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Going to the Next Level / Presentation at IFLA 2014, Lyon
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Going to the Next Level / Presentation at IFLA 2014, Lyon

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Presentation given at IFLA 2014 in Lyon, to the Biomedical Libraries section.

Presentation given at IFLA 2014 in Lyon, to the Biomedical Libraries section.

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  • LIGHT INTRODUCTION: Explain how honeybees conduct a form of critical appraisal
  • In this slide, will talk about the five steps for those possibly unfamiliar, and how librarians typically only get involved in stages 1 or 2. Particularly in SRs. <br /> <br /> STAGE 3: “Critical appraisal is the systematic evaluation of clinical research papers in order to establish: <br /> Does this study address a clearly focused question? <br /> Did the study use valid methods to address this question? <br /> Are the valid results of this study important? <br /> Are these valid, important results applicable to my patient or population?”
  • “Critical appraisal is the systematic evaluation of clinical research papers in order to establish: <br /> Does this study address a clearly focused question? <br /> Did the study use valid methods to address this question? <br /> Are the valid results of this study important? <br /> Are these valid, important results applicable to my patient or population?” <br />
  • “Critical appraisal is the systematic evaluation of clinical research papers in order to establish: <br /> Does this study address a clearly focused question? <br /> Did the study use valid methods to address this question? <br /> Are the valid results of this study important? <br /> Are these valid, important results applicable to my patient or population?” <br />
  • Collaborators: we noticed health professionals have different expectations and varying degrees of flexibility; nurses and less academic areas seem more flexible <br />
  • …although most were also involved in CA teaching anyway
  • …although most were also involved in CA teaching anyway
  • Hill erport: mention Harrison, J. and Beraquet, V. (2010), Clinical librarians, a new tribe in the UK: roles and responsibilities. Health Information & Libraries Journal, 27: 123–132. doi: 10.1111/j.1471-1842.2009.00862.x

Going to the Next Level / Presentation at IFLA 2014, Lyon Going to the Next Level / Presentation at IFLA 2014, Lyon Presentation Transcript

  • GOING TO THE NEXT LEVEL How Health Librarians are Engaging with Critical Appraisal Martin Morris, MSc • Genevieve Gore, MLIS martin.morris@mcgill.ca • genevieve.gore@mcgill.ca McGill University, Montreal, Canada
  • 2 First: Why the honey bee?
  • Introduction
  • ASK the question ACQUIRE the evidence APPRAISE the evidence APPLY the Evidence ASSESS 4 The EBM Cycle
  • Our Research Questions • Health librarians are taking part in courses on evidence appraisal • We are also constantly seeking ways to develop collaboration with our health professional colleagues • Is critical appraisal (stage 3 of EBM) the next big opportunity for health librarians? • Are health librarians genuinely engaging with this opportunity? • We thought there was little literature on the subject 5 Why are we asking this question?
  • 6 Our Research Questions To what degree are health sciences librarians engaging in critical appraisal of the medical evidence? What attitudes do health sciences librarians display to this engagement?
  • 7 Methodology The study is a scoping review conducted according to Arksey & O’Malley’s guidelines (2005).
  • Methodology #1 8 What is a scoping review? Search Strategy Scoping reviews are a type of literature review that aims to provide an overview of the type, extent and quantity of research available on a given topic Two concepts: LIBRARIAN + CRITICAL APPRAISAL/EBM/EBHC
  • 9 Search Strategy (LISTA) S1 SU librarians S2 SU information S3 TX librarian# S4 TX informationist# S5 SU occupational roles S6 SU medical librarianship S7 TX information professional* S8 SU knowledge workers S9 SU librarians attitudes S10 TX information specialist# S11 TX information provider# S12 TX medical librarian* S13 TX hospital librarian* S14 TX informaticist# S15 TX knowledge worker# S16 SU medical libraries S17 OR/S1-S16 S18 SU evidence-based medicine S19 TX critical* apprais* S20 TX critical* think* S21 TX evidence-based S22 TX systematic* review* S23 TX evaluat* evidence S24 TX EBM S25 TX EBMP S26 TX EBHC S27 TX evidence N3 apprais* S28 TX quality N3 assess* S29 TX quality N3 apprais* S30 OR/S18-S29 S31 S17 AND S30 Methodology #2 Searches executed 31 March 2014.
  • 10 Inclusion/ Exclusion Criteria Methodology #3 Inclusion: Health Librarianship Stage 3 of the EBM cycle (APPRAISE) Language: • English, French, German, Spanish, Italian Exclusion: Research synthesis not librarianship Not health librarianship (including EBL not EBM) Only stage 1,2 of EBM (ASK, ACQUIRE) Full text not available Abstract only
  • Findings
  • Database searching (n = 4223) Embase on Ovid: 846 Ovid MEDLINE: 792 PubMed (not Medline): 64 LISTA (ProQuest): 1138 / LISA (ProQuest): 1383 Identified through other sources (to come) After duplicates removed (n=2275) Records screened (n=2275) Full text assessed for eligibility (n=363) Included in qualitative analysis (n=105) Records excluded (n=1912) FT excluded (n = 258) Duplicate: 2 / Language: 31 Research synthesis not lib’ship: 13 / Not health lib’ship: 69 / Only stage 1,2 of EBM: 91 / FT not available: 2 / Abstract: 3 / Other: 47 12
  • Emerging Themes
  • 14 Emerging Themes 1. How does the literature define Critical Appraisal?
  • There is a lack of rigour in the literature regarding the meaning of CA, from: –General checks of quality from an info lit point of view, to –Biostatistical appraisal of study quality –And various other levels in between 15 CA in the literature
  • • The concept of CA is referred to in many ways in the literature and it is frequently unclear which level of CA is intended • The term CA predates the term EBM. • Some of our 105 studies may include a lower level of CA 16 CA in the literature
  • 17
  • 18 Emerging Themes 2. What attitudes do librarians have towards Critical Appraisal?
  • • We tallied positive and negative librarian attitudes towards CA – We noticed that more librarians reported positive attitudes than negative. But the reports are highly self-selecting • We did the same, where possible, for collaborator attitudes – We saw no clear picture. However, collaborators regularly develop positive attitudes after working with a librarian who conducts CA 19 Attitudes to CA
  • • Maden-Jenkins summarises attitude barriers to librarian involvement in CA teaching which we also saw reflected in the literature: – “Lack of confidence” – “Lack of willing”, not wanting to take the lead – Perceived attitude of others • Concern about resistance from medical staff – Fear • Of the unknown, of statistics 20 Attitudes to CA #2
  • • She also reports perceived skills/knowledge barriers to librarian involvement: – Lack of knowledge, not sure what it is • Resulting in perceived lack of facilitation/teaching skills – Lack of specific statistical, mathematical knowledge – Difficulty of understanding or “getting your head around it” – Few opportunities to practice 21 Attitudes to CA #3
  • 22 Emerging Themes 3. What real-world examples are there of librarians getting involved in Critical Appraisal?
  • 23 CA in context #1 • Clinical Librarians • Informationist trends
  • • We spotted many types of librarian engagement with CA: – Librarians taking part in training, learning how to conduct CA at various levels – Librarians conducting training • Librarians conducting CA in various contexts – Filtering/evaluating the literature (rarely clear what this means) – Biostatistics, medical statistics, etc. 24 CA in context #2
  • 25 CA in context #3 • Vanderbilt: From Clinical Librarians to Informationists to Information Specialists: The Clinical Informatics Consult Service (CICS) – “Information specialists” synthesise the literature, analyse study methodology.
  • 26 Emerging Themes 4. If we ignore Critical Appraisal, will we become irrelevant?
  • • CA appears to be expected more and more in certain contexts. • Do health librarians need to routinely learn this in order to stay relevant? • Non-librarian, medical info specialists:We noticed various non-librarian informaticists and knowledge brokers conducting CA. 27 Staying Relevant
  • 28 Emerging Themes 5. Is there really a lack of relevant literature and a need for further research in this area? (Clue:Yes)
  • • There is no seminal article on this subject • Maden-Jenkins conducted research into librarians and CA (as quoted earlier). But she limited her research to training and her work is now 5 years old. • Research is needed into the broader field, and with a consistent definition of CA. 29 Lack of literature
  • Limitations
  • • During screening, particularly FT screening, we found other terms for CA which were not used in the original search strategies • The grey lit search was not completed in time for this presentation (of NHS, Canadian provincial health authorities, etc.) • Snowball searching also not complete 31 Limitations
  • Next Steps
  • • We need more evidence to find out what health librarians really think about CA – Diffusion of Innovation approach – What about collaborators? – Do collaborators really want librarian involvement? 33 What next?
  • 34 References Listing of the 105 articles we selected for data extraction: http://bit.ly/1mWvC2x Arksey, H., & O'Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19-32. Maden-Jenkins, M. (2010). Healthcare librarians and the delivery of critical appraisal training: Attitudes, level of involvement and support. Health Information and Libraries Journal, 27(4), 304-315. Maden-Jenkins, M. (2011). Healthcare librarians and the delivery of critical appraisal training: Barriers to involvement. Health Information and Libraries Journal, 28(1), 33-40.
  • 35 Thank you for listening!