searching ebm resources
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Life Sciences Library
Winter 2012
Robin Featherstone, MLISLiaison Librarian (Medicine)robin.featherstone@mcgill.ca
Searching Resources in Evidence-Based Medicine
Objectives
By the end of this lecture, you will be able to:
1. Describe the Evidence-Based Medicine (EBM) process
2. Formulate clinical questions using PICO3. Locate best available medical evidence
2
Evidence-Based Medicine: The Process
3
Formulating the clinical question
Searching the Evidence
Appraising the Evidence
Incorporating evidence into decision-making
Evaluating the Process
Formulating the clinical question
Searching the Evidence
Your patient for whom you are uncertain about therapy, diagnosis, or prognosis
LINK
Patient ScenarioFormulate a Clinical Question
Patient, Population, or Problem
Intervention
Comparison
Outcomes
Patient Scenario
You have been asked to review the practice guidelines for treating warts. You are confident that cryotherapy is the most effective treatment but a colleague suggested some alternatives to investigate, including duct tape. Could duct tape be used for eliminating warts? Does the literature provide evidence to support this treatment?
Clinical Scenario
Patient ScenarioClinical Question
In patients with common warts, is duct tape as effective as cryotherapy in eliminating warts?
PICO
Systematic Reviews
Randomized control trials
Cohort studies
Case-control studies
Case reportsEditorials
Animal research
All types of articles found in MEDLINE
What is the Evidence?
Question Best Evidence
Cost-effectiveness •Economic analyses
Diagnosis •Diagnostic validation studies•Prospective studies / blind comparison to a gold standard
Etiology •Randomized controlled trials•Case-control or cohort studies•Case series
Prevention •Randomized controlled trials•Cohort studies, case control studies•Systematic reviews / meta-analyses
Prognosis •Inception cohort studies•Case control studies•Case series
Quality of life •Qualitative studies
Therapy •Randomized controlled trials•Systematic reviews / meta-analyses
1 Heneghan, Carl, and Douglas Badenoch. Evidence-Based Medicine Toolkit. 2nd ed. Malden, Mass.: BMJ Books/Blackwell Pub., 2006.2 Glover, Jan, and Lei Wang. Find it Fast: The Clinical Question : www.med.yale.edu/library/education/guides/screencasts/finditfast/finditfast_2/
Levels of Evidencefor Therapy Question
Level of Evidence Type of Study
1a Systematic reviews of randomized controlled trials (RCTs)
1b Individual RCTs with narrow confidence interval2a Systematic reviews of cohort studies2b Individual cohort studies and low-quality RCTs3a Systematic reviews of case-control studies3b Case-control studies4 Case series and poor quality cohort and case-control
studies5 Expert opinion
9
Levels of evidence (2001). Centre for Evidence Based Medicine. Retrieved 26 Aug 2008 from http://www.cebm.net/index.aspx?o=1025
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Summaries
Information Sourcesfor Therapy Question
Synopsis of
synthesis
1. Soundness of evidence-based approach2. Comprehensiveness and specificity3. Ease of use4. Availability
Criteria for Selecting an Information Source
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Information Sourcesfor Therapy Question
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Information Sourcesfor Therapy Question
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Information Sourcesfor Therapy Question
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Information Sourcesfor Therapy Question
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Information Sourcesfor Therapy Question
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Information Sourcesfor Therapy Question
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Information Sourcesfor Therapy Question
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Course Website
http://www.mcgill.ca/library/library-findinfo/courses/guides/ebm_intro/
19
1. UpToDate is a _______ resource. And Medline is a ________ resource.
2. The 5 stages in the EBM process are _______.3. The best evidence to answer a therapy question
is _______.4. To find systematic reviews of RCTs use _______.5. To evaluate a clinical topic page, look for
_______.
Summary Quiz
LINK
Life Sciences Library
Winter 2012
Robin Featherstone, MLISLiaison Librarian (Medicine)robin.featherstone@mcgill.ca
Questions
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