Database Searching for Evidence Based Medicine Literature

1. Welcome Database Searching for Evidence Based Medicine Literature Peggy Edwards, AMLS TTUHSC - Preston Smith Library Lubbock, Texas 79430 July 2014

2. 1) Database Searching- Mandatory Attendance J • how to search the Cochrane EBM Databases • PowerPoint lecture and hands-on follow along • search for article(s) that answer your question • one-on-one searching guidance with assigned librarian

3. 2) Group Discussion “EBM Journal Club” with Dr. Griswold

4. Evidence-Based Practice is guided by thoughtful integration of the best available scientific knowledge with clinical expertise.

5. Steps in the Evidence-Based Process are: http://guides.mclibrary.duke.edu/content.php?pid=431451&sid=3529499 (Duke University Medical Center, accessed 8/2/2013)

6. 1. Assess the patient

7. How can you recognize and formulate clinical questions as they occur? • pay careful attention to the questions that spontaneously occur to you • questions often are about: diagnosis therapy etiologyprognosis • mentally formulate a PICO question

8. 2. Ask the question

9. What if too many questions arise? Patients may have several active problems: • your questions may be too numerous to even ask, let alone answer. What is the most important issue for this patient now? Which question, when answered, will help me most? • Select from the many questions • the few questions that are most important to answer right away. Dawes, Martin. Centre for Evidence-Based Medicine, Learning EBM. Hp. April 9, 2001. Powerpoint: Practice of Evidence-Based Medicine. University of Oxford. Available: http://www.cebm.net/learning_ebm.asp. 10 Apr. 2005.

10. What is the study category? • Determine if your PICO question is about: diagnosis therapy etiology prognosis

11. Study Category Suggested Best Method of Investigation Therapy RCT>cohort>case control>case series Diagnosis prospective, blind comparison to a gold standard Etiology/Harm RCT>cohort>case control>case series Prognosis cohort>case control>case series Prevention RCT>cohort>case control>case series Clinical Exam prospective, blind comparison to a gold standard Economic Analysis Cost See hand-out Medical Library Association. MLANET, Education, Web-based Learning. Hp. Nov, 2001. Web-based Courses: EBM and the Medical Librarian. Available: http://www.mlanet.org/education/web/web_courses.html10 Apr. 2005.

12. 3. Acquire the evidence

13. www.cochrane.org

14. Hierarchy of Evidence and Corresponding Databases See hand-out

15. EBM Reviews via OVID www.ttuhsc.edu/libraries Mouse over Databases and click OVID

16. Select ACP Journal Club ✔

17. Select Cochrane Central Register of Controlled Trials ✔

18. Select Cochrane Database of Systematic Reviews ✔

19. Select DARE: Database of Reviews of Effects ✔

20. Click Search Enter as the first keyword search. “abdominal aortic aneurysm”

21. Results in the first search set.

22. Truncation locates suffix variations in one step! Enter an asterisk * after the prefix. For example: gene* retrieves genes genetics genetically but also generalization.

23. Enteras the second keyword search. screen*

24. Click Search Limit the search for words appearing only in the Title.

25. Click And X X AND Click on the boxes next to set 1 and set 2.

26. Boolean Logic - AND aaa screen* and

27. Results of AND combination. (Note that AND narrows results.)

28. Other search techniques: diagnosis OR differential diagnosis Use Boolean OR Note: “OR” broadens a result diagnosis or differential diagnosis

29. Search Strategy using “OR”

30. Click Display to view articles

31. Search Results

32. Access to Full Text

33. or Check Availability

34. Scroll up to search strategy

35. Click Click box to select all ✔ Remove Selected

36. Click Change

37. Select Cochrane Central Register of Controlled Trials ✔

38. Search Page

39. Hands-On

40. Cochrane Central Register of Controlled Trials

41. Cochrane Central Register of Controlled Trials • details of published articles: • 3/5th’s records are from PubMed • relevant records from Embase • other published and unpublished sources • reports from conference proceedings i.e. updated reports of controlled trials

42. ✔ Map Term to Subject Heading un-Check

43. 1) In venous leg ulcers that have prolonged healing , what is the role of venous reflux pattern, ulcer characteristics, and mobility?

44. Answer to 1 Prolonged healing of venous leg ulcers: the role of venous reflux, ulcer characteristics and mobility. Hjerppe A, Saarinen JP, Venermo MA, Huhtala HS, VaalastiA Journal of wound care. 19(11):474, 476, 478 passim, 2010 Nov.

45. Click Change

46. Select Cochrane Database of Systematic Reviews ✔

47. Cochrane Database of Systematic Reviews

48. What is a Systematic Review? Systematic review review of a clearly formulated question uses systematic and explicit methods to: select and critically appraise relevant research collect and analyze data from studies included in the review Meta-analysis uses statistical techniques in a systematic reviewto integrate the results • When searching for evidence-based literature • start by trying to locate a meta-analysis or a systematic review From: Cochrane Collaboration athttp://www.cochrane.org/resources/glossary.htm

49. Cochrane Database of Systematic Reviews • Cochrane Database of Systematic Reviews • assessed randomized trials • Trials meeting assessment criteria • are combined to produce a more statistically reliable result • increase the power of the findings of numerous studies • some studies on their own are too small to produce reliable results • Cochrane Database of Systematic Reviews • over 800 international journals are searched to locate articles • Authors in the Cochrane Collaboration Groups • appraise and synthesize evidence • create structured abstracts

50. Click EBM Reviews