1. Where do I get info? GP Update, Ipswich 2006 Kev Hopayian

2. Ethical dimension Evidence informs but cannot dictate practice Decisions should be informed by evidence, guided by expertise, and centered on the values of the patient.

3. Professionalism in communicating evidence Knowledge Problem solving Interpersonal skills Respect

4. The questions we ask Novices Beginning of training, Ask general questions e.g. How do I treat heart failure? e.g. What are benefits of adding sprionolactone or a betablocker to ACE in heart failure? Experts Have acquired experience, Ask specific questions Foreground BackgroundBackground

5. Studies Syntheses Synopses Systems Search for Evidence Primary research e,g. Medline Syntheses e.g. Cochrane e.g Guidelines, computer support systems Notes and commentaries e.g. Bandolier

6. Where to go? Gateway http://www.nelh.nhs. Background http://www.gpnotebook.co.uk/homepage.cfm Foreground

7. Synopses Clinical Evidence +ve growing collection, can “drill down” -ve biased to therapy http://www.nelh.nhs.uk/clinical_evidence.asp Bandolier +ve educational too, good read http://www.jr2.ox.ac.uk/bandolier/ Centre for Reviews and Dissemination Summarises and adds its own commentaries on syntheses (reviews) including Cochrane reviews http://www.york.ac.uk/inst/crd/darehp.htm

8. Syntheses SUMSearch +ve Searches at multiple levels Returns results in heirarchy (reviews, guidelines, systematic reviews, primary studies) http://sumsearch.uthscsa.edu/ PubMed Clinical queries +ve allows you to set sensitivity of search -ve returns non-heirarchical results http://www.ncbi.nlm.nih.gov:80/entrez/query/static/clinical.html

9. Primary studies Not for the faint hearted but definitely the business (you’ll need a password from your librarian) http://nhs.dialog.com/