Finding Evidence Based Clinical Information in the Cochrane Library and PubMed EAHIL Continuing Education Course Helsinki June 24th. 2008. Hilde Strømme, Ullevaal University Hospital, Medical Library
Is the Cage Questionnaire a good tool to diagnose alcoholism?
Is acupuncture effective for smoking cessation?
Can pressure relieving mattresses prevent pressure ulcers?
Can measels-mumps-rubella vaccine (MMR) cause autism?
In primary nocturnal enuresis in children, do alarm systems compared with pharmacological therapies produce fewer wet beds in the short term and the long term?
Will the quality of literature searches performed by health personnel improve if they have guidance from a librarian?
PICO: The components of a clinical question Outcome Comparison Intervention or Exposure Population Patient Problem What happens? What is the outcome? What do we compare the intervention with? Not always necessary. What do we do to them? What are they exposed to? Who are the patients? What is the problem? O C I P
In primary nocturnal enuresis in children, do alarm systems compared with pharmacological therapies produce fewer wet beds in the short term and the long term? Nocturnal enuresis in children Alarm systems Fewer wet beds Pharmacological therapies Outcome Comparison Intervention or Exposure Population Patient Problem O C I P
PICO and Search Terms Pharmalogical therapies Alarm systems Nocturnal enuresis in children antidiuretic agents desmopressin imipramine alarm* nocturnal enuresis bedwetting nighttime urinary incontinence O C I P OR AND
Can measels-mumps-rubella vaccine (MMR vaccine) cause autism? Children Autism MMR vaccine (No vaccine) Outcome Comparison Intervention or Exposure Population Patient Problem O C I P
PICO and Search Terms Autism MMR vaccine Children Autism Autistic disorder Kanner’s Syndrome (Asperger Sydrome) Measles-Mumps-Rubella Vaccine MMR Vaccine Mumps Measles Rubella Vaccine Virivac Pluserix Priorix Trimovax Triviraten Berna O C I P OR AND
Evidence Pyramid Systematic review RCT Cohort Studies Case Control Studies Cross Sectional Studies Case Series Case Report Ideas, Editorials, Opinions Animal research In vitro (’test tube’) research
Identify, compare and summarize ALL relevant studies
As close to objective as we get
Compare and summarize SOME relevant studies
May be biased
Relevant databases Resources/Databases Study design Question Qualitative Studies Randomised Controlled Trial Controlled Trial Cohort Case Control Cohort Case Control Case Series Cohort Cross Sectional
Medline (and others)
Cochrane Database of Systematic Reviews, HTA og DARE (in The Cochrane Library), Clinical Evidence, Joanna Briggs, PEDro