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Finding the Evidence     Pragmatic Information Retrieval in the of    Context of Evidence-based Healthcare    Exeter  Sept...
 
 
 
 
 
 
“ It’s publish or perish –  and he didn’t publish!”
Just One Definition of EBHC:   <ul><li>An approach to health care practice  </li></ul><ul><li>in which the clinician is aw...
Preconditions for Successful EBHC  <ul><li>Start with a focused, answerable question </li></ul><ul><li>Select a high-yield...
Preconditions for Successful EBHC  <ul><li>Start with a focused, answerable question </li></ul><ul><li>Select a high-yield...
Unfocused (unanswerable) Questions <ul><li>Is health promotion a good thing? </li></ul><ul><li>How to treat diabetes in pr...
Answerable question <ul><li>How effective is a single dose </li></ul><ul><li>of dexamethasone in  </li></ul><ul><li>outpat...
Answerable question <ul><li>Does the presence of a  </li></ul><ul><li>Doula reduce caesarean </li></ul><ul><li>section rat...
Answerable question <ul><li>How effective is aspirin in </li></ul><ul><li>preventing DVT in patients </li></ul><ul><li>fol...
Answerable question <ul><li>What is the predictive value of </li></ul><ul><li>PCR compared to routine  </li></ul><ul><li>b...
Answerable question <ul><li>How effective is  </li></ul><ul><li>acupuncture in smoking  </li></ul><ul><li>cessation progra...
Aspects of the   ‘Answerable Question’   <ul><li>P atient or  P roblem </li></ul><ul><li>I ntervention or exposure </li></...
Preconditions for Successful EBHC  <ul><li>Start with a focused, answerable question </li></ul><ul><li>Select a high-yield...
High-yield Databases  Extracting · Evaluative · Synthesizing Databases <ul><li>PubMed  (especially Clinical Queries Option...
Preconditions for Successful EBHC  <ul><li>Start with a focused, answerable question </li></ul><ul><li>Select a high-yield...
Answerable question <ul><li>How effective is a single dose </li></ul><ul><li>of dexamethasone in  </li></ul><ul><li>outpat...
Suggested Search Strategy  <ul><li>Think ‘Telegram’  </li></ul><ul><li>?  </li></ul>
Answerable question <ul><li>How effective is a single dose </li></ul><ul><li>of dexamethasone in  </li></ul><ul><li>outpat...
Answerable question <ul><li>How effective is a single dose </li></ul><ul><li>of dexamethasone in  </li></ul><ul><li>outpat...
Answerable question <ul><li>How effective is a single dose </li></ul><ul><li>of  dexamethasone  in  </li></ul><ul><li>outp...
Answerable question <ul><li>How effective is a  single dose </li></ul><ul><li>of  dexamethasone  in  </li></ul><ul><li>out...
The search-formulation ‘telegramme’ (here: on PubMed)
 
Answerable question <ul><li>How effective is aspirin in </li></ul><ul><li>preventing DVT in patients </li></ul><ul><li>fol...
Answerable question <ul><li>How effective is aspirin in </li></ul><ul><li>preventing DVT in patients </li></ul><ul><li>fol...
Answerable question <ul><li>How effective is  aspirin  in </li></ul><ul><li>preventing DVT in patients </li></ul><ul><li>f...
Answerable question <ul><li>How effective is  aspirin  in </li></ul><ul><li>preventing  DVT  in patients </li></ul><ul><li...
 
 
 
 
Archie Cochrane  1909-1988  Cochrane AL. Effectiveness and Efficiency. Random Reflections on Health Services.  London: Nuf...
Archie Cochrane  1909-1988  All  effective  treatment  must be free! A. Cochrane  circa 1935
Answerable question <ul><li>How effective is  </li></ul><ul><li>acupuncture in smoking  </li></ul><ul><li>cessation progra...
 
 
<ul><li>To recap … </li></ul>
Preconditions for Successful EBHC  <ul><li>Start with a focused, answerable question </li></ul><ul><li>Select a high-yield...
And finally  ...  <ul><li>Start with a subject to which  </li></ul><ul><li>you know the answer:  </li></ul><ul><li>calibra...
The curtain closes,  only questions remain Brecht: The good woman of Szechwan The End
And finally, again  ...  <ul><li>Start with a subject to which  </li></ul><ul><li>you know the answer:  </li></ul><ul><li>...
Calibrate your skills! <ul><li>How effective are stockings to </li></ul><ul><li>prevent DVT in long-haul  </li></ul><ul><l...
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  1. 1. Finding the Evidence Pragmatic Information Retrieval in the of Context of Evidence-based Healthcare Exeter September 2010 Kate Boody Reinhard Wentz
  2. 8. “ It’s publish or perish – and he didn’t publish!”
  3. 9. Just One Definition of EBHC: <ul><li>An approach to health care practice </li></ul><ul><li>in which the clinician is aware of the </li></ul><ul><li>evidence in support of his/her </li></ul><ul><li>clinical practice, and the strength of </li></ul><ul><li>that evidence </li></ul><ul><li>Postgraduate Medical Journal 1996;72:1 </li></ul>
  4. 10. Preconditions for Successful EBHC <ul><li>Start with a focused, answerable question </li></ul><ul><li>Select a high-yield database </li></ul><ul><li>Formulate a simple search </li></ul>
  5. 11. Preconditions for Successful EBHC <ul><li>Start with a focused, answerable question </li></ul><ul><li>Select a high-yield database </li></ul><ul><li>Formulate a simple search </li></ul>
  6. 12. Unfocused (unanswerable) Questions <ul><li>Is health promotion a good thing? </li></ul><ul><li>How to treat diabetes in pregnancy? </li></ul><ul><li>Is physiotherapy useful? </li></ul><ul><li>Why is Mrs. Gupta depressed? </li></ul>
  7. 13. Answerable question <ul><li>How effective is a single dose </li></ul><ul><li>of dexamethasone in </li></ul><ul><li>outpatient croup? </li></ul>
  8. 14. Answerable question <ul><li>Does the presence of a </li></ul><ul><li>Doula reduce caesarean </li></ul><ul><li>section rates? </li></ul>
  9. 15. Answerable question <ul><li>How effective is aspirin in </li></ul><ul><li>preventing DVT in patients </li></ul><ul><li>following hip-replacement? </li></ul>
  10. 16. Answerable question <ul><li>What is the predictive value of </li></ul><ul><li>PCR compared to routine </li></ul><ul><li>blood culture in the </li></ul><ul><li>treatment of neonatal sepsis? </li></ul>
  11. 17. Answerable question <ul><li>How effective is </li></ul><ul><li>acupuncture in smoking </li></ul><ul><li>cessation programs? </li></ul>
  12. 18. Aspects of the ‘Answerable Question’ <ul><li>P atient or P roblem </li></ul><ul><li>I ntervention or exposure </li></ul><ul><li>C omparison </li></ul><ul><li>O utcome </li></ul><ul><li>= PICO </li></ul>
  13. 19. Preconditions for Successful EBHC <ul><li>Start with a focused, answerable question </li></ul><ul><li>Select a high-yield database </li></ul><ul><li>Formulate a simple search </li></ul>
  14. 20. High-yield Databases Extracting · Evaluative · Synthesizing Databases <ul><li>PubMed (especially Clinical Queries Option) </li></ul><ul><li>Cochrane Library </li></ul><ul><li>Google Scholar </li></ul><ul><li>NHS Evidence </li></ul><ul><li>TRIP </li></ul><ul><li>Quality Sites on the Web etc. </li></ul>
  15. 21. Preconditions for Successful EBHC <ul><li>Start with a focused, answerable question </li></ul><ul><li>Select a high-yield database </li></ul><ul><li>Formulate a simple search </li></ul>
  16. 22. Answerable question <ul><li>How effective is a single dose </li></ul><ul><li>of dexamethasone in </li></ul><ul><li>outpatient croup? </li></ul>
  17. 23. Suggested Search Strategy <ul><li>Think ‘Telegram’ </li></ul><ul><li>? </li></ul>
  18. 24. Answerable question <ul><li>How effective is a single dose </li></ul><ul><li>of dexamethasone in </li></ul><ul><li>outpatient croup? </li></ul>
  19. 25. Answerable question <ul><li>How effective is a single dose </li></ul><ul><li>of dexamethasone in </li></ul><ul><li>outpatient croup ? </li></ul>
  20. 26. Answerable question <ul><li>How effective is a single dose </li></ul><ul><li>of dexamethasone in </li></ul><ul><li>outpatient croup ? </li></ul>
  21. 27. Answerable question <ul><li>How effective is a single dose </li></ul><ul><li>of dexamethasone in </li></ul><ul><li>outpatient croup ? </li></ul>
  22. 28. The search-formulation ‘telegramme’ (here: on PubMed)
  23. 30. Answerable question <ul><li>How effective is aspirin in </li></ul><ul><li>preventing DVT in patients </li></ul><ul><li>following hip-replacement? </li></ul>
  24. 31. Answerable question <ul><li>How effective is aspirin in </li></ul><ul><li>preventing DVT in patients </li></ul><ul><li>following hip-replacement ? </li></ul>
  25. 32. Answerable question <ul><li>How effective is aspirin in </li></ul><ul><li>preventing DVT in patients </li></ul><ul><li>following hip-replacement ? </li></ul>
  26. 33. Answerable question <ul><li>How effective is aspirin in </li></ul><ul><li>preventing DVT in patients </li></ul><ul><li>following hip-replacement ? </li></ul>
  27. 38. Archie Cochrane 1909-1988 Cochrane AL. Effectiveness and Efficiency. Random Reflections on Health Services. London: Nuffield Provincial Hospitals Trust, 1972 All effective treatment must be free! A. Cochrane circa 1935
  28. 39. Archie Cochrane 1909-1988 All effective treatment must be free! A. Cochrane circa 1935
  29. 40. Answerable question <ul><li>How effective is </li></ul><ul><li>acupuncture in smoking </li></ul><ul><li>cessation programs? </li></ul>
  30. 43. <ul><li>To recap … </li></ul>
  31. 44. Preconditions for Successful EBHC <ul><li>Start with a focused, answerable question </li></ul><ul><li>Select a high-yield database </li></ul><ul><li>Formulate a simple search </li></ul>
  32. 45. And finally ... <ul><li>Start with a subject to which </li></ul><ul><li>you know the answer: </li></ul><ul><li>calibrate your skills (why?) </li></ul>
  33. 46. The curtain closes, only questions remain Brecht: The good woman of Szechwan The End
  34. 47. And finally, again ... <ul><li>Start with a subject to which </li></ul><ul><li>you know the answer: </li></ul><ul><li>calibrate your skills (why?) </li></ul>
  35. 48. Calibrate your skills! <ul><li>How effective are stockings to </li></ul><ul><li>prevent DVT in long-haul </li></ul><ul><li>airline passengers? </li></ul>

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