Transcript Workshop 3: Searching for the evidence

Searching for the Evidence
Workshop
with Diana Blackwood & Sandra Pullman
15th February 2008
Session outcomes
Enhanced 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 literature
e.g. Medline, CINAHL,PsycINFO, AMED. ScienceDirect, Social Work
Abstracts, Proquest, Embase.
Free resources on the web for busy
practitioners
e.g. special tools like TRIP, SUMsearch, Google the Evidence
(SCHARR), PEDRO plus many resource lists, tutorials
Tips for the Cochrane Library
 Remember these are mostly full text reviews
 Not all have subject headings
Try restricting your search words to title,
keywords & abstract
For a “mini” search, limit from PubMed
Medline via the tag 1469-493X[jour]
Joanna Briggs Institute
Searching via “Connect”
Hot search tips for databases
limit by publication type e.g. RCT,
Clinical Trial, Meta-analysis
use study design subject headings
use expert strategies/filters (see your
handouts for CINAHL & MEDLINE)
try the Clinical Queries filter in
PubMed
Examples of “expert” EBP filters
for Medline
DIAGNOSIS
(sensitivity or predictive value).tw.
CAUSE
(risk or cohort).tw. or case-control studies/
THERAPY
clinical trial.pt. or (double blind$ or placebo$).tw.
PROGNOSIS
exp 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
More information?
Many free EBM tutorials and sites on
the Web
See your handout for a list of resources
Ask a librarian for help