Using the Biomedical Library & It’s Resources: Becoming Efficient Information Managers Physical Therapy Fall 2008

Clista Clanton Information Services Librarian Education Coordinator Contact Information: Phone: (251) 414-8210 Fax: (251) 460-7638 Email: [email_address]

Information Services Librarian

Education Coordinator

Contact Information:

Phone: (251) 414-8210

Fax: (251) 460-7638

Email: [email_address]

Baugh Biomedical Library – Campus Site Primarily supports the academic health sciences (College of Medicine, College of Nursing & Allied Health) University of South Alabama: Biomedical Library Sites

Baugh Biomedical Library – Campus Site

Primarily supports the academic health sciences (College of Medicine, College of Nursing & Allied Health)

University of South Alabama: Biomedical Library Sites University Medical Center site Primarily supports the clinical medicine specialties-collection concentrates on patient care and treatment

University Medical Center site

Primarily supports the clinical medicine specialties-collection concentrates on patient care and treatment

University of South Alabama: Biomedical Library Sites Children’s and Women’s Hospital site Primarily supports obstetrics, gynecology, and pediatrics – which is reflected by the library’s collection.

Children’s and Women’s Hospital site

Primarily supports obstetrics, gynecology, and pediatrics – which is reflected by the library’s collection.

What is Evidence Based Practice (EBP) A process by which you: (1) ask clinical questions that can be answered through research and other evidence sources; (2) find the best evidence to answer these clinical questions; (3) appraise the validity of the evidence to support answers to clinical questions; (4) integrate the evidence with clinical expertise and patients’ perspectives; and (5) evaluate the effectiveness of carrying out all of the above. Short definition: “the integration of best research evidence with clinical expertise and patient values.” 1 1 Sackett, DL. Evidence-based medicine: how to practice and teach EBM. New York: Churchill-Livingston, 2000.

Evidence Based Practice (EBP) Research Evidence Evidence-based practice moves beyond the anecdotal treatment modes of the past toward the future of objective, data driven, scientifically researched practice regimes. Meta-analyses Systematic Reviews Clinical Trials Other types of research studies (both quantitative and qualitative)

Meta-analyses

Systematic Reviews

Clinical Trials

Other types of research studies (both quantitative and qualitative)

The Medical Literature Primary – original research Experimental (an intervention is made or variables are manipulated) Randomized Control Trials Controlled trials Observational (no intervention or variables are manipulated) Cohort studies Case-control studies Case reports Secondary – reviews of original research Reviews Meta-analysis Systematic reviews Practice guidelines Decision analysis Consensus reports Editorial, commentary

Primary – original research

Experimental (an intervention is made or variables are manipulated)

Randomized Control Trials

Controlled trials

Observational (no intervention or variables are manipulated)

Cohort studies

Case-control studies

Case reports

Secondary – reviews of original research

Reviews

Meta-analysis

Systematic reviews

Practice guidelines

Decision analysis

Consensus reports

Editorial, commentary

Evidence Pyramid Case Series/Case Reports Case Control Studies Cohort Studies Randomized Controlled Trial Systematic Review Meta-analysis Animal Research

Real world factors that decide clinician’s approach to the literature: Clinician’s awareness that new information is available Perception that current options are unacceptable or didn’t work Availability of familiar sources Perceived likelihood that an answer can be found Fear of liability if the correct approach is not followed Time available to search for the answer Green ML, Ciampi MA, Ellis PJ. Residents’ medical information needs in clinics: are they being met? Am J Med. 2000; 109:218-23. Ely JW, Osheroff JA, Ebell MH, et al. Analysis of questions asked by family doctors regarding patient care. BMJ. 1999;319:358-61. Ebell MH, Shaughnessy AF. Information mastery: integrating continuing medical education with the information needs of clinicians. J Cont Ed Health Prof. 2003;23:S53-62.

Clinician’s awareness that new information is available

Perception that current options are unacceptable or didn’t work

Availability of familiar sources

Perceived likelihood that an answer can be found

Fear of liability if the correct approach is not followed

Time available to search for the answer

Patient-Centered Information Management Usefulness of any information source = Relevance X Validity Work Slawson DC, Shaughnessy AF. Teaching evidence-based medicine: Should we be teaching information management instead? Acad Med 2005;80:685-689

Information Management Focuses on using currently available information tools to remain up to date With new valid information That is relevant to the care of patients Is accessible while taking care of patients

Focuses on using currently available information tools to remain up to date

With new valid information

That is relevant to the care of patients

Is accessible while taking care of patients