Transcript Evidence on the run

When the evidence is needed quickly
by
Terence M Harrison
Clinical Librarian, RMH Health Sciences Library
The six steps
1.
2.
3.
4.
5.
6.
Formulate your query
Check your terms
Select sources
Carry out searches
Evaluate results
Turn evidence into practice
1. Formulate your query
• Patient
• Intervention
• Comparisons
• Outcomes
• adult with occult
pneumothorax
• chest tubes/catheters
for 24 hours
• conservative
management or
observation
• reduced morbidity
after positive pressure
ventilation
2. Check your terms (via MeSH)
3. Select sources*
• Top-level evidence sources (e.g. Cochrane,
PubMed Clinical queries, etc)
• Evidence Summaries
• Guidelines (local, national, international)
• Drugs info speciality sites
* Note: for more extensive searching, see longer list of
sources listed on Evidence Direct website.
Examples of Evidence
Summaries
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Cochrane*
Clinical Evidence
ACP Journal Club
Best Bets
Up-to-Date
Bandolier
Trip (summaries etc via meta-search engine)
* Summaries in Database of Abstracts of Reviews of Effects, Central Register of
Controlled Trials, HTA Database, Economic Evaluation Database
5a. Evaluate results
• Cochrane concluded that
patients with occult
pneumothorax who require
positive pressure ventilation
should undergo tube
thoracostomy.
• Clinical Evidence found no
RCTs comparing chest tube
drainage versus observation.
• Best Bets found no harm in
observation only.
• Trip came up with a handful of
results, the most relevant being
the one from Best Bets
• Evidence level: 1b
• Evidence level: 1a*
• Evidence level: 1a*
• Evidence level: 1a*
* Evidence levels for Evidence Summaries are assessed individually
and depend on extent of research involved and sources quoted.
5b. Summarise results
The evidence demonstrated that while
there is no harm in observation, if a
patient does require positive pressure
ventilation then a tube thoracostomy
will be needed.
6. Turn evidence into practice
• Apply results to practice
• Order via Inter-Library Loan the full-text
versions of search results
• Add results to a local (departmental)
database of searches
• Contribute results to RMH Guidelines