Where do I get info?

GP Update, Ipswich 2006

Kev Hopayian

Ethical dimension

• Evidence informs but cannot dictate practice

• Decisions should be informed by evidence, guided by expertise, and centered on the values of the patient .

Professionalism in communicating evidence

• Knowledge

• Problem solving

• Interpersonal skills

• Respect

The questions we askNovicesBeginning of training, Ask general questions

e.g. How do I treat heart failure?

e.g. What are benefits ofadding sprionolactone ora betablocker to ACEin heart failure?

ExpertsHave acquired experience, Ask specific questions

ForegroundForeground

BackgroundBackgroundBackgroundBackground

Studies

Syntheses

Synopses

Systems

Search for Evidence

Primary research e,g. Medline

Syntheses e.g. Cochrane

e.g Guidelines, computer support systems

Notes and commentariese.g. Bandolier

Where to go?

Gatewayhttp://www.nelh.nhs.Backgroundhttp://www.gpnotebook.co.uk/homepage.cfm

Foreground

Synopses

Clinical Evidence +ve growing collection, can “drill down”-ve biased to therapy http://www.nelh.nhs.uk/clinical_evidence.asp

Bandolier+ve educational too, good readhttp://www.jr2.ox.ac.uk/bandolier/

Centre for Reviews and Dissemination Summarises and adds its own commentaries on syntheses (reviews)

including Cochrane reviewshttp://www.york.ac.uk/inst/crd/darehp.htm

Syntheses

SUMSearch

+ve Searches at multiple levels

Returns results in heirarchy (reviews, guidelines, systematic reviews, primary studies)

http://sumsearch.uthscsa.edu/

PubMed Clinical queries

+ve allows you to set sensitivity of search

-ve returns non-heirarchical results

http://www.ncbi.nlm.nih.gov:80/entrez/query/static/clinical.html

Primary studies

Not for the faint hearted but definitely the business (you’ll need a password from your librarian)

http://nhs.dialog.com/