Searching for the Evidence
Workshop with Diana Blackwood & Sandra Pullman
15th February 2008
Session outcomesEnhanced awareness of the range of
useful EB information sources for health professionals
Increased expertise in searching the mountains of websites and publications to find the best evidence.
EBP – what it really is
Evidence-based practice (EBP) is an approach to decision-making that integrates the best available evidence with clinical expertise and patient values.
Taken from Monash University, Medicine Nursing & Health Sciences www.mihsr.monash.org/cce/ebdm.html
What is the best way to …
manage fever in a child?promote leg ulcer healing in a diabetic?prevent DVTs in post-op patients?assist elderly people to remember to take
their medications at home?screen for prostate cancer?help people stop smoking?
5 steps of EBP decision making
Taken from Monash University, Medicine Nursing & Health Sciences www.mihsr.monash.org/cce/ebdm.html
Levels of evidence
Systematic reviews, or meta-analysis of multiple controlled studies
Individual experimental study Individual quasi-experimental study Systematic review of multiple non-experimental studies Individual non-experimental study (includes qualitative) Case report, or systematically obtained, verifiable
quality/programme evaluation data Respected authorities/Expert committees “Someone told me about it”
Adapted from Clinical Practice Model Resource Centre
How do I start?Secondary sources - expert summaries
e.g. Cochrane Library, Joanna Briggs, clinical practice guidelines, NICE, NICS, CATbank, Bandolier, Best Evidence & other commentary journals, Dynamed, Nursing Reference Center, BMJ Clinical Evidence
Primary sources - journal literaturee.g. Medline, CINAHL,PsycINFO, AMED. ScienceDirect, Social Work Abstracts,
Proquest, Embase.
Free resources on the web for busy practitionerse.g. special tools like TRIP, SUMsearch, Google the Evidence (SCHARR),
PEDRO plus many resource lists, tutorials
Remember these are mostly full text reviews Not all have subject headingsTry restricting your search words to title,
keywords & abstractFor a “mini” search, limit from PubMed
Medline via the tag 1469-493X[jour]
Tips for the Cochrane Library
Joanna Briggs Institute
Searching via “Connect”
limit by publication type e.g. RCT, Clinical Trial, Meta-analysis
use study design subject headingsuse expert strategies/filters (see your
handouts for CINAHL & MEDLINE)try the Clinical Queries filter in
PubMed
Hot search tips for databases
Examples of “expert” EBP filters for Medline
DIAGNOSIS(sensitivity or predictive value).tw.
CAUSE (risk or cohort).tw. or case-control studies/
THERAPYclinical trial.pt. or (double blind$ or placebo$).tw.
PROGNOSISexp cohort studies/ or prognosis/ or survival analysis/
N.B. available via automatic filtering on PubMed
Clinical queries link at PubMed -www.pubmed.gov
Tools for the busy practitioner
TRIP (Turning Research into Practice) www.tripdatabase.com
Google the Evidence (SCHARR) http://tinyurl.com/2poh3a
Evidence Australia (Royal Melbourne Hospital) http://mh1.mh.org.au/library/eds/ea.htm
SUMSearch http://sumsearch.uthscsa.edu/
CATbank http://cebm.jr2.ox.ac.uk/docs/catbank.html
Many free EBM tutorials and sites on the Web
See your handout for a list of resourcesAsk a librarian for help
More information?
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