Evidence Analysis Library Part I EAL Part I presentation includes: List of Current EAL Projects Steps in Evidence Analysis Process Navigating the EAL Updated September 2006 www.adaevidencelibrary.com Online Resource with the best available research on important dietetics topics in a practitionerfriendly format Key messages Definition Why evidence-based practice? Current Projects/Topics Steps in Evidence Analysis Process Example from EAL Definition/Description “Evidence-Based Dietetics Practice is the use of systematically reviewed scientific evidence in making food and nutrition practice decisions by integrating best available evidence with professional expertise and client values to improve outcomes.” Revised by EBP Committee and approved by HOD Leadership January 2006 Why Evidence-based Practice? • To improve patient outcomes • To improve patient safety & the quality & efficiency of practice • To take advantage of the “exploding” body of biomedical knowledge • Thousands of new research studies appear every month Current EAL Projects Diseases & Conditions Chronic Kidney Disease (revision) Diabetes 1 & 2 (revision) Disorders of Lipid Metabolism (Hyperlipidemia revision) Gestational Diabetes (revision) revision of 2001 Guidelines (CD format) Current EAL Projects (continued) Diseases & Conditions Adult weight management Determinants of Pediatric Overweight (FNPA) Chronic Obstructive Pulmonary Disease (COPD) Critical Illness Gluten Intolerance/ Celiac Heart Failure HIV/AIDS Current EAL Projects (continued) Diseases & Conditions Hydration Hypertension Nutrition in Athletic Performance Nutrition Care in Bariatric Surgery Oncology Pediatric Weight Management Spinal Cord Injury & Nutrition Unintended weight loss Current EAL Projects (continued) Nutrition Care Process Assessment Estimating Energy Expenditure/ Indirect Calorimetry Intervention Nutrition Counseling Current EAL Projects (continued) Foods Non-nutritive sweeteners Current EAL Projects (continued) Nutrients Fiber Did you see “your” project? To suggest a new project for possible analysis in the future when resources become available, send an email to: topics@adaevidencelibrary.com Evidence Analysis Process Steps in ADA’s Evidence Analysis Process Steps in ADA’s Evidence Analysis Process 1) Formulate Questions. Expert Workgroup defines questions and the analytical framework; lists keywords for search terms, and determines Inclusion / Exclusion Criteria for Literature Review. 2) Gather and Classify Evidence Reports Lead Analyst conducts Literature Review for each question; records information online in Search Plan & Results. Work group approves list of included articles for analysis. Steps in ADA’s Evidence Analysis Process 3) Critically Appraise Each Report Analysts critically review articles and create article Worksheets that are reviewed by Lead Analysts and expert workgroup. 4) Write the Evidence Summary Analysts and Lead Analysts complete Evidence Summaries and Overview Tables that are reviewed and approved by expert workgroup. Steps in ADA’s Evidence Analysis Process 5) Grade the Conclusion Statement Workgroup members reach consensus on a brief conclusion statement (the answer to the evidence analysis question) and assign a grade based on the strength and quality of the evidence. Next Steps Publish online to the EAL Question, Conclusion, Grade, Search Plan & Results, Evidence Summary, Overview Table, Article Worksheets, and Quality Checklists are published online. Position Papers and Guidelines Published Evidence Analysis Questions are used in ADA position papers and to support guideline recommendations. Example from EAL Drill down to the level of detail desired. Question Conclusion Statement & Grade Search Plan & Results Evidence Summary Bibliography Worksheets & Quality Checklists Example: www.adaevidencelibrary.com Select Diseases and Conditions tab. 1. Select a project from list of Diseases & Conditions. 2. Choose a topic Disorders of Lipid Metabolism (select project) Macronutrients (choose topic) 3. Choose a sub-topic - if needed Trans-fatty acids (sub-topic) Question What is the relationship between diets high in trans fatty acids and serum cholesterol levels? Bibliography for Topic Conclusion Statement/Grade “Mouse over” or click on Question to see Conclusion & Grade Trans-fatty acids raise total cholesterol and LDL-C. Unlike saturated fatty acids, trans-fatty acids do not increase and may decrease HDL-C. Trans-fatty acids increase the TC/HDL-C ratio in a dose dependent manner. GRADE I Search Plan and Results •Date Searched •Inclusion Criteria •Exclusion Criteria •Search Terms •Databases searched •Articles identified from handsearch •Included Articles •Excluded Articles with reason for exclusion Grades Conclusion Grading Table Link to Evidence Summary Evidence Summary Narrative Summary Evidence Summary Of the research available to answer question Page Down Evidence Summary to Bibliography Bibliography for Question is listed at end of Evidence Summary (and linked to worksheets) Worksheet •Citation / PubMed ID •Date •Study Design •Class •Rating (+/0/-) •Research Purpose •Inclusion Criteria •Exclusion Criteria •Description of Study Protocol •Data Collection Summary •Description of Actual Data Sample •Summary of Results •Author Conclusion •Reviewer Comments Page Down Worksheet to Quality Criteria Checklist Answers to questions determine the Quality Rating of Article: Positive (+) Negative (-) Neutral () Search on EAL Enter topic and click on “Search.” Example: low carbohydrate Results: Questions, Evidence Summaries, Worksheets, and Topics that use the term, “low carbohydrate” are displayed in a table. 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