Alice Whitman Memorial Library Library Home Page Library 101 in ANGEL
Evidence Based PracticeSEARCHING FOR THE EVIDENCEGebb, B.A., Young, Z., & Anderson, B.A. (2012). Evaluating and using the evidence. In B.A. Anderson & S. Stone (Eds.), Best practices in midwifery: Using the evidence to implement change. New York: Springer Publishing.
Evidence Based Practice• What is EBP? – Most commonly cited definition is “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.” – Sackett, D.L., Rosenberg, W.M.C., Gray, J.A.M., Haynes, R.B., & Richardson, W.S. (1996, January 13). Evidence-based medicine: what it is and what it isn’t. BMJ, 312(71). Retrieved from http://www.bmj.com/content/312/7023/71.full
Evidence Based Practice The EBP Cycle• Identifying a clinical problem• Formulating a focused, answerable question• Locating relevant and appropriate resources• Searching for information• Critically appraising the information• Implementation in clinical practice
What is Evidence? Systematic Hierarchy of Research EvidenceHierarchy of Research Evidence Reviews Meta-Analyses Critical Appraisal Randomized Controlled Trials Cohort and case-controlled studies Consensus Statements Anecdotal Information
Search Strategy• Form a clinical question – Must be focused and answerable NOT What are therapies for depression? INSTEAD Does exercise reduce depressive symptoms in women?
Form a Clinical QuestionPICO framework: P – patient/problem I – intervention C – comparison O – outcome
Form a Clinical QuestionDoes exercise reduce depressive symptoms inwomen? P – women with depression (age group?) I – exercise (how strenuous? how often?) C – medication O – symptom reduction, quality of life
Boolean Operators AND – both terms must be present (will narrow a search) OR – either term is present (will broaden a search) NOT – only first term is present (will exclude terms)
Boolean Operators• exercise AND depression – will retrieve articles with both words• zoloft OR sertraline – will retrieve articles with either word• exercise NOT running – will retrieve articles with exercise and exclude those with running
Subject Headings• Specific words or phrases selected from a controlled vocabulary that describe a work – MEDLINE = MeSH – CINAHL = CINAHL Headings
Limiters• Parameters for your search – MEDLINE limiters include: • Age group • Publication type • Language • Dates
Research Filters• Research filters are pre-designed search strategies• Clinical Queries – PubMed page: http://www.ncbi.nlm.nih.gov/pubmed/clinical – Limiter in MEDLINE (EBSCOhost) – ((clinical[Title/Abstract] AND trial[Title/Abstract]) OR clinical trials[MeSH Terms] OR clinical trial[Publication Type] OR random*[Title/Abstract] OR random allocation[MeSH Terms] OR therapeutic use[MeSH Subheading])
Where is the Evidence?• Traditional bibliographic databases• Meta-search engines• Point of Care resources
Bibliographic Databases• MEDLINE – via EBSCOhost – via PubMed• CINAHL• Cochrane Library• Joanna Briggs Institute
Finally…• Don’t forget about librarians as a resource!• Call us before starting your literature review!
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