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Community Training in Evidence Based Practice 3-28-13
 

Community Training in Evidence Based Practice 3-28-13

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  • Discussion: The main focus here is to make sure attendees are clear on the basics of PubMed’s purpose. We want to stress how they can access it. We want to be clear about the type of information that is contained in it. Also, they need to be clear on how this relates to EBP, and how they can translate their search queries into the database, get results, and identify the level (basic, filtered, unfiltered) of those results. Action: After a brief talk on this slide, we will take them to the web site and discuss the basic features and tools. We will look at how to search, and what search results look like.
  • Discussion: We want to begin to show attendees how to formulate their basic searches. Attendees will see how to choose their search terms and how PubMed delivers the results.Action: The example to be used for searches will be “diabetes type 2 insulin.” This shows basic choice of keywords for a Problem/Patient and an Intervention. After a brief discussion of the results display, attendees will be show how to identify their basic, filtered, and unfiltered information through article types, dates of publication, and additional filters such as age, sex, etc.
  • Discussion: Attendees will be exposed to the Clinical Queries search of PubMed. The focused/filtered aspect of these results will be discussed.Action: The same example will be used “diabetes type 2 insulin.” A comparison between search results and identifying the level of literature will be the stressed.
  • Discussion: Many articles found in PubMed are not free. We will address the distinction between accessing free articles (i.e. PubMed Central) and needing to access items through a library.Action: We will identify the “full-text” option from search results, and we will view an individual article record through the TMC Library’s subscription to show how finding full-text through your local library may work.
  • Action: Assist anyone who needs help. We will briefly discuss what everyone found and any problems that were encountered.
  • Discussion: Who makes it? What does it have? What can it do?Action: The example “diabetes type 2 insulin” will be used to demonstrate the basic functions of the site.
  • Discussion: Who makes it? What does it have? What can it do?Action: The example “diabetes type 2 insulin” will be used to demonstrate the basic functions of the site.
  • Discussion: Who makes it? What does it have? What can it do?Action: The example “diabetes type 2 insulin” will be used to demonstrate the basic functions of the site.
  • Discussion: Who makes it? What does it have? What can it do?Action: The example “diabetes type 2 insulin” will be used to demonstrate the basic functions of the site.
  • Discussion: Who makes it? What does it have? What can it do?Action: The example “diabetes type 2 insulin” will be used to demonstrate the basic functions of the site.
  • Discussion: Who makes it? What does it have? What can it do?Action: The example “diabetes type 2 insulin” will be used to demonstrate the basic functions of the site.
  • Action: Assist anyone who needs help. We will briefly discuss what everyone found and any problems that were encountered.
  • Action: Assist anyone who needs help. We will briefly discuss what everyone found and any problems that were encountered.
  • Action: Assist anyone who needs help. We will briefly discuss what everyone found and any problems that were encountered.

Community Training in Evidence Based Practice 3-28-13 Community Training in Evidence Based Practice 3-28-13 Presentation Transcript

  • CommunityTraining inEvidence-BasedPracticeThis project has been funded in whole or in part with Federal fundsfrom the National Library of Medicine, National Institutes of Health,under Contract No. HHSN-276-2001-000007-C with the HoustonAcademy of Medicine-Texas Medical Center Library
  • Agenda for today:-Attendees will understand the basics of evidence-based practice and resources that can assistsearches for evidence-based literature. (25 min)-Attendees will search PubMed and PubMedClinical queries for evidence-based literature.(45 min)-Break (5 min)-Attendees will apply search strategies acrossmultiple other “free to search” resources forlocating evidence-based literature. (45 min)- Attendees will learn how to obtain informationfrom their local libraries or other free informationsources. (5 min)
  • Evidence-BasedPracticeBasics
  • Evidence-Based PracticeClinicalExpertiseBestResearchEvidencePatientValues &ExpectationsEBP
  • Why EBP?Continually discovering improvedtreatments and methodsHealthcare providers must staycurrentEBP keeps healthcare providers up-to-date
  • Evidence Based Practice:A 5-step Practice1) Assess: What is it you want to know?2) Ask: Use PICO to create a question3) Acquire: Search for good evidence4) Appraise: Assess the evidence5) Apply: Use what you’ve found
  • Assess & Ask: PICOPatient: Who is your patient?Intervention: What do you wantto do with this patient?Comparison (optional): Is therean alternative treatment/causeetc. to consider?Outcome: What do you hope toaccomplish?
  • PICO Example:In an 86-year old manwith coronary arterydisease, is aspirin amore effective agentthan heparin inreducing risk ofstroke?
  • Acquire:Identify & Select Resources3 CategoriesBackgroundInformationFilteredInformationUnfilteredInformation
  • Unfiltered InformationProvide original research (are not criticallyappraised)• Individual Journal Articles (not critically appraised)• Randomized Controlled Trials (RCTs)• Clinical Trials• Cohort Studies• Case-controlled Studies• Case Series/ReportsInclude:• PubMed• Ovid MEDLINE• Cochrane Central Register of Controlled Trials• PsychINFO• CINAHLDatabases:Provide broad overviews of medicaltopics• Clinical reference books• Clinical reference websites• Practice GuidelinesInclude:• MedlinePLUS• National Institute of HealthDatabases:
  • Unfiltered InformationProvide original research (are not criticallyappraised)• Individual Journal Articles (not critically appraised)• Randomized Controlled Trials (RCTs)• Clinical Trials• Cohort Studies• Case-controlled Studies• Case Series/ReportsInclude:• PubMed• Ovid MEDLINE• Cochrane Central Register of Controlled Trials• PsychINFO• CINAHLDatabases:FilteredProvide reviews of original research (arecritically appraised)• Systematic Reviews• Meta-Analyses• Critically Appraised Topics and ArticlesInclude:• Cochrane Database of Systematic Reviews• Ovid MEDLINE• PubMed• National Guideline Clearinghouse (topics)• The ACP Journal Club (articles)Databases:
  • Provide original research (are not criticallyappraised)• Individual Journal Articles (not critically appraised)• Randomized Controlled Trials (RCTs)• Cohort Studies• Case-controlled Studies• Case Series/ReportsInclude:• PubMed• Ovid MEDLINE• Cochrane Central Register of Controlled Trials• PsychINFO• CINAHLDatabases:
  • • A) A newspaper article about breast cancer in theHouston Chronicle• B) A “Letter from the Editor” about obesity inParenting Magazine• C) Information about Type 2 Diabetes from the“Health Topics” section of MedlinePLUS• D) Information Dr. Oz writes on his Facebook pageWhich ofthese isanEvidenceBasedPracticeResource?
  • • A) A newspaper article about breast cancer in theHouston Chronicle• B) A “Letter from the Editor” about obesity inParenting Magazine• C) Information about Type 2 Diabetes from the“Health Topics” section of MedlinePLUS• D) Information Dr. Oz writes on his Facebook pageWhich ofthese isanEvidenceBasedPracticeResource?
  • Thank you!AnyQuestions?
  • (http://www.pubmed.gov)• PubMed is a freely searchable literature databaseprovided by the National Library of Medicine.• It contains 22 million biomedical citations.• A mobile version is available on tablets andsmartphones.
  • Translating your PICO question into a PubMed databasesearch (search strategy)• Pick out the most important key terms from your PICO question.• Usually, when more search terms are entered into a search query, it willresult in fewer articles.• Use “Article Types” to find your filtered or unfiltered results.• Use “Publication Dates” to specify the most recent results or a defined timeperiod.• “Additional Filters” can help you narrow your results closer to the key termsfrom your PICO question.
  • PubMed vs. PubMed Clinical Queries• Performing a basic PubMed search will look in all records of thedatabase for your search terms.• Clinical Queries adds specifications to your search to locateitems in a subset of articles that relate to you search.• You can find filtered literature through “Systematic Reviews.”• You can find unfiltered literature through “Clinical StudyCategories.”
  • Obtaining articles• Some free full-text articles are availablethrough PubMed Central.• Having a membership with a library canincrease the full-text access to items found inPubMed.
  • Searching Exercise• Spend some time practicing searches inPubMed.• Find 1 example of a filtered article.• Find 1 example of an unfiltered article.
  • Questions?
  • “Free to search”resourcesThere are many freelyaccessible web sites thatcontain reliable evidence-based health information.These are available fromboth private and publicorganizations.
  • Medline Plus (http://www.medlineplus.gov)• A consumer level resource containing information on a wide range of topicson health from the National Library of Medicine• Users can browse/search by Health Topics to view information on specificconditions.• Users can browse/search Drugs & Supplements to view information onpharmaceuticals.• The entire site is available in Spanish, as well as, multiple Languages forsome information.
  • National Institutes of Health (http://health.nih.gov)• The National Institutes of Health oversee many governmentalhealth organizations, including the National Library of Medicine.Their Health Information site provides consumer levelinformation.• Health Topics can be browsed alphabetically or searched.• Health Categories give broad topics to browse.
  • TRIP Database (http://www.tripdatabase.com)• A commercially run site that includes content from PubMed,The Cochrane Library, and other evidence based sources.• Basic search enables you to find information across multiplesources.• PICO search function lets you translate you PICO questioneasily.
  • Clinical Trials (http://www.clinicaltrials.gov)• This focuses on searching for information with regards to clinical studies(both publicly and privately funded) that have been completed or arecurrently active.• What are clinical trials? “A research study using human subjects toevaluate the effect of interventions or exposures on biomedical orhealth-related outcomes.”• Basic search can be used to search across all available clinical studyinformation.
  • The Community Guide (www.thecommunityguide.org)• This gives access to findings from all Community PreventiveServices Task Force findings. It highlights systematic reviews andstrives to present interventions that are effective.• Browse Topics for a broad view of findings related to various healthconditions.• Searching enables access to items available from The CommunityGuide or the Center for Disease Control and Prevention.
  • “Free to search” exercise• Find 2 items concerning a health topic of yourchoosing (articles, web sites, or other) from any ofthe sites discussed.• Identify if these items are basic, filtered, orunfiltered levels of evidence.
  • Where else can I go?• Public libraries are great resources for accessingdatabases, help with searching, and other guidance.• The TMC Library is currently creating a subject guidebased around this class. It will be available athttp://libguides.library.tmc.edu/ on or before April 30,2013.
  • Questions?Thank You!