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?