Robin Parker & Melissa Helwig. Reference Questions The Search

TIPS & TRICKS IN HEALTH SCIENCESRobin Parker & Melissa Helwig

PART 1 & 2 Reference Questions The Search

REFERENCE QUESTIONSThings to consider:

Background vs Foreground Question6S pyramid

BACKGROUND QUESTIONS Ask for general knowledge about a condition or thing Tend to have two components:

A question root (who, what, when, how, why?) and a verb A disorder, test, treatment or other aspect of health care

Examples: What causes SARS? What causes migraines? How often should women over the age of 40 have a mammogram?

BACKGROUND QUESTIONS

Where to find the answers: Textbooks (ex. Harrisons Principles of Internal Medicine) Handbooks (ex. Handbook of Fluid, Electrolyte & Acid-Base Imbalances)

Databases (ex. Dynamed)

FOREGROUND QUESTION Ask for specfic knowledge to inform clinical decisions or actions Have essential components: PICO OR PIOx OR PICOT

Examples of Foreground Questions: In young children with acute otitis media, is short-term antibiotic therapy as effective as long-term antibiotic therapy?

Among family members of patients undergoing diagnostic procedures, does standard care, listening to tranquil music or audiotaped comedy routines make a difference in the reduction of reported anxiety? 

SO WHAT DOES THIS MEAN FOR A SEARCH?

BEFORE WE SEARCH DON’T FORGET 6S

DiCenso A, Baley L, Haynes RB. (2009). Accessing preappraised evidence: fine-tuning the 5S model into a 6S model. ACP Journal Club, 151(3): JC3-2-3. Available online: http://plus.mcmaster.ca/macplusfs/documentation/Haynes_6S_Editorial.pdf

WHERE TO SEARCH…Point of care tools

Dynamed, Clinical Key, etc

Citation Databases PubMed, CINAHL, Web of Science, PsycINFO

Specialized/hybrid databases Cochrane Library, Canadian Electronic Library

Other resources Association, society websites, government sources, statistics

SEARCH One of your med students has identified a potential mentor for their RIM program with similar area of interest in family practice, specifically related to end of life care. Before meeting with this potential mentor, they want to scope the literature, become familiar with the research in the field, and get some ideas for potential research questions for their RIM project. You open PubMed to start a literature search with the student.

SEARCH - FOCUSED In order to have a more focused question, the student decides to look at the role of hydration (fluid therapy) in palliative care at end of life.

Population/ setting

Intervention Outcomes

Terminal care hydration Quality of life

End of life Fluid therapy dementia

Palliative care rehydration pain

Terminally ill Fluid*

URLSSearching in PubMed:

http://libcasts.library.dal.ca/Kellogg/PubMed/index.php

Answering a clinical question:

http://libcasts.library.dal.ca/Kellogg/EBP/Module%201_Clinical%20Question/

Developing a search stragegy

http://libcasts.library.dal.ca/Kellogg/EBP/Module%202_Viable%20Search%20Strategy_Final/index.php