (Patient UK professional & patient information) SCIE,
Updated August 2015

13. How Evidence Search works
Mostly searching the full text of selected web resources
Results are ranked according to relevancy
how frequently the search terms appear, and where they appear in the documents
the quality of the documents, based on the relative hierarchy of evidence
the date of publication of the document
Evidence Search aims to ensure users can find the best quality, most relevant results on the first search results page. The search results are displayed in order of relevancy, the most ‘relevant’ results appearing at the top. Relevancy takes into account:
how frequently the search terms appear, and where they appear in the documents. For example, occurrences of search terms in the title are more important than occurrences in the body of the document;
the quality of the documents, based on the relative hierarchy of evidence. For example, Guidelines and Commissioning Guides are promoted above Primary Research articles;
the date of publication of the document, with newer documents appearing above similar, but older documents.
The results are displayed by Relevancy by default, but users can also choose to display them ordered by Publication Date – with the most recent at the top.

14. How to use Evidence Search - some search tips:
Search using the terms you consider to be most relevant – terms are automatically combined with AND
Try a range of terms if you don’t find what you want first time. You can use “OR” to search for synonyms
eg. ( poverty or deprivation) mental health
Truncation may be useful, BUT can affect the ranking so use with care
e.g. pregnan* retrieves all terms with the stem pregnan* including pregnancy, pregnancies, pregnant
Search using the terms you consider to be most helpful…
It’s better not to type a whole question. You can just use single search terms.
They will automatically be combined. Your results will contain all the terms you type in.
For most clinical therapy questions think about the (1) the problem and (2) intervention.
Synonyms and automatic plurals
For example (paediatric or child) hand injury   -Will return all results for (either term -  paediatric or child / children) and hand/s and injury injuries
Hand ( decontamination or hygiene) - all results for hand/s and (either term i.e decontamination or hygiene)
Searches can also be done using one word or several words. Users can also use OR to get a fuller set of phrase results. For example a search for "allergic rhinitis" OR "hay fever" will return results which contain either of the phrases “allergic rhinitis” or “hay fever".

15. How to use Evidence Search some more tips:
For exact phrases use inverted commas
e.g. “expert patient” - all results will include the exact phrase “expert patient”, rather documents with the word expert unrelated to the word patient
Try using fewer terms: select only terms that are key
Use the filter by tool to narrow your search by Evidence type e.g.
* Guidance * Evidence Summaries
* Systematic Reviews * Information for the public
Refining your search
Initial search returns may give too many results. Users can search again by adding more search terms, but can also use search filters.
Search filters – see the Evidence types definition leaflet and slide 20 for more information
A feature of Evidence Search is search filters which appear on the left of the results page with initial search results. Filters can limit results, for example, to results from a particular source of information, or a particular type of evidence such as guidelines.
. The Sources filter can also be useful if you want to limit to a particular information producer e.g. Cochrane, SIGN, UKMi…

16. Filtering for medicines information
Key filters include:
Prescribing and technical information
Safety alerts
Medicines current awareness
Information for the public
Medicines information is located in a number of places. It can also be found as part of wider Guidance documents and in NICE Pathways.
Key filters inc.
Prescribing and technical information / listed under Guidance and Policy
Safety alerts / listed under Guidance and Policy
Current awareness – UKMi compiled last 3 months only Listed separately under Medicines Current Awareness
Patient Information – PPIs (patient packet inserts). Listed separately under Information for the Public

17. Medicines search results “roll-up/roll-down” feature
This feature works for:
SPCs (summaries of product characteristics) and patient information leaflets from the electronic Medicines Compendium (eMC).
Public Assessment Reports from the MHRA

18. Example search #1
How should Crohn’s disease be managed?

19. Simple search on Crohns
Note Filters on L hand side of screen – see following slide notes for further details.

20. Filter by evidence type/ Guidance
For the full range of evidence types filters options see the evidence type definitions table.
(1) Guidance Filter – use to find Guidance i.e. recommendations based on the best available evidence. These are the starting point for questions relating to patient or end user care.
(2) Evidence summaries filter - can be helpful where no recent or specific guidance is available. Evidence summaries are a critical assessment of the current evidence, without providing recommendations for practice.
Produced following a clear and transparent process but do not meet the full requirements for a systematic review e.g. in that the inclusion criteria may be less comprehensive (for example by time period, type of evidence or exhaustivity of search/selection).
They are most useful for providing decision-makers, either local or national, with a critical assessment of the current evidence. This should be a complete, comprehensive and objective assessment of the relevant evidence. (3) Systematic Review filter will retrieve all the Cochrane SRs + a range of other manually uploaded SRs. NB the full collection of Cochrane Systematic reviews is automatically updated on Evidence Search. Rigorous systematic reviews ( like those from the Cochrane Collaboration) are trustworthy. They summarise the evidence on a clearly formulated review question according to a predefined protocol using systematic and explicit methods to identify, select and appraise relevant studies, and to extract, collate and report their findings.
(4) Accredited filter – allows you limit your search to only those Guidance providers who have been awarded the Accreditation Mark Since 2009, the NICE Accreditation have accredited >70 guidance development processes.
(4) Sources filter – allows you to limit to a particular source
(5) Date filter – you can limit to the last 3 months, the last 6 months, the last year or the last 3 years. NB just because a resource is recent it does not necessarily mean that it is the best one. Remind participants that they should critically appraise all the results they find.

21. Filter results by by source

22. Example search #2
Sharon Barnes, a 35 year-old pregnant lady comes into your clinic that has been recently diagnosed with irritable bowel syndrome. She has read about peppermint oil having beneficial effects in a ‘Women’s Own’ magazine. She wants to know if peppermint oil is a safe and effective treatment for IBS.
What advice can you give her using guidance from NICE Evidence Search?
Keep search simple – search on: Patient (Person) / Problem and intervention or therapy. Suggested search: pregnant ibs peppermint oil NOTE abbreviation ibs and full term will be automatically searched for. As you’ll see full term – irritable bowel syndrome is highlighted in your search results.

23. Results filtered by Guidance
Good immediate relevance with this search that can be checked by filtering by Guidance.

24. Recommendations peppermint oil, ibs, pregnancy - CKS
Accessed Note searching within CKS can help locate where the specific therapy is located. See slide #28 for more information about CKS.

25. Browsing and searching key NICE sources
All these sources are sources on Evidence Search. They are also separately browsable and searchable.

26. NICE Evidence search workshop
Browsing and searching Clinical Knowledge Summaries (CKS)

27. What are Clinical Knowledge Summaries?
Primary care in focus
Structured information inc.
Background information, Goals, Diagnosis,
Management, Prescribing information
Evidence, References
Procured by NICE
Searchable via NICE Evidence Search and as an individual resource
Browsable as an individual resource
Structure
Summary
Have I got the right topic?
How up to date is this topic?
Goals and outcome measures [for this topic]
Background information
Definition Prevalence Risk factors Complications and prognosis
Diagnosis
Management
Prescribing information
Evidence
References

28. Generic example health and social care: goals
Note:
Browse by topic option
Browse by Specialities
Educational slides for some topics with teachers’ notes

29. NICE Evidence search workshop
Browsing and searching NICE Pathways

30. What are NICE pathways?
Graphical presentation of NICE guidance – interactive flowcharts
Bring together related guidance, between and within topics
Link other products – Quality Standards and implementation resources
Provide a useful format for multiple audiences – a network of NICE information
Produced by NICE
Searchable via NICE Evidence search and as an individual resource
Browsable separately

31. NICE Pathways – browse A-Z

32. Domestic violence
About: scope of Pathway with links to source guidance
Resources: additional support materials
Quality standards: set out the priority areas for quality improvement in health and social care. They cover areas where there is variation in care. Each standard contains: a set of statements to help you improve quality information on how to measure progress. They are drawn from NICE Guidance and other accredited Guidance providers

33. Domestic violence and abuse
Further information available from all boxes outlined in teal (dark green) All text version of the guideline available from source guidance. You can also search to find more specific information. If there are results within the pathway, they are shown first. Any results in other pathways are also shown.

34. Domestic violence and abuse

35. NICE Evidence search workshop
Browsing and searching the BNF and BNFc

36. What is the BNF/ BNFc? Key medicine prescribing source
Structured information resource
Updated every month
Procured by NICE
Searchable via NICE Evidence Search and as an individual resource
Browsable by chapter and appendices
The British National Formulary and the British National Formulary for Children provide authoritative and practical information on the selection and clinical use of medicines.

37. Note the new site colour scheme has not yet been added
Note the new site colour scheme has not yet been added. Last checked 13 February Explore – if you know the print version you will find it easy to navigate. Generic drug names are always in CAPITALS. Note:
the helpful A-Z index
Guidance on prescribing
What’s new section
Appendices

39. NICE Evidence search workshop
Additional – browsing NICE Guidance by area

40. Browse NICE Guidance
Click on the NICE Guidance tab. Note range of browse options.

42. Oral and dental health example
Everything NICE has produced on the topic of oral and dental health. Includes related guidelines and NICE Pathways.
Can access NICE Pathways, Quality Standards, work in development Interventional procedures guidance, NICE guidelines, Technology appraisal guidance

43. NICE Guideline example
formats – (1) Web based (2) pdf version download ( print version) (3) NICE Pathway ( graphical representation) Note Evidence supporting this guideline History showing development of this guideline Tools and resources

44. Note range of tools and resources varies according to the guideline topic.

45. NICE Evidence search workshop
Journals and databases links
NB: only licenced for NHS Staff and for students on NHS commissioned undergraduate courses

46. Healthcare databases advanced search (HDAS) These journals and databases licenced. The latter include BNI, CINAHL, EMBASE and Medline. They are for NHS staff or students on placement in the NHS who have an Athens account. NB Pharmacy students are not eligible for NHS Athens accounts because of the way their courses are currently funded. If you work for the NHS in England ask your local Librarian about setting up an Athens account. Note: University Staff and Students without Athens access will be able access key databases via their university licenced accounts.

47. NICE Evidence search workshop
Keeping up to date and apps

48. NICE footer - keeping in touch: some options to explore
Sign in to subscribe to newsletters, register as a stakeholder, comment on consultations. Browse previous newsletters via the NICE webpage footer. Range of Newsletters:
NICE News monthly
Update for Primary Care
Social Care Update
Surveillance report alerts
Evidence Library bulletin.
Note other links to Blogs relating to Guidance, NICE Twitter feed, Facebook and LinkedIn pages See also Guidance App.

49. NICE apps for smartphones and tablets https://www. nice. org
NICE apps for smartphones and tablets smartphones-and-tablets
These apps are available to download for free by health and social care professionals in England, Scotland and Wales.

50. In summary Consider using Evidence Search first:
Whenever you want to find high quality sources especially guidelines, care pathways, systematic reviews and medicines information
When you need a quick answer. It can be a short-cut to high quality, mostly full text resources.
Useful trial, pharmaceutical and statistical data. Links directly to all Cochrane Reviews.
Remember Evidence Search is a developing resource and that you can contribute to its development.

51. Contacting Evidence search
Let us know if you have an enquiry or
suggestion about NICE Evidence search