Evidence-based Medicine Literature Searching SC
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This document provides guidance on evidence-based medicine (EBM) literature searching. It discusses the hierarchy of levels of evidence and acquiring the best evidence through systematic reviews, individual studies, and databases. It outlines six prerequisites for successful literature searching and strategies such as using textbooks, primary literature databases like PubMed, and secondary sources. The document also discusses resources for EBM knowledge translation including clinical decision support systems, guidelines, and quality improvement tools.
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Evidence-based Medicine Literature Searching SC
- 1. EBM Literature Searching Dr. Imad Salah Ahmed Hassan MD FACP FRCPI MSc MBBS Chairman, Knowledge Translation Committee Department of Medicine, KAMC,KSA
- 2. What is Best Evidence? Hierarchy of Levels of Evidence
- 3. Acquire the Best Evidence: Finding the Best Evidence First Hierarchy of Sources of Evidence Pyramid Pre-appraised, systematic reviews: Cochrane Pre-appraised, individual studies: ACP Journal Club, BestBets Databases with EBM background: CKS, Essential Evidence Plus ®, DynaMed®, ACP’s PIER, BMJ Best Treatment, Guidelines Clearinghouse, Guidelines Finder Highly referenced, current e-textbook: Up-to-Date Standard e-textbooks (emedicine) Primary Resources: PubMed (Clinical Queries), Medline *Adapted from Shaughnessy and Slawson
- 4. Self-Education & Training in EBM EBM Resources: http://guides.mclibrary.duke.edu/content.php?pid=274 373&sid=2262393 http://www.med.yale.edu/library/education/guides/feat ure/finditfast CEBM Website: http://www.youtube.com/user/cebmed, http://www.cebm.net/index.aspx?o=1965 YouTube: http://www.youtube.com/watch?v=odfo9CQGi0c
- 6. The 6 Prerequisites for successful Literature Searching 1 2 3 4 5 6 • Know how to use a computer/electronic device. • Know the Internet Jargon of Terms. • Know the EBM Jargon of Terms. • Know how to formulate your question. • Know where to go. • Know what to do when you get there: the site’s technical language/know-how.
- 7. Learn how to navigate your resource: Website Tutorial
- 9. Resources For EBM Knowledge Translation EBM Hunting Tools EBM Resources Advanced EBM Skills Point of Care Clinical Resources Updates New Evidence Decision Support Systems Critical Appraisal Tools EvidenceBased Guidelines & Policies EvidenceBased Quality Improvement •DynaMed •Essential Evidence Plus •First Consult •UpToDate •Clinical Evidence •ACP PIERS •Mc Master Plus: STAT REF •BMJ Evidence Updates/Alerts •ACP Journal Club •Open Clinical •Dxplain •Emergency Medicine on the Web •Clinical Decision Making Calculators •EBM toolbox •CATmaker •Evidence based medicine toolkit •EBM Calculator •National Guideline Clearinghouse • NHS Evidence • ICSI Institute for Clinical Systems Improvements •AHRQ •Institute for Healthcare Improvement •Knowledge Translation Clearinghouse •NICE
- 10. Hunting for Evidence Please use in conjunction with the Hyperlinked Page.
- 11. “Finding Evidence”: Searching Strategy 1 2 3 4 • Decide if the question is a Foreground or Background Question • Convert clinical Foreground question to searchable question (e.g. PICO) • Choose the database you want to search: Primary (e.g. Pubmed), Secondary (e.g. Cochrane)or Tertiary (e.g. Trip Database) • Apply filters to restrict your search (e.g. PubMed limits linked to PICO such as gender, age, study type limits)
- 12. “Finding Evidence”: Searching Strategy 5 6 7 8 • Appraise your Primary studies: Critical Appraisal Tools • Assess result (e.g. using systematic review worksheet) • Decide if you have enough information to make a decision • If not then refine steps 2-4 until you either have an answer or decide there isn’t enough evidence to make an evidence based decision
- 13. Secrets of Literature Searching Strategies for Literature Searching: Strategy 1: Background Knowledge: Textbooks/eTextbooks e.g. emedicine
- 14. Secrets of Literature Searching Strategies for Literature Searching: Strategy 2: Foreground Knowledge: Primary Literature/Original Studies= Pubmed, Embase, Cinahl etc
- 15. Secrets of Literature Searching Strategies for Literature Searching: Strategy 3: Foreground Knowledge: Secondary Literature/Preappraised Literature Focused/Specific Broad/General Topic
- 16. Diagnosis e.g. Troponin in ACS Uric acid in Pre-eclampsia Therapy e.g. – Misoprostol for PPH – Statins for hypercholesterolemia – Specific procedure Systematic Review Sites e.g. Cochrane Technology Assessment Sites e.g. Cochrane Guidelines e.g. Guideline Clearinghouse Evidence Based eTextbooks e.g. Dynamed
- 17. Broad/General Topic Management of Postpartum Guidelines e.g. Hemorrhage Management of hypertension Management of Fetal Respiratory Evidence Based eTextbooks e.g. Distress Syndrome UpToDate Management of cancer pain Guideline Clearinghouse On-line eTextbooks
- 18. Secrets of Literature Searching Strategies for Literature Searching: Strategy 4: Foreground Knowledge: Evidence-based Quality Improvement: Policies, Pathways, Order Sets etc NICE Pathways: guidance at your fingertips- www.nice.org.uk Society of Hospital Medicine: http://www.hospitalmedicine.org/ AHRQ Agency for Healthcare Research and Quality http://www.ahrq.gov/ Institute for Healthcare Improvement: http://www.ihi.org/IHI/Topics/LeadingSystemImprovement/ ICSI Institute for Clinical Systems Improvements http://www.icsi.org/index.aspx
- 19. Secrets of Literature Searching Strategies for Literature Searching: Strategy 1: Background Knowledge: Textbooks/eTextbooks e.g. emedicine e.g. Pancreatitis, Appendicitis How to access emedicine: Three ways! (applies to all EBM Websites) 1: Google it: pancreatitis emedicine 2. Click on the www address from the hyperlinked page 3: Saved address from your favorites links menu.
- 21. Topic Headings
- 23. Secrets of Literature Searching Strategies for Literature Searching: Strategy 2: Foreground Knowledge: Primary Literature/Original Studies= Pubmed, Embase, Cinahl etc
- 24. A PICO for Appendicitis P Acute Appendicitis I Ultrasound C Computerized Tomography O Diagnostic Accuracy
- 25. Option 1: Use Pubmed via pico (for both Primary and Secondary Literature)
- 27. Click on PICO
- 28. Select Publication Type from drop-down menu
- 30. TBL The Bottom Line Increase your hits by using the Related option if this hit is the closest to your PICO
- 31. http://pubmedhh.nlm.nih.gov/nlm/ PubMed for Handhelds (PubMed4Hh): Download to your device from Play Store MEDLINE/PubMed Search MEDLINE/PubMed Read Journal Abstracts PICO search Patient, Intervention, Comparison, Outcome askMEDLINE free-text, natural language search
- 32. Option 2: Use Pubmed search box (for both Primary and Secondary Literature)
- 36. Option 3: Use the “Clinical Queries” option in Pubmed. (for both Primary and Secondary Literature)
- 39. Secrets of Literature Searching Strategies for Literature Searching: Strategy 3: Foreground Knowledge: Secondary Literature/Preappraised Literature Focused/Specific Broad/General Topic
- 40. Looking for EBM information in Guideline Clearinghouse directly from Google
- 44. Looking for EBM information in UpToDate directly from Google
- 48. Looking for Calculators for Decision Making e.g. Pancreatitis
- 49. Looking for Calculators for Decision Making
- 50. Looking for Calculators for Decision Making e.g. Pancreatitis
- 51. Looking for EBM Calculator in UpToDate
- 52. Technology Assessment Database in the COCHRANE LIBRARY
- 53. Critical Appraisal Checklists http://www.gla.ac.uk/departments/generalpracticeprimarycare/ebp/ checklists/#d.en.19536 Checklist for an article on treatment or prevention Checklist for an article on qualitative research Checklist for an article on decision analysis Checklist for an article on an educational intervention Checklist for an article on prognosis Checklist for an article on harm or causation Checklist for an article on guidelines Checklist for an article on diagnosis or screening Checklist for a systematic review Checklist for economic evaluations Looking for EBM Critical Appraisal Tools
- 54. Critical Appraisal Calculators Oxford Centre for EBM: http://www.cebm.net/?o=1023
- 55. Secrets of Literature Searching Strategies for Literature Searching: Strategy 4: Foreground Knowledge: Evidence-based Quality Improvement: Policies, Pathways etc NICE Pathways: guidance at your fingertips- www.nice.org.uk Society of Hospital Medicine: http://www.hospitalmedicine.org/ AHRQ Agency for Healthcare Research and Quality http://www.ahrq.gov/ Institute for Healthcare Improvement: http://www.ihi.org/IHI/Topics/LeadingSystemImprovement/ ICSI Institute for Clinical Systems Improvements http://www.icsi.org/index.aspx
- 59. For a bad incident: An evidence-based M&M Report ready for use. WebM&M Morbidity & Mortality Rounds: http://www.webmm.ahrq.gov/
- 62. For high readmission rates
- 68. Boolean operator „OR‟ The George Boole After its creatorBoolean Operators Akobeng AK. Arch Dis Child 2005 ; 90 : 837 – 840.
- 69. Boolean operator „AND‟ After its creator George Boole Akobeng AK. Arch Dis Child 2005 ; 90 : 837 – 840.
- 70. Boolean operator „NOT‟ After its creator George Boole Akobeng AK. Arch Dis Child 2005 ; 90 : 837 – 840.
- 71. Boolean search After its creator George Boole Boolean operators Peptic ulcer OR Hemorrhage Peptic ulcer AND Hemorrhage Peptic ulcer NOT Hemorrhage Meaning
- 72. Summary Competency in Literature Searching is a must for an effective healthcare force.
Editor's Notes
- SmartArt custom animation effects: pictures peek-in(Basic)To reproduce the SmartArt effects on this page, do the following:On the Home tab, in the Slides group, click Layout, and then click Blank. On the Insert tab, in the Illustrations group, click SmartArt.In the Choose a SmartArt Graphic dialog box, in the left pane, click Matrix. In the Matrix pane, double-click Titled Matrix (second option from the left) to insert the graphic into the slide. Select the graphic. Under SmartArt Tools, on the Format tab, click Size, and then do the following:In the Height box, enter 5.67”.In the Width box, enter 8.5”.Under SmartArt Tools, on the Format tab, click Arrange, click Align, and then do the following:Click Align to Slide.Click Align Middle. Click Align Center. Select the graphic, and then click one of the arrows on the left border. In the Type your text here dialog box, enter text in the top-level bullet only (text for the rounded rectangle at the center of the graphic). To remove the [Text] placeholder in the second-level bullets, select each bullet and press SPACE.On the slide, select the graphic. Under SmartArtTools, on the Design tab, in the SmartArtStyles group, click More, and then under Best Match for Document click Moderate Effect.Select the rounded rectangle at the center of the graphic. On the Home tab, in the Font group, select 28 from the Font Size list, click the arrow next to Font Color, and then click White, Background 1 (first row, first option from the left).With the rounded rectangle selected, under SmartArtTools, on the Format tab, in the bottom right corner of the ShapeStyles group, click the FormatShape dialog box launcher. In the FormatShape dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Linear.In the Direction list, select LinearUp (second row, second option from the left).Under Gradient stops, click Add or Remove until three stops appear in the drop-down list.Also under Gradient stops, customize the gradient stops as follows:Select Stop 1 from the list, and then do the following:In the Stop position box, enter 0%.Click the button next to Color, and then under Theme Colors click White, Background 1, Darker 35% (fifth row, first option from the left).Select Stop 2 from the list, and then do the following: In the Stop position box, enter 80%.Click the button next to Color, and then under Theme Colors click White, Background 1, Darker 35% (fifth row, first option from the left).Select Stop 3 from the list, and then do the following: In the Stop position box, enter 100%.Click the button next to Color, and then under Theme Colors click White, Background 1, Darker 15% (third row, first option from the left).Right-click the top left shape in the graphic, and then click Format Shape. In the Format Shape dialog box, in the left pane, click Fill. In the Fill pane, click Picture or texture fill,and then under Insert from, click File.In the Insert Picture dialog box, select a picture and then click Insert. Right-click the top right shape in the graphic, and then click Format Shape. In the Format Shape dialog box, in the left pane, click Fill. In the Fill pane, click Picture or texture fill,and then under Insert from, click File.In the Insert Picture dialog box, select a picture and then click Insert. Right-click the bottom left shape in the graphic, and then click Format Shape. In the Format Shape dialog box, in the left pane, click Fill. In the Fill pane, click Picture or texture fill,and then under Insert from, click File.In the Insert Picture dialog box, select a picture and then click Insert. Right-click the bottom right shape in the graphic, and then click Format Shape. In the Format Shape dialog box, in the left pane, click Fill. In the Fill pane, click Picture or texture fill,and then under Insert from, click File.In the Insert Picture dialog box, select a picture and then click Insert. To reproduce the animation effects on this slide, do the following:On the Animations tab, in the Animations group, click CustomAnimation.On the slide, select the graphic, and then do the following in the CustomAnimation task pane: Click Add Effect, point to Entrance, and then click MoreEffects. In the Add Entrance Effect dialog box, under Subtle, click Expand. Under Modify: Expand, in the Speed list, select Fast.Under Modify: Expand, in the Start list, select After Previous.Also in the Custom Animation task pane, click the arrow to the right of theanimation effect, and then click EffectOptions. In the Expand dialog box, on the SmartArt Animation tab, in the Group Graphic list, select One by one.Also in the Custom Animation taskpane, click the double-arrow below the animation effect to expand the list of effects, and then do the following:Press and hold CTRL, and then select all five animation effects in the Custom Animation task pane. Under Modify: Expand, in the Start list, select With Previous.Press and hold CTRL, select the second, third, fourth, and fifth animation effects (expand effects for the picture-filled rectangles), and then do the following:Click Change, point to Entrance, and then click MoreEffects. In the Change Entrance Effect dialog box, under Basic, click Peek In. Under Modify: Peek In, in the Speed list, select Fast.Select the second animation effect. Under Modify: Peek In, in the Start list, select After Previous.Select the third animation effect. Under Modify: Peek In, in the Direction list, select From Left.Select the fourth animation effect. Under Modify: Peek In, in the Direction list, select From Right.Select the fifth animation effect. Under Modify: Peek In, in the Direction list, select From Top.To reproduce the background effects on this slide, do the following:Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Radial.Click the button next to Direction, and then click From Corner (fifth option from the left).Under Gradient stops, click Add or Remove until two stops appear in the drop-down list.Also under Gradient stops, customize the gradient stops as follows:Select Stop 1 from the list, and then do the following:In the Stop position box, enter 0%.Click the button next to Color, and then under Theme Colors click White, Background 1 (first row, first option from the left).Select Stop 2 from the list, and then do the following: In the Stop position box, enter 71%.Click the button next to Color, and then under Theme Colors click White, Background 1, Darker 15% (third row, first option from the left).
- For reproduction steps for this slide, refer to the PowerPoint template titled “Static text effects for PowerPoint slides” (STATIC_TEXT.potx), slide number 17.