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Evidence Based Searching Part 1

Kerry Sullivan, MLIS Health Sciences Librarian March 2011. Evidence Based Searching Part 1. Your hosts Kerry Sullivan Michelle Hajder QUESTIONS? We will have time for Q&A at the end of the session

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Evidence Based Searching Part 1

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  1. Kerry Sullivan, MLIS Health Sciences Librarian March 2011 Evidence Based Searching Part 1

  2. Your hosts • Kerry Sullivan • Michelle Hajder QUESTIONS? • We will have time for Q&A at the end of the session • Expand the Questions window in the GoToWebinar module (usually on the right) and type in your questions for the presenters

  3. GoToWebinar Control Panel 3

  4. Overview • Evidence in practice • Formulating the clinical question • Levels of evidence and quality • Resources for finding evidence

  5. Evidence-Based Medicine (EBM) is defined as: "The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.“ • Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn't. British Medical Journal, 312(7023), 71-72.

  6. The Institute of Medicine (IOM) defines “Evidence-Based Practice" as a combination of the following three factors: (1) best research evidence, (2) best clinical experience, and (3) consistent with patient values • (IOM, 2001; http://www.iom.edu/)

  7. Research • Clinician knowledge • Patient needs

  8. Efficiency! • Asking better questions • Knowing where to look for evidence • Quickly filtering out the noise

  9. Formulating the Question • Defining a clinical question by the specific patient and problem lends itself to effectively finding relevant evidence. • EBP begins and ends with the patient.

  10. Clinical Question Anatomy PICO PICO is a mnemonic that helps one remember the key components of a well focused question. 

  11. PICO • P = Patient, Population or Problem • I = Intervention, Prognostic Factor, or Exposure • C = Comparison (if there is one) • O = Outcome

  12. You are a part of a health policy task force working in conjunction with the public school system to address student obesity & related health risks. They are interested in instituting a program that will raise awareness of health risks for overweight children and inquire about body mass index testing for this purpose.

  13. PICO • P = School age children • I = BMI testing in schools • C = Diet and/or Exercise • O = Diabetes prevention

  14. Our clinical question Do BMI screenings in schools help prevent obesity in children?

  15. Library Guide http://libraryguides.waldenu.edu/healthevidence

  16. Filtered Resources Highest Levels of Evidence • Systematic Reviews / Meta-Analysis • Critically Appraised Topics • Critically Appraised Articles

  17. Systematic Reviews • Cochrane Database of Systematic Reviews • Database of Abstracts of Reviews of Effects • Joanna Briggs Institute

  18. Systematic Reviews What makes them so special? Reliability! • Address a clearly formulated question • Sound methodology with strict guidelines • Updated regularly with oversight

  19. Critically Appraised Topics Synthesized! One page summaries of the evidence from appropriate studies that answer a clinical question and is regularly updated.

  20. Critical Appraisal • Evaluates the methodology (validity) • Provides an interpretation of results • relative risk reduction • absolute risk reduction • number needed to treat Barratt, A., Wyer, P. C., Hatala, R., McGinn, T., Dans, A. L., Keitz, S., Moyer, V., et al. (2004). Tips for learners of evidence-based medicine: 1. Relative risk reduction, absolute risk reduction and number needed to treat. CMAJ, 171(4), 353-358.

  21. Resources • Joanna Briggs Institute Evidence Based Resources • Annual Reviews (Medicine, Public Health Nutrition, etc) • National Guideline Clearinghouse • http://www.guideline.gov • AHRQ Evidence Based Practice • Agency for Healthcare Research & Quality • http://www.ahrq.gov/

  22. Critically Appraised Articles • ACP Journal Club • Bandolier • Evidence Based Journal series • Evidence-Based Medicine, Evidence-Based Nursing, etc. • Evidence Updates • International Journal of Evidence-Based Healthcare

  23. Unfiltered Resources • MEDLINE with Full Text • CINAHL Plus with Full Text • PsycINFO

  24. Trip Database Turning Research Into Practice http://www.tripdatabase.com

  25. Library Guide http://libraryguides.waldenu.edu/healthevidence

  26. Point-of-Care Products • UpToDate http://www.uptodate.com/ • Dynamed http://www.ebscohost.com/dynamed • FirstConsult http://www.mdconsult.com • eMedicine http://www.emedicine.medscape.com

  27. Questions?

  28. ASK – A – LIBRARIAN library@waldenu.edu 800-930-0914 Thank you!

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