Life Sciences Library   Searching Resources in Evidence-           Based Medicine                               Robin Feat...
ObjectivesBy the end of this lecture, you will be able to:1. Describe the Evidence-Based Medicine (EBM)   process2. Formul...
Evidence-Based Medicine: The Process                                                  Formulating          Evaluating     ...
Patient Scenario     Formulate a Clinical QuestionPatient, Population, or ProblemInterventionComparisonOutcomes
Patient Scenario              Clinical ScenarioYou have been asked to review the practice guidelinesfor treating warts. Yo...
Patient Scenario          Clinical Question                PICOIn patients with common warts, is duct tape aseffective as ...
What is the Evidence?  Systematic Reviews                   Case-control studies Randomized control trialsCohort studies  ...
Question                         Best Evidence           Cost-effectiveness               •Economic analyses           Dia...
Levels of Evidence                               for Therapy Question Level of Evidence Type of Study          1a         ...
Information Sources              for Therapy Question                            Synopsis                               of...
Criteria for Selecting an Information                     Source1.   Soundness of evidence-based approach2.   Comprehensiv...
Information Sources   for Therapy Question          Filtered
Information Sources   for Therapy Question          Filtered
Information Sources   for Therapy Question          Filtered
Information Sources   for Therapy Question          Filtered
Information Sources   for Therapy Question          Filtered
Information Sources   for Therapy Question          Filtered         Unfiltered
Information Sources   for Therapy Question         Unfiltered
Course Websitehttp://www.mcgill.ca/library/library-findinfo/courses/guides/ebm_intro/                                     ...
http://m.library.mcgill.ca/healthsciguide/
Summary Quiz1. UpToDate is a _______ resource. And Medline is   a ________ resource.2. The 5 stages in the EBM process are...
Life Sciences Library               Questions                               Robin Featherstone, MLIS                      ...
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Searching EBM Resources

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  • Remind them about the room that they are in.
  • Show them the page, what it offers for each resource.
  • Searching EBM Resources

    1. 1. Life Sciences Library Searching Resources in Evidence- Based Medicine Robin Featherstone, MLIS Liaison Librarian (Medicine) robin.featherstone@mcgill.caWinter 2012
    2. 2. ObjectivesBy the end of this lecture, you will be able to:1. Describe the Evidence-Based Medicine (EBM) process2. Formulate clinical questions using PICO3. Locate best available medical evidence 2
    3. 3. Evidence-Based Medicine: The Process Formulating Evaluating the clinical the Process question Your patient for whom you are uncertain about therapy, diagnosis, or Searching Incorporating prognosis the evidence into Evidence decision- making Appraising the Evidence LINK 3
    4. 4. Patient Scenario Formulate a Clinical QuestionPatient, Population, or ProblemInterventionComparisonOutcomes
    5. 5. Patient Scenario Clinical ScenarioYou have been asked to review the practice guidelinesfor treating warts. You are confident that cryotherapyis the most effective treatment but a colleaguesuggested some alternatives to investigate, includingduct tape.Could duct tape be used for eliminating warts? Doesthe literature provide evidence to support thistreatment?
    6. 6. Patient Scenario Clinical Question PICOIn patients with common warts, is duct tape aseffective as cryotherapy in eliminating warts?
    7. 7. What is the Evidence? Systematic Reviews Case-control studies Randomized control trialsCohort studies Case reports Editorials Animal research All types of articles found in MEDLINE
    8. 8. Question Best Evidence Cost-effectiveness •Economic analyses Diagnosis •Diagnostic validation studies •Prospective studies / blind comparison to a gold standard Etiology •Randomized controlled trials •Case-control or cohort studies •Case series Prevention •Randomized controlled trials •Cohort studies, case control studies •Systematic reviews / meta-analyses Prognosis •Inception cohort studies •Case control studies •Case series Quality of life •Qualitative studies Therapy •Randomized controlled trials •Systematic reviews / meta-analyses1 Heneghan, Carl, and Douglas Badenoch. Evidence-Based Medicine Toolkit. 2nd ed. Malden, Mass.: BMJ Books/Blackwell Pub., 2006.2 Glover, Jan, and Lei Wang. Find it Fast: The Clinical Question : www.med.yale.edu/library/education/guides/screencasts/finditfast/finditfast_2/
    9. 9. Levels of Evidence for Therapy Question Level of Evidence Type of Study 1a Systematic reviews of randomized controlled trials (RCTs) 1b Individual RCTs with narrow confidence interval 2a Systematic reviews of cohort studies 2b Individual cohort studies and low-quality RCTs 3a Systematic reviews of case-control studies 3b Case-control studies 4 Case series and poor quality cohort and case-control studies 5 Expert opinionLevels of evidence (2001). Centre for Evidence Based Medicine. Retrieved 26 Aug 2008 from http://www.cebm.net/index.aspx?o=1025 9
    10. 10. Information Sources for Therapy Question Synopsis of synthesis Summaries Filtered 1b 1a 1b 1a 2b 2a 2b 2a Unfiltered 3b 3b4 5 4 5
    11. 11. Criteria for Selecting an Information Source1. Soundness of evidence-based approach2. Comprehensiveness and specificity3. Ease of use4. Availability
    12. 12. Information Sources for Therapy Question Filtered
    13. 13. Information Sources for Therapy Question Filtered
    14. 14. Information Sources for Therapy Question Filtered
    15. 15. Information Sources for Therapy Question Filtered
    16. 16. Information Sources for Therapy Question Filtered
    17. 17. Information Sources for Therapy Question Filtered Unfiltered
    18. 18. Information Sources for Therapy Question Unfiltered
    19. 19. Course Websitehttp://www.mcgill.ca/library/library-findinfo/courses/guides/ebm_intro/ 19
    20. 20. http://m.library.mcgill.ca/healthsciguide/
    21. 21. Summary Quiz1. UpToDate is a _______ resource. And Medline is a ________ resource.2. The 5 stages in the EBM process are _______.3. The best evidence to answer a therapy question is _______.4. To find systematic reviews of RCTs use _______.5. To evaluate a clinical topic page, look for _______. LINK
    22. 22. Life Sciences Library Questions Robin Featherstone, MLIS Liaison Librarian (Medicine) robin.featherstone@mcgill.caWinter 2012

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