Using the Library&

Searching for the Evidence

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Alice Whitman Memorial Library

Alice Whitman Memorial Library

Library Home Page Library 101

SEARCHING FOR THE EVIDENCEEvidence Based Practice

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.

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

Systematic Reviews

Met

a-Analyses

Critical Appraisal

Rando

mized C

ontrolled Trials

Cohort and case-

controlled studies

Consensus Statements

Anecdotal Information

Hier

arch

y of

Res

earc

h Ev

iden

ceWhat is Evidence?

Hierarchy of Research Evidence

Evidence Based PracticeThe 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

Form a Clinical Question

• Must be focused and answerable

NOTWhat are therapies for depression?

INSTEADDoes exercise reduce depressive symptoms in women?

Form a Clinical Question

PICO framework:

P – patient/problemI – interventionC – comparisonO – outcome

Form a Clinical Question

Does exercise reduce depressive symptoms in women?

P – women with depression (age group?)I – exercise (how strenuous? how often?)C – medicationO – symptom reduction, quality of life

Locate Resources

• Where is the Evidence?– Traditional bibliographic databases– Meta-search engines– Point of Care resources

Bibliographic Databases

• MEDLINE– via EBSCOhost– via PubMed

• CINAHL• Cochrane Library• Joanna Briggs Institute EBP Resources

Meta-search Engines

• SUMsearch – http://sumsearch.org• TRIP database – http://www.tripdatabase.org

Point of Care Tools

• DynaMed• Essential Evidence Plus• Natural Standard• Lexicomp

Search for Information

• Advanced Search Strategies– Boolean Operators– Field Searching– Subject Headings– Limiters– Research Filters

Boolean OperatorsAND – 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)

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

Field Searching

Subject Headings

• Specific words or phrases selected from a controlled vocabulary that describe a work – MEDLINE = MeSH– CINAHL = CINAHL Headings

Limiters• Parameters for your search – MEDLINE limiters include:• Age group• Publication type• Language• Dates

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])

Additional Tools

• Search Alerts– MyNCBI– MyEBSCOhost– RSS Feeds

Citation Management

Finally…

• Don’t forget about librarians as a resource!• Call us before starting your literature review!

Library Staff• Billie Anne Gebb, Director of Library Services– billieanne.gebb@frontier.edu– (859) 899-2519

• Zach Young, Assistant Director of Library Services – zach.young@frontier.edu– (859) 899-2511

• Aimee Niles, Library Technician– aimee.niles@frontier.edu – (859) 899-2526

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http://frontierlibrary.blogspot.com/ • Email• Phone