1. Internet Resources PubMed/Clinical Queries PubMed/Filters Additional Resources

2. (HINARI) PubMed Conduct systematic reviews of the literature Limit to specific populations & publication types Utilize EBM built-in filtersbuilt-in filters Set up and distribute alerts relating to evidence-based medicine

3. We now search for evidence-based articles using PubMed. From the main HINARI webpage, go to PubMed by clicking on Search inside HINARI full- text using PubMed. Remember you must login to HINARI to have access to the full-text articles.

4. 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.

5. On the PubMed Clinical Queries page, we have entered the pregnancy pregnancy complications AND developing countries search.

6. 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 1357 articles for Therapy: Broad and 165 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 http://www.ncbi.nlm.nih.gov/pubmed/clinical

7. For the Scope option, we will enter Narrow and for the same pregnancy complications AND developing countries search.

8. The Therapy (Category) and Narrow (Scope) pregnancy complications AND developing countries search has resulted in 145 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.

9. We have displayed all 145 articles for this search including 80 HINARI and 80 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.

10. 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 pregnancy complications AND developing countries AND systematic [sb] search resulted in 165 articles.

11. Another tool from PubMed is using the Filters option – see the left-column. In the Article types filter list, click on Customize. Check the boxes for Meta-Analysis, Randomized Control Trial and Systematic Reviews Article types. Finally, click on the Show box. Filters can be activated from any search results page. Remember to clear them before beginning other searches.

12. Note how the various Filters have been displayed under the Article types list. You now can use of the filters with the hypertension AND diet search.

13. We have checked the Meta-Analysis box in the Article types section and entered hypertension AND diet in the PubMed Search box. The search Results number is 86. Note the Filters activated: Meta- Analysis line below the Results number.

14. Now displayed are the results of a hypertension AND diet search with the Systematic Reviews Article types filter activated. The citations for this search include 109 Free Full text and 167 HINARI articles.

15. Now displayed are the results of a hypertension AND diet search with the Randomized Controlled Trial Article types filter activated. The citations for this search include 371 Free Full text and 689 HINARI articles.

16. The final displayed search are the results of a hypertension AND diet search with the Meta-Analysis, Systematic Reviews and Randomized Controlled Trial Article types filters activated. The citations for this search total 1598. Remember to clear the filters.

17. From the Contents drop down menu, access PubMed Health’s information in the following categories: For consumers, DARE Reviews, Executive summaries, Clinical guides, Full text reviews, Methods resources, and Drugs A-Z. PubMed Health provides information for consumers and clinicians on prevention and treatment of diseases and conditions. It specializes in reviews of clinical effectiveness research, with easy-to-read summaries for consumers as well as full technical reports. Additional Evidence-based Health Resources

18. To learn more about EBM, go to the online tutorial Introduction to Evidence-Based Medicine from the Health Sciences Library, University of North Carolina (USA):

19. Trip Database www.tripdatabase.com/ Evidence Updates - BMJ and McMaster University plus.mcmaster.ca/evidenceupdates/ Knowledge Translation Learning Modules – Canadian Institutes of Health Research www.cihr-irsc.gc.ca/e/39128.html Additional Evidence-based Health Resources continued

20. Bandolier Knowledge: Oxford University www.medicine.ox.ac.uk/bandolier/knowledge.html The Campbell Library www.campbellcollaboration.org/library www.campbellcollaboration.org/library University of York: Center for Reviews and Dissemination www.crd.york.ac.uk/crdweb/www.crd.york.ac.uk/crdweb/ EBM Librarian https://sites.google.com/site/ebmlibrarian/

21. McMaster PLUS collection hiru.mcmaster.ca/hiru/HIRU_McMaster_PLUS_proje cts.aspx hiru.mcmaster.ca/hiru/HIRU_McMaster_PLUS_proje cts.aspx National Guidelines Clearinghouse www.guideline.gov/ Grey Matters: a practical search tool for evidence- based medicine http://www.cadth.ca/en/resources/finding-evidence- is/grey-matters

22. Additional Clinical Practice Guidelines resources National Guideline Clearinghouse (USA) www.guideline.gov/ Open Clinical: Clinical Practice Guidelines www.openclinical.org/guidelines.html

23. Review: 5 Steps to evidence-based health care Step 1 Ask: Formulate your question foreground clinical question PICO format population, intervention, comparison intervention, outcome Step 2 Access: Search for the evidence – highest quality studies are included in a systematic review types of studies evidence hierarchies

24. Step 3: Appraise the evidence - use criteria to evaluate the studies for: validity (internal & external) impact Step 4 Apply: Put the evidence into practice patient setting Step 5: Assess progress and performance patient yourself

25. This is the end of HINARI Module 6 There is a Work Book to accompany this part of the module. The workbook will take you through a live session covering the topics included in this demonstration with working examples. Updated 2015 10