an introduction to ebm for health librarians
TRANSCRIPT
ldquoHealth librarians amp expert searching emerging roles in an evidence-based erardquo
Dean Giustini UBC librarian October 2014
Expert searcher teacher hellipOR a researcher (will you aim to be one of these experts OR all three)
What is evidence-based medicine
ldquohellipevidence-based medicine (EBM) is the conscientious explicit amp judicious use of current best evidence in making
decisions about the care of individual patientsrdquo
Sackett et al BMJ 199631271-72
Dr David Sackett
Landmark article in 1992 JAMAGuyatt G Cairns J et al (McMaster University)
JAMA 1993 ndash 2000ldquoUsers Guides to the Medical Literaturerdquo
Last 15 years three (3) trends Explosion of systematic reviews
Rise of search engines eg Google Scholar
Knowledge distillation amp ldquopushrdquo 20 services
EBM ndash a glance back 20 years
EBM integrates evidence with care
hellipevidence should always integrate with clinical expertise amp preferences values amp circumstances of patients amp families
Patient ValuesLocal Conditions
Best Evidence
Clinical Expertise
bull Background questions require use of background information
bull Foreground questions are asked by experts
bull Answers are found by searching the biomedical databases
Is it background hellipor foreground
Five Steps of EBM
The five steps
bull Step 1 mdash Frame your clinical question
bull Step 2 mdash Find the ldquobest evidencerdquo
bull Step 3 mdash Critically appraise that evidence
bull Step 4 mdash Integrate best evidence into practice
bull Step 5 mdash Evaluate steps 1-4
Ask
Access
Appraise
Assess
Apply
Use PICO to frame foreground
QsP = Patient Can you describe the patient or problem
I = Intervention What main intervention (or treatment) will be considered
C = ComparisonDo you want a placebo comparison or drug comparison
O = OutcomeWhat is the desired outcome or effect for the patient
Is equal to
Relevance of information X validityEffortwork required
Health librarians have two (2) options Find relevant information for physician (they determine its value)
Find authoritative sources that do the finding validating for clinician
Usefulness of medical information
MOST clinically relevant (at the top) Least clinically relevant (at the bottom)
Hierarchy of Evidence Tr
acki
ng
Do
wn
Filtered amp Critically Appraised
Expert Opinion Not Filtered
Background info
Valid
ityStren
gth o
f Inferen
ce
Time Sp
ent in
Critical A
pp
raisal
Hierarchy of Evidence find evidence at level for clinician
Where is ALL the evidence
SYSTEMATIC REVIEWS
bull Cochrane Library via OvidSP
bull PubMed Clinical Queries Haynes filters
CLINICAL PRACTICE GUIDELINES
bull National Guideline Clearinghouse (US)
bull Canadian Medical Association Infobase
RESEARCH CRITIQUES
bull ACP Journal Club 1996-
bull Bandolier 1994- amp BestBETs
EVIDENCE SUMMARIES
bull BMJ Clinical Evidence amp FirstConsult
bull UpToDate
META-SEARCH ENGINESbull TRIP+ amp SUMSearch
P = Patient population or problem (Who is the patient or population of patients What is the disease)
I = Intervention (What do you want to do with this patient eg treat diagnose observe)
C = Comparison intervention (What is the alternative to intervention eg placebo different drug nothing)
O = Outcome (What are the relevant outcomes (eg morbidity mortality death complications)
PICO frames the information need
bull Defines a clinical scenario
bull Prepare you to search
bull Places focus on patient-centered questions
bull Developing a clinical question using PICO requiresbull some background about the condition
bull some understanding the patient
bull outcomes amp beliefs important to the patient
bull Prognosisndash Disability Quality of life Cost Improvement of symptoms
Why use PICO
bull Search via OvidSP
bull Includes all Cochrane topic reviews ldquoCochrane Libraryrdquo
bull Includes clinical trials register
bull Articles reviewed in ACP Journal Club or BMJ Evidence-Based Medicine
bull Papers in Database of Abstracts of Reviews of Effectiveness (DARE)
bull Studies in DARE meet strict EBM scoring criteria
Uses ldquoKeywordsrdquo to search OvidSPrsquos EBMRUBC library access httpresourceslibraryubcca644
EBM Reviews (meta-search)
Cochrane Database of Systematic Reviews
bull Search via OvidSP
bull Independent non-for-profit international collaboration
bull Reviews are among studies of highest scientific evidence
bull Minimal bias evidence includedexcluded on basis of explicit criteria
bull Reviews involve exhaustive searching for studies amp clinical trials both published and unpublished
bull Abstracts are available for free consumer summaries are free also
UBC library access httpresourceslibraryubcca231
Uses ldquoKeywordsrdquo to search Cochrane hellip
Database of Abstracts of Reviews of Effects (DARE)
bull Search via OvidSP
bull Produced by the National Health Services Centre for Reviews and Dissemination (NHS CRD) at the University of York England
bull DARE is a full text database containing critical assessments of systematic reviews from a variety of medical journals
bull DARE contains structured abstracts of systematic reviews
bull Its records cover topics such as diagnosis prevention rehabilitation screening and treatment
UBC library access httpresourceslibraryubcca489
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
What is evidence-based medicine
ldquohellipevidence-based medicine (EBM) is the conscientious explicit amp judicious use of current best evidence in making
decisions about the care of individual patientsrdquo
Sackett et al BMJ 199631271-72
Dr David Sackett
Landmark article in 1992 JAMAGuyatt G Cairns J et al (McMaster University)
JAMA 1993 ndash 2000ldquoUsers Guides to the Medical Literaturerdquo
Last 15 years three (3) trends Explosion of systematic reviews
Rise of search engines eg Google Scholar
Knowledge distillation amp ldquopushrdquo 20 services
EBM ndash a glance back 20 years
EBM integrates evidence with care
hellipevidence should always integrate with clinical expertise amp preferences values amp circumstances of patients amp families
Patient ValuesLocal Conditions
Best Evidence
Clinical Expertise
bull Background questions require use of background information
bull Foreground questions are asked by experts
bull Answers are found by searching the biomedical databases
Is it background hellipor foreground
Five Steps of EBM
The five steps
bull Step 1 mdash Frame your clinical question
bull Step 2 mdash Find the ldquobest evidencerdquo
bull Step 3 mdash Critically appraise that evidence
bull Step 4 mdash Integrate best evidence into practice
bull Step 5 mdash Evaluate steps 1-4
Ask
Access
Appraise
Assess
Apply
Use PICO to frame foreground
QsP = Patient Can you describe the patient or problem
I = Intervention What main intervention (or treatment) will be considered
C = ComparisonDo you want a placebo comparison or drug comparison
O = OutcomeWhat is the desired outcome or effect for the patient
Is equal to
Relevance of information X validityEffortwork required
Health librarians have two (2) options Find relevant information for physician (they determine its value)
Find authoritative sources that do the finding validating for clinician
Usefulness of medical information
MOST clinically relevant (at the top) Least clinically relevant (at the bottom)
Hierarchy of Evidence Tr
acki
ng
Do
wn
Filtered amp Critically Appraised
Expert Opinion Not Filtered
Background info
Valid
ityStren
gth o
f Inferen
ce
Time Sp
ent in
Critical A
pp
raisal
Hierarchy of Evidence find evidence at level for clinician
Where is ALL the evidence
SYSTEMATIC REVIEWS
bull Cochrane Library via OvidSP
bull PubMed Clinical Queries Haynes filters
CLINICAL PRACTICE GUIDELINES
bull National Guideline Clearinghouse (US)
bull Canadian Medical Association Infobase
RESEARCH CRITIQUES
bull ACP Journal Club 1996-
bull Bandolier 1994- amp BestBETs
EVIDENCE SUMMARIES
bull BMJ Clinical Evidence amp FirstConsult
bull UpToDate
META-SEARCH ENGINESbull TRIP+ amp SUMSearch
P = Patient population or problem (Who is the patient or population of patients What is the disease)
I = Intervention (What do you want to do with this patient eg treat diagnose observe)
C = Comparison intervention (What is the alternative to intervention eg placebo different drug nothing)
O = Outcome (What are the relevant outcomes (eg morbidity mortality death complications)
PICO frames the information need
bull Defines a clinical scenario
bull Prepare you to search
bull Places focus on patient-centered questions
bull Developing a clinical question using PICO requiresbull some background about the condition
bull some understanding the patient
bull outcomes amp beliefs important to the patient
bull Prognosisndash Disability Quality of life Cost Improvement of symptoms
Why use PICO
bull Search via OvidSP
bull Includes all Cochrane topic reviews ldquoCochrane Libraryrdquo
bull Includes clinical trials register
bull Articles reviewed in ACP Journal Club or BMJ Evidence-Based Medicine
bull Papers in Database of Abstracts of Reviews of Effectiveness (DARE)
bull Studies in DARE meet strict EBM scoring criteria
Uses ldquoKeywordsrdquo to search OvidSPrsquos EBMRUBC library access httpresourceslibraryubcca644
EBM Reviews (meta-search)
Cochrane Database of Systematic Reviews
bull Search via OvidSP
bull Independent non-for-profit international collaboration
bull Reviews are among studies of highest scientific evidence
bull Minimal bias evidence includedexcluded on basis of explicit criteria
bull Reviews involve exhaustive searching for studies amp clinical trials both published and unpublished
bull Abstracts are available for free consumer summaries are free also
UBC library access httpresourceslibraryubcca231
Uses ldquoKeywordsrdquo to search Cochrane hellip
Database of Abstracts of Reviews of Effects (DARE)
bull Search via OvidSP
bull Produced by the National Health Services Centre for Reviews and Dissemination (NHS CRD) at the University of York England
bull DARE is a full text database containing critical assessments of systematic reviews from a variety of medical journals
bull DARE contains structured abstracts of systematic reviews
bull Its records cover topics such as diagnosis prevention rehabilitation screening and treatment
UBC library access httpresourceslibraryubcca489
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
Landmark article in 1992 JAMAGuyatt G Cairns J et al (McMaster University)
JAMA 1993 ndash 2000ldquoUsers Guides to the Medical Literaturerdquo
Last 15 years three (3) trends Explosion of systematic reviews
Rise of search engines eg Google Scholar
Knowledge distillation amp ldquopushrdquo 20 services
EBM ndash a glance back 20 years
EBM integrates evidence with care
hellipevidence should always integrate with clinical expertise amp preferences values amp circumstances of patients amp families
Patient ValuesLocal Conditions
Best Evidence
Clinical Expertise
bull Background questions require use of background information
bull Foreground questions are asked by experts
bull Answers are found by searching the biomedical databases
Is it background hellipor foreground
Five Steps of EBM
The five steps
bull Step 1 mdash Frame your clinical question
bull Step 2 mdash Find the ldquobest evidencerdquo
bull Step 3 mdash Critically appraise that evidence
bull Step 4 mdash Integrate best evidence into practice
bull Step 5 mdash Evaluate steps 1-4
Ask
Access
Appraise
Assess
Apply
Use PICO to frame foreground
QsP = Patient Can you describe the patient or problem
I = Intervention What main intervention (or treatment) will be considered
C = ComparisonDo you want a placebo comparison or drug comparison
O = OutcomeWhat is the desired outcome or effect for the patient
Is equal to
Relevance of information X validityEffortwork required
Health librarians have two (2) options Find relevant information for physician (they determine its value)
Find authoritative sources that do the finding validating for clinician
Usefulness of medical information
MOST clinically relevant (at the top) Least clinically relevant (at the bottom)
Hierarchy of Evidence Tr
acki
ng
Do
wn
Filtered amp Critically Appraised
Expert Opinion Not Filtered
Background info
Valid
ityStren
gth o
f Inferen
ce
Time Sp
ent in
Critical A
pp
raisal
Hierarchy of Evidence find evidence at level for clinician
Where is ALL the evidence
SYSTEMATIC REVIEWS
bull Cochrane Library via OvidSP
bull PubMed Clinical Queries Haynes filters
CLINICAL PRACTICE GUIDELINES
bull National Guideline Clearinghouse (US)
bull Canadian Medical Association Infobase
RESEARCH CRITIQUES
bull ACP Journal Club 1996-
bull Bandolier 1994- amp BestBETs
EVIDENCE SUMMARIES
bull BMJ Clinical Evidence amp FirstConsult
bull UpToDate
META-SEARCH ENGINESbull TRIP+ amp SUMSearch
P = Patient population or problem (Who is the patient or population of patients What is the disease)
I = Intervention (What do you want to do with this patient eg treat diagnose observe)
C = Comparison intervention (What is the alternative to intervention eg placebo different drug nothing)
O = Outcome (What are the relevant outcomes (eg morbidity mortality death complications)
PICO frames the information need
bull Defines a clinical scenario
bull Prepare you to search
bull Places focus on patient-centered questions
bull Developing a clinical question using PICO requiresbull some background about the condition
bull some understanding the patient
bull outcomes amp beliefs important to the patient
bull Prognosisndash Disability Quality of life Cost Improvement of symptoms
Why use PICO
bull Search via OvidSP
bull Includes all Cochrane topic reviews ldquoCochrane Libraryrdquo
bull Includes clinical trials register
bull Articles reviewed in ACP Journal Club or BMJ Evidence-Based Medicine
bull Papers in Database of Abstracts of Reviews of Effectiveness (DARE)
bull Studies in DARE meet strict EBM scoring criteria
Uses ldquoKeywordsrdquo to search OvidSPrsquos EBMRUBC library access httpresourceslibraryubcca644
EBM Reviews (meta-search)
Cochrane Database of Systematic Reviews
bull Search via OvidSP
bull Independent non-for-profit international collaboration
bull Reviews are among studies of highest scientific evidence
bull Minimal bias evidence includedexcluded on basis of explicit criteria
bull Reviews involve exhaustive searching for studies amp clinical trials both published and unpublished
bull Abstracts are available for free consumer summaries are free also
UBC library access httpresourceslibraryubcca231
Uses ldquoKeywordsrdquo to search Cochrane hellip
Database of Abstracts of Reviews of Effects (DARE)
bull Search via OvidSP
bull Produced by the National Health Services Centre for Reviews and Dissemination (NHS CRD) at the University of York England
bull DARE is a full text database containing critical assessments of systematic reviews from a variety of medical journals
bull DARE contains structured abstracts of systematic reviews
bull Its records cover topics such as diagnosis prevention rehabilitation screening and treatment
UBC library access httpresourceslibraryubcca489
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
EBM integrates evidence with care
hellipevidence should always integrate with clinical expertise amp preferences values amp circumstances of patients amp families
Patient ValuesLocal Conditions
Best Evidence
Clinical Expertise
bull Background questions require use of background information
bull Foreground questions are asked by experts
bull Answers are found by searching the biomedical databases
Is it background hellipor foreground
Five Steps of EBM
The five steps
bull Step 1 mdash Frame your clinical question
bull Step 2 mdash Find the ldquobest evidencerdquo
bull Step 3 mdash Critically appraise that evidence
bull Step 4 mdash Integrate best evidence into practice
bull Step 5 mdash Evaluate steps 1-4
Ask
Access
Appraise
Assess
Apply
Use PICO to frame foreground
QsP = Patient Can you describe the patient or problem
I = Intervention What main intervention (or treatment) will be considered
C = ComparisonDo you want a placebo comparison or drug comparison
O = OutcomeWhat is the desired outcome or effect for the patient
Is equal to
Relevance of information X validityEffortwork required
Health librarians have two (2) options Find relevant information for physician (they determine its value)
Find authoritative sources that do the finding validating for clinician
Usefulness of medical information
MOST clinically relevant (at the top) Least clinically relevant (at the bottom)
Hierarchy of Evidence Tr
acki
ng
Do
wn
Filtered amp Critically Appraised
Expert Opinion Not Filtered
Background info
Valid
ityStren
gth o
f Inferen
ce
Time Sp
ent in
Critical A
pp
raisal
Hierarchy of Evidence find evidence at level for clinician
Where is ALL the evidence
SYSTEMATIC REVIEWS
bull Cochrane Library via OvidSP
bull PubMed Clinical Queries Haynes filters
CLINICAL PRACTICE GUIDELINES
bull National Guideline Clearinghouse (US)
bull Canadian Medical Association Infobase
RESEARCH CRITIQUES
bull ACP Journal Club 1996-
bull Bandolier 1994- amp BestBETs
EVIDENCE SUMMARIES
bull BMJ Clinical Evidence amp FirstConsult
bull UpToDate
META-SEARCH ENGINESbull TRIP+ amp SUMSearch
P = Patient population or problem (Who is the patient or population of patients What is the disease)
I = Intervention (What do you want to do with this patient eg treat diagnose observe)
C = Comparison intervention (What is the alternative to intervention eg placebo different drug nothing)
O = Outcome (What are the relevant outcomes (eg morbidity mortality death complications)
PICO frames the information need
bull Defines a clinical scenario
bull Prepare you to search
bull Places focus on patient-centered questions
bull Developing a clinical question using PICO requiresbull some background about the condition
bull some understanding the patient
bull outcomes amp beliefs important to the patient
bull Prognosisndash Disability Quality of life Cost Improvement of symptoms
Why use PICO
bull Search via OvidSP
bull Includes all Cochrane topic reviews ldquoCochrane Libraryrdquo
bull Includes clinical trials register
bull Articles reviewed in ACP Journal Club or BMJ Evidence-Based Medicine
bull Papers in Database of Abstracts of Reviews of Effectiveness (DARE)
bull Studies in DARE meet strict EBM scoring criteria
Uses ldquoKeywordsrdquo to search OvidSPrsquos EBMRUBC library access httpresourceslibraryubcca644
EBM Reviews (meta-search)
Cochrane Database of Systematic Reviews
bull Search via OvidSP
bull Independent non-for-profit international collaboration
bull Reviews are among studies of highest scientific evidence
bull Minimal bias evidence includedexcluded on basis of explicit criteria
bull Reviews involve exhaustive searching for studies amp clinical trials both published and unpublished
bull Abstracts are available for free consumer summaries are free also
UBC library access httpresourceslibraryubcca231
Uses ldquoKeywordsrdquo to search Cochrane hellip
Database of Abstracts of Reviews of Effects (DARE)
bull Search via OvidSP
bull Produced by the National Health Services Centre for Reviews and Dissemination (NHS CRD) at the University of York England
bull DARE is a full text database containing critical assessments of systematic reviews from a variety of medical journals
bull DARE contains structured abstracts of systematic reviews
bull Its records cover topics such as diagnosis prevention rehabilitation screening and treatment
UBC library access httpresourceslibraryubcca489
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
bull Background questions require use of background information
bull Foreground questions are asked by experts
bull Answers are found by searching the biomedical databases
Is it background hellipor foreground
Five Steps of EBM
The five steps
bull Step 1 mdash Frame your clinical question
bull Step 2 mdash Find the ldquobest evidencerdquo
bull Step 3 mdash Critically appraise that evidence
bull Step 4 mdash Integrate best evidence into practice
bull Step 5 mdash Evaluate steps 1-4
Ask
Access
Appraise
Assess
Apply
Use PICO to frame foreground
QsP = Patient Can you describe the patient or problem
I = Intervention What main intervention (or treatment) will be considered
C = ComparisonDo you want a placebo comparison or drug comparison
O = OutcomeWhat is the desired outcome or effect for the patient
Is equal to
Relevance of information X validityEffortwork required
Health librarians have two (2) options Find relevant information for physician (they determine its value)
Find authoritative sources that do the finding validating for clinician
Usefulness of medical information
MOST clinically relevant (at the top) Least clinically relevant (at the bottom)
Hierarchy of Evidence Tr
acki
ng
Do
wn
Filtered amp Critically Appraised
Expert Opinion Not Filtered
Background info
Valid
ityStren
gth o
f Inferen
ce
Time Sp
ent in
Critical A
pp
raisal
Hierarchy of Evidence find evidence at level for clinician
Where is ALL the evidence
SYSTEMATIC REVIEWS
bull Cochrane Library via OvidSP
bull PubMed Clinical Queries Haynes filters
CLINICAL PRACTICE GUIDELINES
bull National Guideline Clearinghouse (US)
bull Canadian Medical Association Infobase
RESEARCH CRITIQUES
bull ACP Journal Club 1996-
bull Bandolier 1994- amp BestBETs
EVIDENCE SUMMARIES
bull BMJ Clinical Evidence amp FirstConsult
bull UpToDate
META-SEARCH ENGINESbull TRIP+ amp SUMSearch
P = Patient population or problem (Who is the patient or population of patients What is the disease)
I = Intervention (What do you want to do with this patient eg treat diagnose observe)
C = Comparison intervention (What is the alternative to intervention eg placebo different drug nothing)
O = Outcome (What are the relevant outcomes (eg morbidity mortality death complications)
PICO frames the information need
bull Defines a clinical scenario
bull Prepare you to search
bull Places focus on patient-centered questions
bull Developing a clinical question using PICO requiresbull some background about the condition
bull some understanding the patient
bull outcomes amp beliefs important to the patient
bull Prognosisndash Disability Quality of life Cost Improvement of symptoms
Why use PICO
bull Search via OvidSP
bull Includes all Cochrane topic reviews ldquoCochrane Libraryrdquo
bull Includes clinical trials register
bull Articles reviewed in ACP Journal Club or BMJ Evidence-Based Medicine
bull Papers in Database of Abstracts of Reviews of Effectiveness (DARE)
bull Studies in DARE meet strict EBM scoring criteria
Uses ldquoKeywordsrdquo to search OvidSPrsquos EBMRUBC library access httpresourceslibraryubcca644
EBM Reviews (meta-search)
Cochrane Database of Systematic Reviews
bull Search via OvidSP
bull Independent non-for-profit international collaboration
bull Reviews are among studies of highest scientific evidence
bull Minimal bias evidence includedexcluded on basis of explicit criteria
bull Reviews involve exhaustive searching for studies amp clinical trials both published and unpublished
bull Abstracts are available for free consumer summaries are free also
UBC library access httpresourceslibraryubcca231
Uses ldquoKeywordsrdquo to search Cochrane hellip
Database of Abstracts of Reviews of Effects (DARE)
bull Search via OvidSP
bull Produced by the National Health Services Centre for Reviews and Dissemination (NHS CRD) at the University of York England
bull DARE is a full text database containing critical assessments of systematic reviews from a variety of medical journals
bull DARE contains structured abstracts of systematic reviews
bull Its records cover topics such as diagnosis prevention rehabilitation screening and treatment
UBC library access httpresourceslibraryubcca489
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
Five Steps of EBM
The five steps
bull Step 1 mdash Frame your clinical question
bull Step 2 mdash Find the ldquobest evidencerdquo
bull Step 3 mdash Critically appraise that evidence
bull Step 4 mdash Integrate best evidence into practice
bull Step 5 mdash Evaluate steps 1-4
Ask
Access
Appraise
Assess
Apply
Use PICO to frame foreground
QsP = Patient Can you describe the patient or problem
I = Intervention What main intervention (or treatment) will be considered
C = ComparisonDo you want a placebo comparison or drug comparison
O = OutcomeWhat is the desired outcome or effect for the patient
Is equal to
Relevance of information X validityEffortwork required
Health librarians have two (2) options Find relevant information for physician (they determine its value)
Find authoritative sources that do the finding validating for clinician
Usefulness of medical information
MOST clinically relevant (at the top) Least clinically relevant (at the bottom)
Hierarchy of Evidence Tr
acki
ng
Do
wn
Filtered amp Critically Appraised
Expert Opinion Not Filtered
Background info
Valid
ityStren
gth o
f Inferen
ce
Time Sp
ent in
Critical A
pp
raisal
Hierarchy of Evidence find evidence at level for clinician
Where is ALL the evidence
SYSTEMATIC REVIEWS
bull Cochrane Library via OvidSP
bull PubMed Clinical Queries Haynes filters
CLINICAL PRACTICE GUIDELINES
bull National Guideline Clearinghouse (US)
bull Canadian Medical Association Infobase
RESEARCH CRITIQUES
bull ACP Journal Club 1996-
bull Bandolier 1994- amp BestBETs
EVIDENCE SUMMARIES
bull BMJ Clinical Evidence amp FirstConsult
bull UpToDate
META-SEARCH ENGINESbull TRIP+ amp SUMSearch
P = Patient population or problem (Who is the patient or population of patients What is the disease)
I = Intervention (What do you want to do with this patient eg treat diagnose observe)
C = Comparison intervention (What is the alternative to intervention eg placebo different drug nothing)
O = Outcome (What are the relevant outcomes (eg morbidity mortality death complications)
PICO frames the information need
bull Defines a clinical scenario
bull Prepare you to search
bull Places focus on patient-centered questions
bull Developing a clinical question using PICO requiresbull some background about the condition
bull some understanding the patient
bull outcomes amp beliefs important to the patient
bull Prognosisndash Disability Quality of life Cost Improvement of symptoms
Why use PICO
bull Search via OvidSP
bull Includes all Cochrane topic reviews ldquoCochrane Libraryrdquo
bull Includes clinical trials register
bull Articles reviewed in ACP Journal Club or BMJ Evidence-Based Medicine
bull Papers in Database of Abstracts of Reviews of Effectiveness (DARE)
bull Studies in DARE meet strict EBM scoring criteria
Uses ldquoKeywordsrdquo to search OvidSPrsquos EBMRUBC library access httpresourceslibraryubcca644
EBM Reviews (meta-search)
Cochrane Database of Systematic Reviews
bull Search via OvidSP
bull Independent non-for-profit international collaboration
bull Reviews are among studies of highest scientific evidence
bull Minimal bias evidence includedexcluded on basis of explicit criteria
bull Reviews involve exhaustive searching for studies amp clinical trials both published and unpublished
bull Abstracts are available for free consumer summaries are free also
UBC library access httpresourceslibraryubcca231
Uses ldquoKeywordsrdquo to search Cochrane hellip
Database of Abstracts of Reviews of Effects (DARE)
bull Search via OvidSP
bull Produced by the National Health Services Centre for Reviews and Dissemination (NHS CRD) at the University of York England
bull DARE is a full text database containing critical assessments of systematic reviews from a variety of medical journals
bull DARE contains structured abstracts of systematic reviews
bull Its records cover topics such as diagnosis prevention rehabilitation screening and treatment
UBC library access httpresourceslibraryubcca489
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
Use PICO to frame foreground
QsP = Patient Can you describe the patient or problem
I = Intervention What main intervention (or treatment) will be considered
C = ComparisonDo you want a placebo comparison or drug comparison
O = OutcomeWhat is the desired outcome or effect for the patient
Is equal to
Relevance of information X validityEffortwork required
Health librarians have two (2) options Find relevant information for physician (they determine its value)
Find authoritative sources that do the finding validating for clinician
Usefulness of medical information
MOST clinically relevant (at the top) Least clinically relevant (at the bottom)
Hierarchy of Evidence Tr
acki
ng
Do
wn
Filtered amp Critically Appraised
Expert Opinion Not Filtered
Background info
Valid
ityStren
gth o
f Inferen
ce
Time Sp
ent in
Critical A
pp
raisal
Hierarchy of Evidence find evidence at level for clinician
Where is ALL the evidence
SYSTEMATIC REVIEWS
bull Cochrane Library via OvidSP
bull PubMed Clinical Queries Haynes filters
CLINICAL PRACTICE GUIDELINES
bull National Guideline Clearinghouse (US)
bull Canadian Medical Association Infobase
RESEARCH CRITIQUES
bull ACP Journal Club 1996-
bull Bandolier 1994- amp BestBETs
EVIDENCE SUMMARIES
bull BMJ Clinical Evidence amp FirstConsult
bull UpToDate
META-SEARCH ENGINESbull TRIP+ amp SUMSearch
P = Patient population or problem (Who is the patient or population of patients What is the disease)
I = Intervention (What do you want to do with this patient eg treat diagnose observe)
C = Comparison intervention (What is the alternative to intervention eg placebo different drug nothing)
O = Outcome (What are the relevant outcomes (eg morbidity mortality death complications)
PICO frames the information need
bull Defines a clinical scenario
bull Prepare you to search
bull Places focus on patient-centered questions
bull Developing a clinical question using PICO requiresbull some background about the condition
bull some understanding the patient
bull outcomes amp beliefs important to the patient
bull Prognosisndash Disability Quality of life Cost Improvement of symptoms
Why use PICO
bull Search via OvidSP
bull Includes all Cochrane topic reviews ldquoCochrane Libraryrdquo
bull Includes clinical trials register
bull Articles reviewed in ACP Journal Club or BMJ Evidence-Based Medicine
bull Papers in Database of Abstracts of Reviews of Effectiveness (DARE)
bull Studies in DARE meet strict EBM scoring criteria
Uses ldquoKeywordsrdquo to search OvidSPrsquos EBMRUBC library access httpresourceslibraryubcca644
EBM Reviews (meta-search)
Cochrane Database of Systematic Reviews
bull Search via OvidSP
bull Independent non-for-profit international collaboration
bull Reviews are among studies of highest scientific evidence
bull Minimal bias evidence includedexcluded on basis of explicit criteria
bull Reviews involve exhaustive searching for studies amp clinical trials both published and unpublished
bull Abstracts are available for free consumer summaries are free also
UBC library access httpresourceslibraryubcca231
Uses ldquoKeywordsrdquo to search Cochrane hellip
Database of Abstracts of Reviews of Effects (DARE)
bull Search via OvidSP
bull Produced by the National Health Services Centre for Reviews and Dissemination (NHS CRD) at the University of York England
bull DARE is a full text database containing critical assessments of systematic reviews from a variety of medical journals
bull DARE contains structured abstracts of systematic reviews
bull Its records cover topics such as diagnosis prevention rehabilitation screening and treatment
UBC library access httpresourceslibraryubcca489
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
Is equal to
Relevance of information X validityEffortwork required
Health librarians have two (2) options Find relevant information for physician (they determine its value)
Find authoritative sources that do the finding validating for clinician
Usefulness of medical information
MOST clinically relevant (at the top) Least clinically relevant (at the bottom)
Hierarchy of Evidence Tr
acki
ng
Do
wn
Filtered amp Critically Appraised
Expert Opinion Not Filtered
Background info
Valid
ityStren
gth o
f Inferen
ce
Time Sp
ent in
Critical A
pp
raisal
Hierarchy of Evidence find evidence at level for clinician
Where is ALL the evidence
SYSTEMATIC REVIEWS
bull Cochrane Library via OvidSP
bull PubMed Clinical Queries Haynes filters
CLINICAL PRACTICE GUIDELINES
bull National Guideline Clearinghouse (US)
bull Canadian Medical Association Infobase
RESEARCH CRITIQUES
bull ACP Journal Club 1996-
bull Bandolier 1994- amp BestBETs
EVIDENCE SUMMARIES
bull BMJ Clinical Evidence amp FirstConsult
bull UpToDate
META-SEARCH ENGINESbull TRIP+ amp SUMSearch
P = Patient population or problem (Who is the patient or population of patients What is the disease)
I = Intervention (What do you want to do with this patient eg treat diagnose observe)
C = Comparison intervention (What is the alternative to intervention eg placebo different drug nothing)
O = Outcome (What are the relevant outcomes (eg morbidity mortality death complications)
PICO frames the information need
bull Defines a clinical scenario
bull Prepare you to search
bull Places focus on patient-centered questions
bull Developing a clinical question using PICO requiresbull some background about the condition
bull some understanding the patient
bull outcomes amp beliefs important to the patient
bull Prognosisndash Disability Quality of life Cost Improvement of symptoms
Why use PICO
bull Search via OvidSP
bull Includes all Cochrane topic reviews ldquoCochrane Libraryrdquo
bull Includes clinical trials register
bull Articles reviewed in ACP Journal Club or BMJ Evidence-Based Medicine
bull Papers in Database of Abstracts of Reviews of Effectiveness (DARE)
bull Studies in DARE meet strict EBM scoring criteria
Uses ldquoKeywordsrdquo to search OvidSPrsquos EBMRUBC library access httpresourceslibraryubcca644
EBM Reviews (meta-search)
Cochrane Database of Systematic Reviews
bull Search via OvidSP
bull Independent non-for-profit international collaboration
bull Reviews are among studies of highest scientific evidence
bull Minimal bias evidence includedexcluded on basis of explicit criteria
bull Reviews involve exhaustive searching for studies amp clinical trials both published and unpublished
bull Abstracts are available for free consumer summaries are free also
UBC library access httpresourceslibraryubcca231
Uses ldquoKeywordsrdquo to search Cochrane hellip
Database of Abstracts of Reviews of Effects (DARE)
bull Search via OvidSP
bull Produced by the National Health Services Centre for Reviews and Dissemination (NHS CRD) at the University of York England
bull DARE is a full text database containing critical assessments of systematic reviews from a variety of medical journals
bull DARE contains structured abstracts of systematic reviews
bull Its records cover topics such as diagnosis prevention rehabilitation screening and treatment
UBC library access httpresourceslibraryubcca489
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
MOST clinically relevant (at the top) Least clinically relevant (at the bottom)
Hierarchy of Evidence Tr
acki
ng
Do
wn
Filtered amp Critically Appraised
Expert Opinion Not Filtered
Background info
Valid
ityStren
gth o
f Inferen
ce
Time Sp
ent in
Critical A
pp
raisal
Hierarchy of Evidence find evidence at level for clinician
Where is ALL the evidence
SYSTEMATIC REVIEWS
bull Cochrane Library via OvidSP
bull PubMed Clinical Queries Haynes filters
CLINICAL PRACTICE GUIDELINES
bull National Guideline Clearinghouse (US)
bull Canadian Medical Association Infobase
RESEARCH CRITIQUES
bull ACP Journal Club 1996-
bull Bandolier 1994- amp BestBETs
EVIDENCE SUMMARIES
bull BMJ Clinical Evidence amp FirstConsult
bull UpToDate
META-SEARCH ENGINESbull TRIP+ amp SUMSearch
P = Patient population or problem (Who is the patient or population of patients What is the disease)
I = Intervention (What do you want to do with this patient eg treat diagnose observe)
C = Comparison intervention (What is the alternative to intervention eg placebo different drug nothing)
O = Outcome (What are the relevant outcomes (eg morbidity mortality death complications)
PICO frames the information need
bull Defines a clinical scenario
bull Prepare you to search
bull Places focus on patient-centered questions
bull Developing a clinical question using PICO requiresbull some background about the condition
bull some understanding the patient
bull outcomes amp beliefs important to the patient
bull Prognosisndash Disability Quality of life Cost Improvement of symptoms
Why use PICO
bull Search via OvidSP
bull Includes all Cochrane topic reviews ldquoCochrane Libraryrdquo
bull Includes clinical trials register
bull Articles reviewed in ACP Journal Club or BMJ Evidence-Based Medicine
bull Papers in Database of Abstracts of Reviews of Effectiveness (DARE)
bull Studies in DARE meet strict EBM scoring criteria
Uses ldquoKeywordsrdquo to search OvidSPrsquos EBMRUBC library access httpresourceslibraryubcca644
EBM Reviews (meta-search)
Cochrane Database of Systematic Reviews
bull Search via OvidSP
bull Independent non-for-profit international collaboration
bull Reviews are among studies of highest scientific evidence
bull Minimal bias evidence includedexcluded on basis of explicit criteria
bull Reviews involve exhaustive searching for studies amp clinical trials both published and unpublished
bull Abstracts are available for free consumer summaries are free also
UBC library access httpresourceslibraryubcca231
Uses ldquoKeywordsrdquo to search Cochrane hellip
Database of Abstracts of Reviews of Effects (DARE)
bull Search via OvidSP
bull Produced by the National Health Services Centre for Reviews and Dissemination (NHS CRD) at the University of York England
bull DARE is a full text database containing critical assessments of systematic reviews from a variety of medical journals
bull DARE contains structured abstracts of systematic reviews
bull Its records cover topics such as diagnosis prevention rehabilitation screening and treatment
UBC library access httpresourceslibraryubcca489
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
Valid
ityStren
gth o
f Inferen
ce
Time Sp
ent in
Critical A
pp
raisal
Hierarchy of Evidence find evidence at level for clinician
Where is ALL the evidence
SYSTEMATIC REVIEWS
bull Cochrane Library via OvidSP
bull PubMed Clinical Queries Haynes filters
CLINICAL PRACTICE GUIDELINES
bull National Guideline Clearinghouse (US)
bull Canadian Medical Association Infobase
RESEARCH CRITIQUES
bull ACP Journal Club 1996-
bull Bandolier 1994- amp BestBETs
EVIDENCE SUMMARIES
bull BMJ Clinical Evidence amp FirstConsult
bull UpToDate
META-SEARCH ENGINESbull TRIP+ amp SUMSearch
P = Patient population or problem (Who is the patient or population of patients What is the disease)
I = Intervention (What do you want to do with this patient eg treat diagnose observe)
C = Comparison intervention (What is the alternative to intervention eg placebo different drug nothing)
O = Outcome (What are the relevant outcomes (eg morbidity mortality death complications)
PICO frames the information need
bull Defines a clinical scenario
bull Prepare you to search
bull Places focus on patient-centered questions
bull Developing a clinical question using PICO requiresbull some background about the condition
bull some understanding the patient
bull outcomes amp beliefs important to the patient
bull Prognosisndash Disability Quality of life Cost Improvement of symptoms
Why use PICO
bull Search via OvidSP
bull Includes all Cochrane topic reviews ldquoCochrane Libraryrdquo
bull Includes clinical trials register
bull Articles reviewed in ACP Journal Club or BMJ Evidence-Based Medicine
bull Papers in Database of Abstracts of Reviews of Effectiveness (DARE)
bull Studies in DARE meet strict EBM scoring criteria
Uses ldquoKeywordsrdquo to search OvidSPrsquos EBMRUBC library access httpresourceslibraryubcca644
EBM Reviews (meta-search)
Cochrane Database of Systematic Reviews
bull Search via OvidSP
bull Independent non-for-profit international collaboration
bull Reviews are among studies of highest scientific evidence
bull Minimal bias evidence includedexcluded on basis of explicit criteria
bull Reviews involve exhaustive searching for studies amp clinical trials both published and unpublished
bull Abstracts are available for free consumer summaries are free also
UBC library access httpresourceslibraryubcca231
Uses ldquoKeywordsrdquo to search Cochrane hellip
Database of Abstracts of Reviews of Effects (DARE)
bull Search via OvidSP
bull Produced by the National Health Services Centre for Reviews and Dissemination (NHS CRD) at the University of York England
bull DARE is a full text database containing critical assessments of systematic reviews from a variety of medical journals
bull DARE contains structured abstracts of systematic reviews
bull Its records cover topics such as diagnosis prevention rehabilitation screening and treatment
UBC library access httpresourceslibraryubcca489
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
Where is ALL the evidence
SYSTEMATIC REVIEWS
bull Cochrane Library via OvidSP
bull PubMed Clinical Queries Haynes filters
CLINICAL PRACTICE GUIDELINES
bull National Guideline Clearinghouse (US)
bull Canadian Medical Association Infobase
RESEARCH CRITIQUES
bull ACP Journal Club 1996-
bull Bandolier 1994- amp BestBETs
EVIDENCE SUMMARIES
bull BMJ Clinical Evidence amp FirstConsult
bull UpToDate
META-SEARCH ENGINESbull TRIP+ amp SUMSearch
P = Patient population or problem (Who is the patient or population of patients What is the disease)
I = Intervention (What do you want to do with this patient eg treat diagnose observe)
C = Comparison intervention (What is the alternative to intervention eg placebo different drug nothing)
O = Outcome (What are the relevant outcomes (eg morbidity mortality death complications)
PICO frames the information need
bull Defines a clinical scenario
bull Prepare you to search
bull Places focus on patient-centered questions
bull Developing a clinical question using PICO requiresbull some background about the condition
bull some understanding the patient
bull outcomes amp beliefs important to the patient
bull Prognosisndash Disability Quality of life Cost Improvement of symptoms
Why use PICO
bull Search via OvidSP
bull Includes all Cochrane topic reviews ldquoCochrane Libraryrdquo
bull Includes clinical trials register
bull Articles reviewed in ACP Journal Club or BMJ Evidence-Based Medicine
bull Papers in Database of Abstracts of Reviews of Effectiveness (DARE)
bull Studies in DARE meet strict EBM scoring criteria
Uses ldquoKeywordsrdquo to search OvidSPrsquos EBMRUBC library access httpresourceslibraryubcca644
EBM Reviews (meta-search)
Cochrane Database of Systematic Reviews
bull Search via OvidSP
bull Independent non-for-profit international collaboration
bull Reviews are among studies of highest scientific evidence
bull Minimal bias evidence includedexcluded on basis of explicit criteria
bull Reviews involve exhaustive searching for studies amp clinical trials both published and unpublished
bull Abstracts are available for free consumer summaries are free also
UBC library access httpresourceslibraryubcca231
Uses ldquoKeywordsrdquo to search Cochrane hellip
Database of Abstracts of Reviews of Effects (DARE)
bull Search via OvidSP
bull Produced by the National Health Services Centre for Reviews and Dissemination (NHS CRD) at the University of York England
bull DARE is a full text database containing critical assessments of systematic reviews from a variety of medical journals
bull DARE contains structured abstracts of systematic reviews
bull Its records cover topics such as diagnosis prevention rehabilitation screening and treatment
UBC library access httpresourceslibraryubcca489
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
P = Patient population or problem (Who is the patient or population of patients What is the disease)
I = Intervention (What do you want to do with this patient eg treat diagnose observe)
C = Comparison intervention (What is the alternative to intervention eg placebo different drug nothing)
O = Outcome (What are the relevant outcomes (eg morbidity mortality death complications)
PICO frames the information need
bull Defines a clinical scenario
bull Prepare you to search
bull Places focus on patient-centered questions
bull Developing a clinical question using PICO requiresbull some background about the condition
bull some understanding the patient
bull outcomes amp beliefs important to the patient
bull Prognosisndash Disability Quality of life Cost Improvement of symptoms
Why use PICO
bull Search via OvidSP
bull Includes all Cochrane topic reviews ldquoCochrane Libraryrdquo
bull Includes clinical trials register
bull Articles reviewed in ACP Journal Club or BMJ Evidence-Based Medicine
bull Papers in Database of Abstracts of Reviews of Effectiveness (DARE)
bull Studies in DARE meet strict EBM scoring criteria
Uses ldquoKeywordsrdquo to search OvidSPrsquos EBMRUBC library access httpresourceslibraryubcca644
EBM Reviews (meta-search)
Cochrane Database of Systematic Reviews
bull Search via OvidSP
bull Independent non-for-profit international collaboration
bull Reviews are among studies of highest scientific evidence
bull Minimal bias evidence includedexcluded on basis of explicit criteria
bull Reviews involve exhaustive searching for studies amp clinical trials both published and unpublished
bull Abstracts are available for free consumer summaries are free also
UBC library access httpresourceslibraryubcca231
Uses ldquoKeywordsrdquo to search Cochrane hellip
Database of Abstracts of Reviews of Effects (DARE)
bull Search via OvidSP
bull Produced by the National Health Services Centre for Reviews and Dissemination (NHS CRD) at the University of York England
bull DARE is a full text database containing critical assessments of systematic reviews from a variety of medical journals
bull DARE contains structured abstracts of systematic reviews
bull Its records cover topics such as diagnosis prevention rehabilitation screening and treatment
UBC library access httpresourceslibraryubcca489
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
bull Defines a clinical scenario
bull Prepare you to search
bull Places focus on patient-centered questions
bull Developing a clinical question using PICO requiresbull some background about the condition
bull some understanding the patient
bull outcomes amp beliefs important to the patient
bull Prognosisndash Disability Quality of life Cost Improvement of symptoms
Why use PICO
bull Search via OvidSP
bull Includes all Cochrane topic reviews ldquoCochrane Libraryrdquo
bull Includes clinical trials register
bull Articles reviewed in ACP Journal Club or BMJ Evidence-Based Medicine
bull Papers in Database of Abstracts of Reviews of Effectiveness (DARE)
bull Studies in DARE meet strict EBM scoring criteria
Uses ldquoKeywordsrdquo to search OvidSPrsquos EBMRUBC library access httpresourceslibraryubcca644
EBM Reviews (meta-search)
Cochrane Database of Systematic Reviews
bull Search via OvidSP
bull Independent non-for-profit international collaboration
bull Reviews are among studies of highest scientific evidence
bull Minimal bias evidence includedexcluded on basis of explicit criteria
bull Reviews involve exhaustive searching for studies amp clinical trials both published and unpublished
bull Abstracts are available for free consumer summaries are free also
UBC library access httpresourceslibraryubcca231
Uses ldquoKeywordsrdquo to search Cochrane hellip
Database of Abstracts of Reviews of Effects (DARE)
bull Search via OvidSP
bull Produced by the National Health Services Centre for Reviews and Dissemination (NHS CRD) at the University of York England
bull DARE is a full text database containing critical assessments of systematic reviews from a variety of medical journals
bull DARE contains structured abstracts of systematic reviews
bull Its records cover topics such as diagnosis prevention rehabilitation screening and treatment
UBC library access httpresourceslibraryubcca489
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
bull Search via OvidSP
bull Includes all Cochrane topic reviews ldquoCochrane Libraryrdquo
bull Includes clinical trials register
bull Articles reviewed in ACP Journal Club or BMJ Evidence-Based Medicine
bull Papers in Database of Abstracts of Reviews of Effectiveness (DARE)
bull Studies in DARE meet strict EBM scoring criteria
Uses ldquoKeywordsrdquo to search OvidSPrsquos EBMRUBC library access httpresourceslibraryubcca644
EBM Reviews (meta-search)
Cochrane Database of Systematic Reviews
bull Search via OvidSP
bull Independent non-for-profit international collaboration
bull Reviews are among studies of highest scientific evidence
bull Minimal bias evidence includedexcluded on basis of explicit criteria
bull Reviews involve exhaustive searching for studies amp clinical trials both published and unpublished
bull Abstracts are available for free consumer summaries are free also
UBC library access httpresourceslibraryubcca231
Uses ldquoKeywordsrdquo to search Cochrane hellip
Database of Abstracts of Reviews of Effects (DARE)
bull Search via OvidSP
bull Produced by the National Health Services Centre for Reviews and Dissemination (NHS CRD) at the University of York England
bull DARE is a full text database containing critical assessments of systematic reviews from a variety of medical journals
bull DARE contains structured abstracts of systematic reviews
bull Its records cover topics such as diagnosis prevention rehabilitation screening and treatment
UBC library access httpresourceslibraryubcca489
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
Cochrane Database of Systematic Reviews
bull Search via OvidSP
bull Independent non-for-profit international collaboration
bull Reviews are among studies of highest scientific evidence
bull Minimal bias evidence includedexcluded on basis of explicit criteria
bull Reviews involve exhaustive searching for studies amp clinical trials both published and unpublished
bull Abstracts are available for free consumer summaries are free also
UBC library access httpresourceslibraryubcca231
Uses ldquoKeywordsrdquo to search Cochrane hellip
Database of Abstracts of Reviews of Effects (DARE)
bull Search via OvidSP
bull Produced by the National Health Services Centre for Reviews and Dissemination (NHS CRD) at the University of York England
bull DARE is a full text database containing critical assessments of systematic reviews from a variety of medical journals
bull DARE contains structured abstracts of systematic reviews
bull Its records cover topics such as diagnosis prevention rehabilitation screening and treatment
UBC library access httpresourceslibraryubcca489
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
Database of Abstracts of Reviews of Effects (DARE)
bull Search via OvidSP
bull Produced by the National Health Services Centre for Reviews and Dissemination (NHS CRD) at the University of York England
bull DARE is a full text database containing critical assessments of systematic reviews from a variety of medical journals
bull DARE contains structured abstracts of systematic reviews
bull Its records cover topics such as diagnosis prevention rehabilitation screening and treatment
UBC library access httpresourceslibraryubcca489
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
ACP Journal Club
bull Search via OvidSPbull Consists of two journals ACP Journal Club (American College of Physicians) and
Evidence-Based Medicine by ACP amp British Medical Journalbull Editors select studies (includes reviews) that are methodologically sound and
clinically relevant (high-quality) bull Some topics may not be foundbull Review top clinical journals top therapy diagnosis harm ampprognosis Qsbull Commentaries on each studys valuebull Helps physicians understand and apply evidencebull Reveals changes in medical knowledge
UBC library access httpresourceslibraryubcca230
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II
Follow up files on HLWIKI
Scoping reviews | Grey literature | Hand-searching |Snowballing
Expert searching | Grey data (hard to find data) | Grey literature searching in medicine | Grey literature - part II