Finding Relevant Evidence to Answer Clinical Questions dr samira alsenany

Finding the right information to answer a given question often depends on the source of the information

Searching for evidence that has already been appraised for the quality of the study methodology and the reliability of its findings is desirable

Pre-appraised literature

Dr SA 2012

Begin with a PICOT question

Determine the source from which the best evidence is available

Clinicians need peer-reviewed research

Dr SA 2012

Textbooks and journals

Consolidated resources

Dr SA 2012

Dr SA 2012

Which of the following sources of evidence is best able to inform a nurse’s clinical practice?

a. A well-designed randomized controlled trial (RCT)

b. A systematic review that encompasses multiple studies

c. Expert opinion of experienced and educated nurses

d. A case study that addresses an unique clinical scenario

Dr SA 2012

b. A systematic review that encompasses multiple studies

Rationale: Systematic reviews are considered to be higher on the hierarchy of evidence than expert opinion or individual RCTs and case studies.

Dr SA 2012

Online databases

Grey literature

Bibliographic versus full-text databases

Dr SA 2012

Librarians are a rich source of assistance

They are especially valuable when time is of the essence

Dr SA 2012

Keyword searching is searching using simple, everyday language

Controlled vocabulary systems, e.g., MeSH

Normally have a hierarchical structure that helps the searcher retrieve the more specific terms that fall under a general term

Most large bibliographic databases (MEDLINE, CINAHL, and PsycINFO) use a controlled vocabulary to describe the content of references

Dr SA 2012

Tell whether the following statement is true or false.

A controlled-vocabulary system may yield fewer hits than a keyword search, but these hits are more likely to be relevant to the clinical question.

Dr SA 2012

True

Controlled vocabulary systems exist to increase the relevance of search results while limiting the number of less-relevant hits.

Dr SA 2012

Combining search terms from within a PICOT question focuses the search results

Consider that different search engines process terms in the search box in different ways

Using the “limit” function is designed to help the searcher pare down the large results list

Manage inclusion and exclusion criteria carefully

Dr SA 2012

Managing citations

Saving searches

Organizing searches

Dr SA 2012

A collection of 6 different databases

“Gold standard” database is the Cochrane Database of Systematic Reviews (CDSR)

Systematic reviews are based on critical appraisal

Dr SA 2012

A comprehensive database of evidence-based clinical practice guidelines

Guidelines are systematically developed statements about a plan of care for a specific set of clinical circumstances involving a particular population

Dr SA 2012

MEDLINE - covers medicine, health, and the biomedical sciences

CINAHL – covers 13 nursing and allied health disciplines

EMBASE - major European biomedical and pharmaceutical database

PsycInfo – covers psychology, behavioral sciences, and mental health

Dr SA 2012

Which of the following online evidence sources is most likely to provide pre-appraised evidence?

a. CINAHL

b. MEDLINE

c. PubMed

d. Cochrane Library

Dr SA 2012

d. Cochrane Library

Rationale: The Cochrane Databases consist of systematic reviews that synthesize evidence from multiple peer-reviewed sources. CINAHL, MEDLINE, and PubMed may contain evidence at a synthesis level, but are more often sources of individual articles that a nurse must appraise.

Dr SA 2012

PubMed

Ovid

EBSCO

Any search for evidence must be followed by critical appraisal

Dr SA 2012

Dr SA 2012