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EBD Course: Lecture 4 Secondary Sources
 

EBD Course: Lecture 4 Secondary Sources

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    EBD Course: Lecture 4 Secondary Sources EBD Course: Lecture 4 Secondary Sources Presentation Transcript

    • Searching
      SohailBajammal
      October 9, 2011
    • Objectives
      Previous lecture
      Differences between primary & secondary sources of evidence
      Overview of popular secondary sources
    • Previous Lecture
    • Steps of Evidence-Based Dentistry

      • Before we go into the “Acquire” and searching, we need to know “what” we are looking for?
      • Then “where” & “how” to look for it.
    • Pyramid of Evidence
      http://servers.medlib.hscbklyn.edu/ebm/2100.htm
    • Today’s Lecture
    • 5A
    • 5S Hierarchy of EvidenceHaynes RB. Evid Based Med 2006;11:162-164
      Computerized decision support system
      Evidence-Based
      Guidelines & Textbooks
      Secondary
      Critically-Appraised
      Journal Articles & Abstracts
      Systematic Reviews
      RCTs, Cohort, Case control, Case series
      Primary
      Expert Opinion: Classical Textbooks
    • Searching for evidence
      Case report, Case series, Case-Control, Cohort, Randomized Trial
      DiCenso A, Bayley L, Haynes RB. Accessing preappraised evidence: fine-tuning the 5S model into a 6S model. ACP Journal Club, 2009
    • Studies(Primary Sources)
    • Primary Sources
      Original articles
      Through databases: MEDLINE, EMBASE
      Using: PubMed, OVID
      You have to retrieve and appraise the articles
      Strength (pyramid) of evidence
    • PubMed
    • MeSH(Medical Subject Headings)
    • It is a “strategy”
      Low Back Pain
      Treatment
      OR
      OR
      Low Back Ache
      Management
      Acute
      OR
      OR
      Low Backache
      Therapy
      AND
      AND
      OR
      OR
      "Low Back Pain"[Mesh]
      Surgery
    • We will talk more aboutSEARCH STRATEGYin the coming few weeks
    • PubMed Tutorials
      20
    • In: Glasziou P, Del Mar C: Evidence-based Practice Workbook: Bridging the gap between health care research and practice. Blackwell Publishing - BMJ Books. 2007. PP 3-13
    • In: Glasziou P, Del Mar C: Evidence-based Practice Workbook: Bridging the gap between health care research and practice. Blackwell Publishing - BMJ Books. 2007. PP 3-13
    • Pyramid of Evidence
      http://library.downstate.edu/EBM2/2100.htm 
    • This what we will be doing the coming few weeks
    • Tough Job
      If you have to do the critical appraisal for every single article you read  Tough
      BUT You need to learn about it in details for the sake of research
    • Don’t say there is “no evidence”
      Instead Weak evidence
      You might not have looked thorough enough
    • Absence of evidence is
      not
      the evidence of absence
    • Satisficing
      ‘‘where busy clinicians will be satisfied with the information they can readily summon, while sacrificing quality for convenience”
      Carter BS, Leuthner S. Decision making in the NICU—strategies, statistics and ‘‘satisficing.’’ Bioethics Forum. 2002;18:7–15.
    • Usefulness of information
      Hurwitz SR, Slawson DA, Shaughnessy A. Orthopaedic information mastery: applying evidence-based information tools to improve patient outcome while saving orthopaedists’ time. J Bone Joint Surg Am. 2000;82:888–895.
    • Secondary Sources
    • Syntheses(Systematic Reviews)
    • Syntheses
      The authors have done the work for you
      Hopefully:
      They asked a good question
      They searched the literature systematically (keywords & MeSH)
      They identified the studies and assessed their quality
      This is called Systematic Review
      If they did statistical combination of results, this is called Meta-analysis
    • How to search for “Syntheses”?
      Same databases: MEDLINE, EMBASE
      Cochrane Library
    • PubMed
    • Available at UQU
    • Are all syntheses good?
      You still have to appraise the quality of these systematic reviews and meta-analyses
    • Synopses(Critically Appraised Abstracts)
    • Synopses
      Physicians with training in research methodology:
      Read the articles
      Assess their quality
      Summarize them for you
      Many sources:
      Database of Abstracts of Reviews of Effects (DARE)
      Evidence-based Dentistry
      Journal of Evidence-Based Dental Practice
      Critically Appraised Topics (CATs)
      Evidence-based sections in many journals
      Others: DynaMed, EvidenceMatters, EssentialEvidence
    • DAREDatabase of Abstracts of Reviews of Effects
      Free
    • Evidence-Based Dentistry Journal
      Available at UQU
    • Journal of Evidence Based Dental Practice
    • Critically Appraised Topics (CATs)
    • SummariesEBM TextbooksEBM Guidelines
    • EBM Textbooks
      UpToDate
    • Guidelines
    • Guidelines
      Types of guidelines:
      Consensus
      Evidence-based
      Use the limiting features in the website
    • Guidelines
      NICE: National Institute for Health & Clinical Excellence
      SIGN: Scottish Intercollegiate Guidelines Network
      NGC: National Guideline Clearinghouse
    • Are all guidelines good quality?
    • Systems
    • Systems
      This is the ultimate goal
      Computerized decision support
      Too sophisticated for us to think about now
    • Paid Services
      DynaMed
      EvidenceMatters
      EssentialEvidence Plus
    • Available at UQU
      DynaMed
    • Evidence Matters
    • EssentialEvidencePlus
    • Meta Search (Many-in-one)
      NHS Evidence
      TripDatabase
      Google Scholar
    • NHS Evidence
    • TRIPDatabase
    • Google Scholar
    • Broad Term  Lots of irrelevant results
    • They will email you when new article cites this article
    • Searching for evidence
      DiCenso A, Bayley L, Haynes RB. Accessing preappraised evidence: fine-tuning the 5S model into a 6S model. ACP Journal Club, 2009
    • The Remaining of the Course
      Primary Sources
      Critical Appraisal of:
      Therapy
      Systematic Review
      Diagnosis
      Prognosis
    • Assignment 3
      What are the secondary sources available for dental students and dentists to practice evidence-based dentistry? Categorize them according to the 5S/6S model
      Visit these sites & describe in your words what are they & what do you think of them.
      If you find other sources, you can add them
      Type at least 2 lines describing each secondary source (size 12 font)
      Assignment due October 18
      Send the assignment to my email (email subject & Word document: EBD3 your name)