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Semelhante a Community Training in Evidence Based Practice 3-28-13
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Community Training in Evidence Based Practice 3-28-13
- 1. Community Training in Evidence- Based Practice This project has been funded in whole or in part with Federal funds from the National Library of Medicine, National Institutes of Health, under Contract No. HHSN-276-2001-000007-C with the Houston Academy of Medicine-Texas Medical Center Library
- 2. Agenda for today: -Attendees will understand the basics of evidence- based practice and resources that can assist searches for evidence-based literature. (25 min) -Attendees will search PubMed and PubMed Clinical queries for evidence-based literature. (45 min) -Break (5 min) -Attendees will apply search strategies across multiple other “free to search” resources for locating evidence-based literature. (45 min) - Attendees will learn how to obtain information from their local libraries or other free information sources. (5 min)
- 4. Evidence-Based Practice Clinical Expertise Best Research Evidence Patient Values & Expectations EBP
- 5. Why EBP? Continually discovering improved treatments and methods Healthcare providers must stay current EBP keeps healthcare providers up- to-date
- 6. Evidence Based Practice: A 5-step Practice 1) Assess: What is it you want to know? 2) Ask: Use PICO to create a question 3) Acquire: Search for good evidence 4) Appraise: Assess the evidence 5) Apply: Use what you’ve found
- 7. Assess & Ask: PICO Patient: Who is your patient? Intervention: What do you want to do with this patient? Comparison (optional): Is there an alternative treatment/cause etc. to consider? Outcome: What do you hope to accomplish?
- 8. PICO Example: In an 86-year old man with coronary artery disease, is aspirin a more effective agent than heparin in reducing risk of stroke?
- 9. Acquire: Identify & Select Resources 3 Categories Background Information Filtered Information Unfiltered Information
- 10. Unfiltered Information Provide original research (are not critically appraised) • Individual Journal Articles (not critically appraised) • Randomized Controlled Trials (RCTs) • Clinical Trials • Cohort Studies • Case-controlled Studies • Case Series/Reports Include: • PubMed • Ovid MEDLINE • Cochrane Central Register of Controlled Trials • PsychINFO • CINAHL Databases: Provide broad overviews of medical topics • Clinical reference books • Clinical reference websites • Practice Guidelines Include: • MedlinePLUS • National Institute of HealthDatabases:
- 11. Unfiltered Information Provide original research (are not critically appraised) • Individual Journal Articles (not critically appraised) • Randomized Controlled Trials (RCTs) • Clinical Trials • Cohort Studies • Case-controlled Studies • Case Series/Reports Include: • PubMed • Ovid MEDLINE • Cochrane Central Register of Controlled Trials • PsychINFO • CINAHL Databases: Filtered Provide reviews of original research (are critically appraised) • Systematic Reviews • Meta-Analyses • Critically Appraised Topics and Articles Include: • Cochrane Database of Systematic Reviews • Ovid MEDLINE • PubMed • National Guideline Clearinghouse (topics) • The ACP Journal Club (articles) Databases:
- 12. Provide original research (are not critically appraised) • Individual Journal Articles (not critically appraised) • Randomized Controlled Trials (RCTs) • Cohort Studies • Case-controlled Studies • Case Series/Reports Include: • PubMed • Ovid MEDLINE • Cochrane Central Register of Controlled Trials • PsychINFO • CINAHL Databases:
- 13. • A) A newspaper article about breast cancer in the Houston Chronicle • B) A “Letter from the Editor” about obesity in Parenting Magazine • C) Information about Type 2 Diabetes from the “Health Topics” section of MedlinePLUS • D) Information Dr. Oz writes on his Facebook page Which of these is an Evidence Based Practice Resource?
- 14. • A) A newspaper article about breast cancer in the Houston Chronicle • B) A “Letter from the Editor” about obesity in Parenting Magazine • C) Information about Type 2 Diabetes from the “Health Topics” section of MedlinePLUS • D) Information Dr. Oz writes on his Facebook page Which of these is an Evidence Based Practice Resource?
- 17. (http://www.pubmed.gov) • PubMed is a freely searchable literature database provided by the National Library of Medicine. • It contains 22 million biomedical citations. • A mobile version is available on tablets and smartphones.
- 18. Translating your PICO question into a PubMed database search (search strategy) • Pick out the most important key terms from your PICO question. • Usually, when more search terms are entered into a search query, it will result in fewer articles. • Use “Article Types” to find your filtered or unfiltered results. • Use “Publication Dates” to specify the most recent results or a defined time period. • “Additional Filters” can help you narrow your results closer to the key terms from your PICO question.
- 19. PubMed vs. PubMed Clinical Queries • Performing a basic PubMed search will look in all records of the database for your search terms. • Clinical Queries adds specifications to your search to locate items in a subset of articles that relate to you search. • You can find filtered literature through “Systematic Reviews.” • You can find unfiltered literature through “Clinical Study Categories.”
- 20. Obtaining articles • Some free full-text articles are available through PubMed Central. • Having a membership with a library can increase the full-text access to items found in PubMed.
- 21. Searching Exercise • Spend some time practicing searches in PubMed. • Find 1 example of a filtered article. • Find 1 example of an unfiltered article.
- 22. Questions?
- 23. “Free to search” resources There are many freely accessible web sites that contain reliable evidence- based health information. These are available from both private and public organizations.
- 24. Medline Plus (http://www.medlineplus.gov) • A consumer level resource containing information on a wide range of topics on health from the National Library of Medicine • Users can browse/search by Health Topics to view information on specific conditions. • Users can browse/search Drugs & Supplements to view information on pharmaceuticals. • The entire site is available in Spanish, as well as, multiple Languages for some information.
- 25. National Institutes of Health (http://health.nih.gov) • The National Institutes of Health oversee many governmental health organizations, including the National Library of Medicine. Their Health Information site provides consumer level information. • Health Topics can be browsed alphabetically or searched. • Health Categories give broad topics to browse.
- 26. TRIP Database (http://www.tripdatabase.com) • A commercially run site that includes content from PubMed, The Cochrane Library, and other evidence based sources. • Basic search enables you to find information across multiple sources. • PICO search function lets you translate you PICO question easily.
- 27. Clinical Trials (http://www.clinicaltrials.gov) • This focuses on searching for information with regards to clinical studies (both publicly and privately funded) that have been completed or are currently active. • What are clinical trials? “A research study using human subjects to evaluate the effect of interventions or exposures on biomedical or health-related outcomes.” • Basic search can be used to search across all available clinical study information.
- 28. The Community Guide (www.thecommunityguide.org) • This gives access to findings from all Community Preventive Services Task Force findings. It highlights systematic reviews and strives to present interventions that are effective. • Browse Topics for a broad view of findings related to various health conditions. • Searching enables access to items available from The Community Guide or the Center for Disease Control and Prevention.
- 29. “Free to search” exercise • Find 2 items concerning a health topic of your choosing (articles, web sites, or other) from any of the sites discussed. • Identify if these items are basic, filtered, or unfiltered levels of evidence.
- 30. Where else can I go? • Public libraries are great resources for accessing databases, help with searching, and other guidance. • The TMC Library is currently creating a subject guide based around this class. It will be available at http://libguides.library.tmc.edu/ on or before April 30, 2013.
Notas do Editor
- Discussion: The main focus here is to make sure attendees are clear on the basics of PubMed’s purpose. We want to stress how they can access it. We want to be clear about the type of information that is contained in it. Also, they need to be clear on how this relates to EBP, and how they can translate their search queries into the database, get results, and identify the level (basic, filtered, unfiltered) of those results. Action: After a brief talk on this slide, we will take them to the web site and discuss the basic features and tools. We will look at how to search, and what search results look like.
- Discussion: We want to begin to show attendees how to formulate their basic searches. Attendees will see how to choose their search terms and how PubMed delivers the results.Action: The example to be used for searches will be “diabetes type 2 insulin.” This shows basic choice of keywords for a Problem/Patient and an Intervention. After a brief discussion of the results display, attendees will be show how to identify their basic, filtered, and unfiltered information through article types, dates of publication, and additional filters such as age, sex, etc.
- Discussion: Attendees will be exposed to the Clinical Queries search of PubMed. The focused/filtered aspect of these results will be discussed.Action: The same example will be used “diabetes type 2 insulin.” A comparison between search results and identifying the level of literature will be the stressed.
- Discussion: Many articles found in PubMed are not free. We will address the distinction between accessing free articles (i.e. PubMed Central) and needing to access items through a library.Action: We will identify the “full-text” option from search results, and we will view an individual article record through the TMC Library’s subscription to show how finding full-text through your local library may work.
- Action: Assist anyone who needs help. We will briefly discuss what everyone found and any problems that were encountered.
- Discussion: Who makes it? What does it have? What can it do?Action: The example “diabetes type 2 insulin” will be used to demonstrate the basic functions of the site.
- Discussion: Who makes it? What does it have? What can it do?Action: The example “diabetes type 2 insulin” will be used to demonstrate the basic functions of the site.
- Discussion: Who makes it? What does it have? What can it do?Action: The example “diabetes type 2 insulin” will be used to demonstrate the basic functions of the site.
- Discussion: Who makes it? What does it have? What can it do?Action: The example “diabetes type 2 insulin” will be used to demonstrate the basic functions of the site.
- Discussion: Who makes it? What does it have? What can it do?Action: The example “diabetes type 2 insulin” will be used to demonstrate the basic functions of the site.
- Discussion: Who makes it? What does it have? What can it do?Action: The example “diabetes type 2 insulin” will be used to demonstrate the basic functions of the site.
- Action: Assist anyone who needs help. We will briefly discuss what everyone found and any problems that were encountered.
- Action: Assist anyone who needs help. We will briefly discuss what everyone found and any problems that were encountered.
- Action: Assist anyone who needs help. We will briefly discuss what everyone found and any problems that were encountered.