<ul><li>Deborah S. Cummins, PhD </li></ul><ul><li>Senior Director, Research & Evidence Analysis </li></ul><ul><li>Research...
EAL ®  Home Page Online Resource with the best available research on important dietetics topics in a practitioner-friendly...
<ul><li>“ Evidence-Based  Dietetics  Practice” </li></ul><ul><li>is the use of  systematically reviewed scientific evidenc...
Why Evidence-based? <ul><li>Improve quality of healthcare </li></ul><ul><li>Decrease wide variations in practice </li></ul...
Objectives <ul><li>Understand the Steps in the American Dietetic Association’s Evidence Analysis Process  </li></ul><ul><l...
Steps in Evidence Analysis Process
<ul><li>If appropriate, next phase: </li></ul><ul><li>Write Position Paper </li></ul><ul><li>Develop Guideline and Toolkit...
Steps in EA Process <ul><li>Step 1:  </li></ul><ul><li>Formulate the Question </li></ul>
Structure of EBP Committee <ul><li>Joint HOD and BOD appointed committee </li></ul><ul><li>Actively practicing in acute ca...
Evidence-Based Practice Committee <ul><li>2009-2010 </li></ul><ul><li>Chair:  Sue Kent, MS, RD, LD </li></ul><ul><li>Vice ...
Evidence Based Practice Committee
New  LIBRARY  Projects in 2009-10  (in RED)
Evidence Analysis Work Group
Steps in EA Process <ul><li>Step 2:  </li></ul><ul><li>Gather and Classify the Research </li></ul>
Example: Question from AWM Work Group <ul><li>How effective is the consumption of low glycemic index foods for reducing en...
Search Plan & Results for each question  Date of Search Inclusion Criteria: -Age -Setting (outpatient) -Sample Size -Accep...
Steps in EA Process <ul><li>Step 3:  </li></ul><ul><li>Critically Appraise Each Article </li></ul>
Literature Review <ul><li>Q.  Who creates the sort list? </li></ul><ul><li>A.  Project Lead Analyst and ADA Librarian </li...
Project Managers/Lead Analysts
Evidence Analysts
Search Plan & Results <ul><li>Included articles  and  Excluded articles (with reason) </li></ul>List Reason for exclusion ...
The Worksheet <ul><ul><li>A worksheet and quality criteria checklist is created for each article </li></ul></ul><ul><ul><l...
Example:  Worksheet  <ul><li>Citation / PubMed ID </li></ul><ul><li>Date </li></ul><ul><li>Study Design </li></ul><ul><li>...
Example: Quality Criteria Checklist Questions related to relevance and validity Determines if article is rated as: Positiv...
Steps in EA Process <ul><li>Step 4:  </li></ul><ul><li>Summarize the Evidence in an Overview Table and Evidence Summary </...
Overview Table <ul><li>List : </li></ul><ul><li>Citation </li></ul><ul><li>Study Design </li></ul><ul><li>Quality Rating <...
Narrative Evidence Summary Example:  Summary of evidence for Low Glycemic Diets question
Evidence Summary - Bibliography Citations linked to worksheets at the bottom of the Evidence Summary
Steps in EA Process <ul><li>Step 5:  </li></ul><ul><li>Develop Conclusion Statement and Grade the Strength of the Supporti...
Example: Conclusion Statement Grade Eight randomized controlled trials report no significant differences in energy intake ...
Explanation of Grades % of Grade I questions on EAL
PUBLISH ON  EAL ®   <ul><li>Available  free  to All ADA Members  </li></ul><ul><li>Question  </li></ul><ul><li>Conclusion ...
<ul><li>Abstracted Articles/Worksheets </li></ul>How much  content  is on EAL ® ?
EAL ®  Usage EAL Launched Sept 2004 Overall Total  Page Views 9/2004 – 11/2009: 7 Million + 7,091,411
EAL Usage Worldwide <ul><li>Users from 191 different countries </li></ul>
Guideline Development
Steps in the EA Process <ul><li>Annual review of Evidence Analysis Guideline Projects </li></ul><ul><li>Review </li></ul><...
Summary <ul><li>ADA’s Evidence Analysis Library can be found at  www.adaevidencelibrary.com </li></ul><ul><li>Questions co...
Resources <ul><li>Check Resources on EAL for additional PowerPoint presentations. </li></ul>
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Deborah S. Cummins, PhD Senior Director, Research

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Deborah S. Cummins, PhD Senior Director, Research

  1. 1. <ul><li>Deborah S. Cummins, PhD </li></ul><ul><li>Senior Director, Research & Evidence Analysis </li></ul><ul><li>Research & Strategic Business Development </li></ul><ul><li>American Dietetic Association </li></ul><ul><li>November 2009 </li></ul><ul><li>ADA Evidence Analysis Process </li></ul>
  2. 2. EAL ® Home Page Online Resource with the best available research on important dietetics topics in a practitioner-friendly format www.adaevidencelibrary.com
  3. 3. <ul><li>“ Evidence-Based Dietetics Practice” </li></ul><ul><li>is the use of systematically reviewed scientific evidence in making food and nutrition practice decisions </li></ul><ul><li>by integrating best available evidence with professional expertise and client values to improve outcomes.” </li></ul>Definition developed by ADA Evidence-based Practice Committee with input from Research Committee, Quality Management Committee, and Scope of Dietetics Practice Task Force. Approved by ADA House of Delegates Leadership Team
  4. 4. Why Evidence-based? <ul><li>Improve quality of healthcare </li></ul><ul><li>Decrease wide variations in practice </li></ul><ul><li>Reduce the gap between what is known from research…and what happens in real life </li></ul><ul><li>Take advantage of biomedical knowledge </li></ul>
  5. 5. Objectives <ul><li>Understand the Steps in the American Dietetic Association’s Evidence Analysis Process </li></ul><ul><li>Identify topics and features in the ADA’s Evidence Analysis Library © </li></ul>
  6. 6. Steps in Evidence Analysis Process
  7. 7. <ul><li>If appropriate, next phase: </li></ul><ul><li>Write Position Paper </li></ul><ul><li>Develop Guideline and Toolkit </li></ul>Steps in EA Process Select Topic Appoint Expert Work Group Define Questions Determine Inclusion/Exclusion Criteria Conduct Literature Review for Each Question Analyze Articles / Critical Appraisal Complete Overview Table and Evidence Summary Develop Conclusion Statement Reach Consensus on Grade Publish to Online EAL
  8. 8. Steps in EA Process <ul><li>Step 1: </li></ul><ul><li>Formulate the Question </li></ul>
  9. 9. Structure of EBP Committee <ul><li>Joint HOD and BOD appointed committee </li></ul><ul><li>Actively practicing in acute care, long-term care, ambulatory care, and public health </li></ul><ul><li>Trained as evidence analysts </li></ul><ul><li>Representatives from QM, Research, NCP/SL, DPBRN Committees and BOD </li></ul>
  10. 10. Evidence-Based Practice Committee <ul><li>2009-2010 </li></ul><ul><li>Chair: Sue Kent, MS, RD, LD </li></ul><ul><li>Vice Chair: Tamie M. Frable-Newman, MS, RD, LDN </li></ul><ul><li>Members: Linda Arpino, MA, RD, CDN Christina Biesemeier, MS, RD, LDN, FADA Claudia Conkin, MS, RD, LD Erica Gradwell, MS, RD Wahida Karmally, DrPH, RD, CDE, CLS Patti S. Landers, PhD, RD, LD Ainsley Malone, MS, RD, LD, CNSD </li></ul>EBP Committee reports jointly to House of Delegates and Board of Directors
  11. 11. Evidence Based Practice Committee
  12. 12. New LIBRARY Projects in 2009-10 (in RED)
  13. 13. Evidence Analysis Work Group
  14. 14. Steps in EA Process <ul><li>Step 2: </li></ul><ul><li>Gather and Classify the Research </li></ul>
  15. 15. Example: Question from AWM Work Group <ul><li>How effective is the consumption of low glycemic index foods for reducing energy intake and promoting weight loss? </li></ul>
  16. 16. Search Plan & Results for each question Date of Search Inclusion Criteria: -Age -Setting (outpatient) -Sample Size -Acceptable dropout rate -Year Range -English Language Databases Searched Search Terms List of Articles Reports Inclusion & Exclusion Criteria
  17. 17. Steps in EA Process <ul><li>Step 3: </li></ul><ul><li>Critically Appraise Each Article </li></ul>
  18. 18. Literature Review <ul><li>Q. Who creates the sort list? </li></ul><ul><li>A. Project Lead Analyst and ADA Librarian </li></ul><ul><li>Q. Who approves the sort list? </li></ul><ul><li>A. Expert Work Group </li></ul>
  19. 19. Project Managers/Lead Analysts
  20. 20. Evidence Analysts
  21. 21. Search Plan & Results <ul><li>Included articles and Excluded articles (with reason) </li></ul>List Reason for exclusion For each article not Included in the Analysis; e.g. Sample size Too small
  22. 22. The Worksheet <ul><ul><li>A worksheet and quality criteria checklist is created for each article </li></ul></ul><ul><ul><li>Responsibility of analyst </li></ul></ul><ul><ul><li>Reviewed by lead analyst </li></ul></ul><ul><ul><li>Approved by workgroup </li></ul></ul>
  23. 23. Example: Worksheet <ul><li>Citation / PubMed ID </li></ul><ul><li>Date </li></ul><ul><li>Study Design </li></ul><ul><li>Class </li></ul><ul><li>Rating (+/0/-) </li></ul><ul><li>Research Purpose </li></ul><ul><li>Inclusion Criteria </li></ul><ul><li>Exclusion Criteria </li></ul><ul><li>Description of Study Protocol </li></ul><ul><li>Data Collection Summary </li></ul><ul><li>Description of Actual Data Sample </li></ul><ul><li>Summary of Results </li></ul><ul><li>Author Conclusion </li></ul><ul><li>Reviewer Comments </li></ul>
  24. 24. Example: Quality Criteria Checklist Questions related to relevance and validity Determines if article is rated as: Positive Quality Negative Quality Neutral Quality
  25. 25. Steps in EA Process <ul><li>Step 4: </li></ul><ul><li>Summarize the Evidence in an Overview Table and Evidence Summary </li></ul>
  26. 26. Overview Table <ul><li>List : </li></ul><ul><li>Citation </li></ul><ul><li>Study Design </li></ul><ul><li>Quality Rating </li></ul><ul><li>Sample Size </li></ul><ul><li>Interventions and Outcomes </li></ul><ul><li>in table format to enable user to compare studies side by side. </li></ul>
  27. 27. Narrative Evidence Summary Example: Summary of evidence for Low Glycemic Diets question
  28. 28. Evidence Summary - Bibliography Citations linked to worksheets at the bottom of the Evidence Summary
  29. 29. Steps in EA Process <ul><li>Step 5: </li></ul><ul><li>Develop Conclusion Statement and Grade the Strength of the Supporting Evidence </li></ul>
  30. 30. Example: Conclusion Statement Grade Eight randomized controlled trials report no significant differences in energy intake or body weight after the consumption of a low-glycemic index diet. Grade I
  31. 31. Explanation of Grades % of Grade I questions on EAL
  32. 32. PUBLISH ON EAL ® <ul><li>Available free to All ADA Members </li></ul><ul><li>Question </li></ul><ul><li>Conclusion </li></ul><ul><li>Grade </li></ul><ul><li>Evidence Summary </li></ul><ul><li>Overview Table </li></ul><ul><li>Worksheets and Quality Checklists for each article </li></ul><ul><li>Search Plan & Results </li></ul><ul><li>Individual EAL Subscriptions are available from www.adaevidencelibrary.com Store </li></ul><ul><li>For Institutional EAL subscriptions, contact khowarter@eatright.org </li></ul>
  33. 33. <ul><li>Abstracted Articles/Worksheets </li></ul>How much content is on EAL ® ?
  34. 34. EAL ® Usage EAL Launched Sept 2004 Overall Total Page Views 9/2004 – 11/2009: 7 Million + 7,091,411
  35. 35. EAL Usage Worldwide <ul><li>Users from 191 different countries </li></ul>
  36. 36. Guideline Development
  37. 37. Steps in the EA Process <ul><li>Annual review of Evidence Analysis Guideline Projects </li></ul><ul><li>Review </li></ul><ul><li>Re-run searches for each question </li></ul><ul><li>Determine if revision is needed </li></ul><ul><li>Document date of review </li></ul><ul><li>Revise </li></ul><ul><li>“ Revise” using EA Process </li></ul><ul><li>Update rating of conclusion statements/recommendations as needed </li></ul>
  38. 38. Summary <ul><li>ADA’s Evidence Analysis Library can be found at www.adaevidencelibrary.com </li></ul><ul><li>Questions contact: </li></ul><ul><li>[email_address] </li></ul>
  39. 39. Resources <ul><li>Check Resources on EAL for additional PowerPoint presentations. </li></ul>

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