8. 5S Hierarchy of EvidenceHaynes RB. Evid Based Med 2006;11:162-164 Computerized decision support system Evidence-Based Guidelines & Textbooks Secondary Critically-Appraised Journal Articles & Abstracts Systematic Reviews RCTs, Cohort, Case control, Case series Primary Expert Opinion: Classical Textbooks
9. Searching for evidence Case report, Case series, Case-Control, Cohort, Randomized Trial DiCenso A, Bayley L, Haynes RB. Accessing preappraised evidence: fine-tuning the 5S model into a 6S model. ACP Journal Club, 2009
11. Primary Sources Original articles Through databases: MEDLINE, EMBASE Using: PubMed, OVID You have to retrieve and appraise the articles Strength (pyramid) of evidence
15. It is a “strategy” Low Back Pain Treatment OR OR Low Back Ache Management Acute OR OR Low Backache Therapy AND AND OR OR "Low Back Pain"[Mesh] Surgery
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19. We will talk more aboutSEARCH STRATEGYin the coming few weeks
23. In: Glasziou P, Del Mar C: Evidence-based Practice Workbook: Bridging the gap between health care research and practice. Blackwell Publishing - BMJ Books. 2007. PP 3-13
24. In: Glasziou P, Del Mar C: Evidence-based Practice Workbook: Bridging the gap between health care research and practice. Blackwell Publishing - BMJ Books. 2007. PP 3-13
30. Tough Job If you have to do the critical appraisal for every single article you read Tough BUT You need to learn about it in details for the sake of research
31. Don’t say there is “no evidence” Instead Weak evidence You might not have looked thorough enough
33. Satisficing ‘‘where busy clinicians will be satisfied with the information they can readily summon, while sacrificing quality for convenience” Carter BS, Leuthner S. Decision making in the NICU—strategies, statistics and ‘‘satisficing.’’ Bioethics Forum. 2002;18:7–15.
34. Usefulness of information Hurwitz SR, Slawson DA, Shaughnessy A. Orthopaedic information mastery: applying evidence-based information tools to improve patient outcome while saving orthopaedists’ time. J Bone Joint Surg Am. 2000;82:888–895.
38. Syntheses The authors have done the work for you Hopefully: They asked a good question They searched the literature systematically (keywords & MeSH) They identified the studies and assessed their quality This is called Systematic Review If they did statistical combination of results, this is called Meta-analysis
39. How to search for “Syntheses”? Same databases: MEDLINE, EMBASE Cochrane Library
50. Synopses Physicians with training in research methodology: Read the articles Assess their quality Summarize them for you Many sources: Database of Abstracts of Reviews of Effects (DARE) Evidence-based Dentistry Journal of Evidence-Based Dental Practice Critically Appraised Topics (CATs) Evidence-based sections in many journals Others: DynaMed, EvidenceMatters, EssentialEvidence
72. Guidelines Types of guidelines: Consensus Evidence-based Use the limiting features in the website
73. Guidelines NICE: National Institute for Health & Clinical Excellence SIGN: Scottish Intercollegiate Guidelines Network NGC: National Guideline Clearinghouse
156. Searching for evidence DiCenso A, Bayley L, Haynes RB. Accessing preappraised evidence: fine-tuning the 5S model into a 6S model. ACP Journal Club, 2009
157. The Remaining of the Course Primary Sources Critical Appraisal of: Therapy Systematic Review Diagnosis Prognosis
158. Assignment 3 What are the secondary sources available for dental students and dentists to practice evidence-based dentistry? Categorize them according to the 5S/6S model Visit these sites & describe in your words what are they & what do you think of them. If you find other sources, you can add them Type at least 2 lines describing each secondary source (size 12 font) Assignment due October 18 Send the assignment to my email (email subject & Word document: EBD3 your name)