Using the Library

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Alice Whitman Memorial Library

Alice Whitman Memorial Library

Library Home Page Library 101 in ANGEL

SEARCHING FOR THE EVIDENCE Evidence 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

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

Systematic Reviews

Meta-Analyses

Critical Appraisal

Randomized Controlled Trials

Cohort and case-controlled studies

Consensus Statements

Anecdotal Information

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What is Evidence?

Hierarchy of Research Evidence

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?

Form a Clinical Question

PICO framework: P – patient/problem I – intervention C – comparison O – 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 – medication O – symptom reduction, quality of life

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)

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])

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

Meta-search Engines

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

Point of Care Tools

• DynaMed • Essential Evidence Plus • Natural Standard • Lexicomp

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, Information Service Librarian – zach.young@frontier.edu – (859) 899-2511

• Kristy Nowak, Library Technician – kristy.nowak@frontier.edu – (859) 899-2526

Stay in Touch!

• Library Information Forum in the Frontier Community Connection

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