An Introduction to Evidence
Based Searching
Kerry Sullivan, MLIS
Health Sciences Librarian
November 2010
• Your hosts
– Kerry Sullivan
– Michelle Hajder
QUESTIONS?
– We will have time for Q&A at the end of the session
– Expand the Questions window in the GoToWebinar
module (usually on the right) and type in your
questions for the presenters
2
GoToWebinar Control Panel
3
Evidence-Based Medicine (EBM) is
defined as: "The conscientious, explicit
and judicious use of current best evidence
in making decisions about the care of
individual patients.“
– Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., &
Richardson, W. S. (1996). Evidence based medicine: What it is and
what it isn't. British Medical Journal, 312(7023), 71-72.
The Institute of Medicine (IOM) defines “Evidence-Based
Practice" as a combination of the following three factors:
(1) best research evidence,
(2) best clinical experience, and
(3) consistent with patient values
– (IOM, 2001; http://www.iom.edu/)
Evidence-Based Health Services Management
is the "systematic application of the best
available evidence to the evaluation of
managerial strategies for improving the
performance of health services organizations.“
– Kovner, A. R., & Rundall, T. G. (2006). Evidence-based
management reconsidered. Frontiers of health services
management, 22(3), 3-22.
Evidence-Based Nursing (EBN) is defined as: "the
application of valid, relevant, research-based
information in nurse decision-making...used
alongside our knowledge of our patients (their
symptoms, diagnoses, and expressed preferences) and
the context in which the decision is taking place
(including the care setting and available resources), and
in processing this information we use our expertise and
judgement."
– Cullum, N. (2008). Evidence-based nursing: An introduction.
Oxford: Malden, MA: Blackwell Pub./BMJ Journals/RCN Pub.
1. Research
2. Clinician knowledge
3. Patient needs
Formulating the Question
• Defining a clinical question by the specific
patient and problem lends itself to
effectively finding relevant evidence.
• EBP begins and ends with the patient.
Clinical Question Anatomy
PICO
PICO is a mnemonic that helps one
remember the key components of a well
focused question.
PICO
• P = Patient, Population or Problem
• I = Intervention, Prognostic Factor, or Exposure
• C = Comparison (if there is one)
• O = Outcome
Our clinical question
• Do BMI screenings in schools prevent
diabetes in children?
PICO
•
•
•
•
P = School age children
I = BMI testing in schools
C = None
O = Diabetes prevention
Search Terms & Strategy
• Keywords/Subjects
– Schools AND BMI AND Diabetes
Limits: children and highest levels of evidence
• Resources
– Library Databases: MEDLINE, CINAHL,
Cochrane, etc.
– Web Based: AHRQ, National Guideline
Clearinghouse, TRIP
Filtered Resources
Highest Levels of Evidence
• Systematic Reviews & Meta-Analysis
– Cochrane Database of Systematic Reviews
– Database of Abstracts of Reviews of Effects
(DARE)
Critically Appraised Topics
• Evidence Synthesis
– Evidence Based Resources from Joanna
Briggs Institute
– Annual Reviews
– National Guideline Clearinghouse
• http://www.guideline.gov
– AHRQ Evidence Based Practice
• Agency for Healthcare Research & Quality
• http://www.ahrq.gov/
Unfiltered Resources
• MEDLINE with Full Text
• CINAHL Plus with Full Text
• PsycINFO
MEDLINE
• Publication types: Clinical trials (all),
RCTs, CCT, Meta-Analysis, Reviews
• Clinical Queries: Therapy, Diagnosis,
Prognosis, Reviews, Etiology, etc.
• Population limits: Age, Gender,
Human/Animal
CINAHL
• Publication types: Clinical Trials, Practice
Guidelines, Systematic Review
• Clinical Queries: Therapy, Prognosis, Review,
Qualitative or Causation
• Population limits: Age, Gender, Inpatients
• Check limits: Evidence-Based Practice
PsycINFO
• Methodology: Systematic Review, MetaAnalysis, Treatment Outcome/Clinical Trial,
Qualitative or Quantitative study
• Population limits: Age Groups & Population
Group
Trip Database
Turning Research Into Practice
http://www.tripdatabase.com
Point-of-Care Products
• UpToDate
http://www.uptodate.com/
• Dynamed
http://www.ebscohost.com/dynamed
• FirstConsult
http://www.mdconsult.com
• eMedicine
http://www.emedicine.medscape.com
Questions?
Thank you!
ASK – A – LIBRARIAN
library@waldenu.edu
800-930-0914