Teaching Critical Evaluation of Biomedical Information in the Digital Age

1. Teaching Critical Evaluation of Biomedical Information in the Digital Age Joseph Dasso, MD, PhD joseph.dasso@hccs.edu

2. Teaching Critical Evaluation of Biomedical Information in the Digital Age • What is critical thinking & why teach it explicitly • Evaluating information on the web • Types of research studies & levels of evidence • Using biomedical information databases • Engaging assignments for critical thinking skills • Critiquing a research paper • Investigating contrasting sides of biomedical issues • Evaluating consumer products or services • Teaching and learning resources at HCCS for writing assignments

3. What is Critical Thinking? • “reasonable, reflective thinking that is focused on deciding what to believe or do” Robert Ennis • “skillful, responsible thinking that is conducive to good judgment because it is sensitive to context, relies on criteria, and is self-correcting” Matthew Lipman • “thinking about your thinking, while you’re thinking, in order to make your thinking better” Richard Paul Nosich, Gerald. 2012. Learning to Think Things Through. Boston: Pearson. p. 2.

4. Answering the critics of critical thinking education • “Students must master lower cognitive skills before they can apply higher thinking skills.” • “Student learn critical thinking in the conventional science course curriculum so there is no advantage in teaching it explicitly.” • “Teaching for critical thinking deprives students of the factual specifics students must learn to be competent in science.” • “I do not have time to teach and evaluate critical thinking skills in my course.” (See articles with counter evidence and arguments in slide notes)

5. Web Sites on Evaluating Web Information • HCCS library http://library.hccs.edu/ (Internet tab/ evaluating web information) • Library of Congress http://www.loc.gov/rr/business/beonline/selectbib.html • John Hopkins U Sheridans Library http://guides.library.jhu.edu/content.php?pid=198142&sid=1665954 • U of British Columbia http://help.library.ubc.ca/evaluating-and-citing-sources/evaluating-information-sources • Justia Law Firm http://virtualchase.justia.com/how-evaluate-information-checklist • HCCS library http://library.hccs.edu/ (Internet tab/ evaluating web information) • Library of Congress http://www.loc.gov/rr/business/beonline/selectbib.html • John Hopkins U Sheridans Library http://guides.library.jhu.edu/content.php?pid=198142&sid=1665954 • U of British Columbia http://help.library.ubc.ca/evaluating-and-citing-sources/evaluating-information-sources • Justia Law Firm http://virtualchase.justia.com/how-evaluate-information-checklist

6. Reading and decoding the web address • What to look for in a URL • Do you recognize the domain name? • e.g. hccs.edu • What is the extension in the domain name? • e.g. .edu, .com, .org, .gov, .net, .mil • Is it an web site from a foreign country? • URL country code extensions, e.g. au = Australia • Are you on a personal page? • Is there a name? • Is there a tilde (~) or percent sign (%)? • Are words, user, people, or members, present?

7. November, Alan. 2008. Web Literacy for Educators. Thousand Oaks, CA: Corwin Press, p. 32

8. Identify and evaluate the web site source (publisher) • www.betterwhois.com searches all domain registrars unlike whois.com • Beware of anonymous sources via private registrations e.g. via Domains by Proxy • www.archive.org an nonprofit Internet Archive (Wayback Machine) that accesses the history of web sites • www.altavista.com (or other search engine) search the name of the organization in quotation marks

9. Identify and evaluate the author(s) • Determine if web authorship is indicated • Look for spelling and grammatical errors • Read the author biography if present • Examine the author’s credentials and professional associations • Search the author’s name with quotation marks • Search for author’s publications and/or patents (www.uspto.gov/patents/index.jsp) • Check the links to and form other web sites

10. Determine the date of publication • Notice creation and revision dates • Find last updated date • Be aware of scripting creating current date • Do not rely on dates provided by search engines • Avoid undated information

11. Determine level of objectivity • Is the author trying to persuade? • Does advertizing influence the content? • Is there inflammatory or provocative language? • Is there over generalization? • Are alternative viewpoints presented fairly

12. Verify & evaluate what the information claims • Use primary sources when possible • Secondary sources should provide references • Look for cited sources, especially peer-reviewed • Evaluate the quality of information • Relevance • Timeliness • Scope and depth of coverage • Accuracy • Balance

13. Public Databases and Search Engines Appropriate for Biomedical Information • General Databases and Meta-Search Engines • Wikipedia (www.wikipedia.com) • Web Crawler (www.webcrawler.com) • Dogpile (www.dogpile.com) • Scholarly Databases & Search Engines • PubMed (www.pubmed.gov) and PubMed Central (www.pubmedcentral.gov) • Cochrane Library (www.thecochranelibrary.com) • CINAHL (Cumulative Index to Nursing and Allied Health) (www.ebscohost.com/biomedical-libraries/the-cinahl-database) and CINAHL Plus (www.cinahl.com) • Google Scholar (www.scholar.google.com)

14. HCCS Library Databases • Health and Medicine • Medline • Health Reference Center Academic • Natural and Alternative Treatments • Multi-Subject Recommended for Health & Medicine • General Reference Gold • Academic One File Note: TexShare Cards facilitate use of other local academic libraries

15. Pub Med • Developed by the National Library of Medicine • Biomedical journal articles date back to 1946 • Has 22 million records • Know how to search by topic, author or journal • Use filters, MeSH terms and combinations of terms to refine search further

16. Cochrane Library • Important resources for evidence-based medicine • Generated by independent nonprofit organization • Named after Archibald Cochrane (1909–1988) a Scottish epidemiologist pioneer of EBM • Contains quality meta-analyses, systematic reviews and clinical trial publications • Abstracts and plain English summaries of systematic reviews are free • Full article access requires subscription in US except in state of Wyoming

17. Types of Study in Medical Research: Part 3 of a Series on Evaluation of Scientific Publications Bernd Röhrig, Jean-Baptist du Prel, Daniel Wachtlin, Maria Blettner Dtsch Arztebl Int. 2009 April; 106(15): 262–268. Published online 2009 April 10. doi: 10.3238/arztebl.2009.0262

18. Prospective Study Retrospective Study Bernd Röhrig et al. Dtsch Arztebl Int. 2009 April; 106(15): 262–268

19. Levels of evidence • Level 1. Interventional randomized controlled trials • Level 2. Interventional non-randomized controlled trials • Level 3. Observational studies with controls • Level 4. Observational studies without controls Determined by US Dept. of Health & Human Services

20. Critiquing an original research article • Is the study relevant to topic? • Is it from a peer-reviewed or scholarly source? • Is it a primary or secondary research article? • Where was the study conducted? • Who funded the study? • Was there a conflict of interest? • Were statistical analyses performed? • What is the study design? • What did the study conclude? • Do the study’s results support the conclusions? (See slide notes for reference with more suggestions on critiquing a research article)

21. Controversial issues in the biomedical sciences • Evolution • Embryonic stem cell research and cloning • Global warming • Genetically-modified foods • Animal rights and suffering • Genetic basis of homosexual orientation • Population growth and control • Environmental preservation and management • Weight loss diets

22. Investigating contrasting sides of biomedical issues • Critique two articles on the same topic with contrasting views • Discuss controversial issues as a class or in small groups • Debate both sides of a controversial issue or make a podcast or narrated PowerPoint presentation evaluating opposing views • Write a research paper evaluating the arguments of opposing views

23. Evaluating consumer products or services • Have students choose products or services relevant to the subject matter • Choose products or services that are not well established empirically • Choose products or services that are advertised on the web • Verify the claims • Scholarly sources • Consumer reviews • Report findings and conclusions

24. Teaching & Learning Resources at HCCS for Writing Assignments • Tutor Centers • Free online tutoring for all HCC students www.hccs.askonline.net • Service to check for plagiarism for HCCS instructors www.turnitin.com originality check

25. Teaching Critical Evaluation of Biomedical Information in the Digital Age Joseph Dasso, MD, PhD joseph.dasso@hccs.edu