4. Evidence Based Practice
SEARCHING FOR THE EVIDENCE
Gebb, 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.
5. 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
6. 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
7. What is Evidence?
Systematic
Hierarchy of Research Evidence
Hierarchy of Research Evidence
Reviews
Meta-Analyses
Critical Appraisal
Randomized Controlled Trials
Cohort and case-controlled studies
Consensus Statements
Anecdotal Information
8. 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?
9. Form a Clinical Question
PICO framework:
P – patient/problem
I – intervention
C – comparison
O – outcome
10. Form a Clinical Question
Does exercise reduce depressive symptoms in
women?
P – women with depression (age group?)
I – exercise (how strenuous? how often?)
C – medication
O – symptom reduction, quality of life
11. 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)
12. 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
14. Subject Headings
• Specific words or phrases selected from a
controlled vocabulary that describe a work
– MEDLINE = MeSH
– CINAHL = CINAHL Headings
15. Limiters
• Parameters for your search
– MEDLINE limiters include:
• Age group
• Publication type
• Language
• Dates
16. 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])
17. Where is the Evidence?
• Traditional bibliographic databases
• Meta-search engines
• Point of Care resources
23. Finally…
• Don’t forget about librarians as a resource!
• Call us before starting your literature review!
24. Library Staff
• Billie Anne Gebb, Director of Library Services
– billieanne.gebb@frontier.edu
– (859) 899-2519
• Zach Young, Information Service Librarian
– zach.young@frontier.edu
– (859) 899-2511
• Kristy Nowak, Library Technician
– kristy.nowak@frontier.edu
– (859) 899-2526
25. Stay in Touch!
• Library Information Forum in the Frontier
Community Connection
• Find us on Facebook
• Follow us on Twitter @FSMFNLibrary
• Read the FNU Library blog:
http://frontierlibrary.blogspot.com/
• Email
• Phone