C:\Fakepath\Exeter Ppt Ppt New Extract

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Exeter Extract

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C:\Fakepath\Exeter Ppt Ppt New Extract

  1. 1. Finding the Evidence Pragmatic Information Retrieval in the of Context of Evidence-based Healthcare Exeter September 2010 Kate Boddy Reinhard Wentz
  2. 2. 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>
  3. 3. 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>
  4. 4. 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. 5. 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>
  6. 6. 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>
  7. 7. Answerable question <ul><li>Does the presence of a </li></ul><ul><li>Doula reduce caesarean </li></ul><ul><li>section rates? </li></ul>
  8. 8. 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>
  9. 9. 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>
  10. 10. Answerable question <ul><li>How effective is </li></ul><ul><li>acupuncture in smoking </li></ul><ul><li>cessation programs? </li></ul>
  11. 11. 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>
  12. 12. 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>
  13. 13. 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>
  14. 14. 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>
  15. 15. 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>
  16. 16. 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. 17. 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>
  18. 18. 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. 19. The search-formulation ‘telegramme’ (here: on PubMed)
  20. 21. 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>
  21. 22. 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>
  22. 23. 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>
  23. 24. 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. 29. Answerable question <ul><li>How effective is </li></ul><ul><li>acupuncture in smoking </li></ul><ul><li>cessation programs? </li></ul>
  25. 32. <ul><li>To recap … </li></ul>
  26. 33. 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>
  27. 34. 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>
  28. 35. The curtain closes, only questions remain Brecht: The good woman of Szechwan The End
  29. 36. 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>
  30. 37. 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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