Evidence Based Practice Resources

5 steps ~ 1. Constructing the Question
2. Searching: Hierarchy of Pre-Processed Evidence

Systems: Clinical Practice Guidelines ; Evidence-Based Texts ~

Synopses: Of Syntheses; Of Studies ~ Syntheses (Systematic Reviews)~ Studies ~ Meta Searches ~ Consumer Resources
3. Critical Appraisal
Other resources: Tutorials ~ Directories
Specialties: Cancer ~ Cardiology

Evidence-Based Practice is a five-step process:

1. Construct a relevant, answerable question from a clinical case.
2. Plan and carry out a search of the literature for the best external evidence.
3. Critically appraise the literature for validity and applicability.
4. Apply the evidence to your clinical practice.
5. Evaluate your performance.

Step 1: Construct a relevant, answerable question from a clinical case.

• Flemming K. EBN notebook. Asking answerable questions. Evidence-Based Nursing 1998;1:36-37.
• Formulating Answerable Clinical Questions (Centre for Evidence-Based Medicine, Mount Sinai Hospital)
• The Well-Built Clinical Question (Duke University Medical Center Library and Health Sciences Library, UNC-Chapel Hill)
• Formulating Patient Centered Questions (University Library, University of Illinois at Chicago)
• Focusing Clinical Questions (Centre for Evidence-Based Medicine, Oxford)

Step 2: Plan and carry out a search of the literature for the best external evidence.

NOTE: To use the resources identified by , you will need to login to LibAccess

Hierarchy of pre-processed evidence

[Adapted from Haynes RB. Haynes R.B. (2007). Of studies, summaries, synopses, and systems: the "5S" evolution of information services for evidence-based healthcare decisions. Evidence-Based Nursing, 10, 6-7]

 

EXAMPLES: SYSTEMS: Computerized decision support SUMMARIES:: Evidence-Based Guidelines ~ Evidence-Based Texts   SYNOPSES OF SYNTHESES: DARE ~ Evidence-Based Abstract Journals   SYNTHESES (Systematic Reviews): Cochrane Database of Systematic Reviews SYNOPSES OF SINGLE STUDIES: Evidence-Based Abstract Journals   SINGLE STUDIES: Clinical Queries

Tips for Searching for the Evidence

Systems

“Decision support services that match information from individual patients with the best evidence from research that applies.”   (Haynes, 2007)

Summaries

"Summaries integrate best available evidence from the lower layers (drawing on syntheses [ie systematic reviews] as much as possible, to provide a full range of evidence concening management options for a given health problem."  (Haynes, 2007)

Clinical Practice Guidelines:

• Best Practice Guidelines (Registered Nurses Association of Ontario)
• AGREE (Appraisal of Guidelines Research & Evaluation)
• Recommended Clinical Practice Guidelines (Guideline Advisory Committee (GAC))
• CMA Infobase: clinical practice guidelines -- Canadian Medical Association
• Clinical Practice Guidelines -- Alberta Medical Association
• National Guideline Clearinghouse (United States)

Evidence-Based Texts

Clinical Evidence
PIER: The Physicians' Information and Education Resource (adult and internal medicine)
[Available through STAT!Ref]

FIRSTConsult

Syntheses: Systematic Reviews

Cochrane Database:

• Cochrane Library
• Cochrane Reviews (Abstracts)
• Cochrane Neonatal Reviews from the National Institute of Child Health & Human Development

Agency for Healthcare Research and Quality (AHRQ)

• EPC Evidence Reports

Synopses

“Synopses of individual studies or systematic reviews encapsulate the key methodologic details and results required to apply the evidence to individual patient care.”   (Haynes, 2001)

Of Syntheses:

• NHS Centre for Reviews and Dissemination (CRD) Databases, including:
  • Database of Abstracts of Reviews of Effects (DARE)
  • NHS Economic Evaluation Database (NHS EED)
  • Health Technology Assessment (HTA) Database
• health-evidence.ca "Promoting evidence based decision making"
• Evidence-Based Abstract Journals

Of Studies:

Evidence-Based Abstract Journals

Evidence-Based Nursing
ACP Journal Club
Evidence-Based Healthcare and Public Health (ceased publication December 2005)
Evidence-Based Medicine
Evidence-Based Mental Health
Evidence-Based Obstetrics & Gynecology
Evidence-Based Oncology

Studies:

Databases:

• MEDLINE:
  • PubMed Clinical Queries
  • Ovid MEDLINE Use the "Limit" feature to add Clinical Queries
  • Using Medical Subject Headings: MeSH (Medical Subject Headings) Browser
• CINAHL:
  • CINAHL Use the "Search Options " feature to add Clinical Queries
• Cochrane Controlled Clinical Trials Register: through Cochrane Library ~ through Ovid
• Public Health +

Meta Searches

• Essential Evidence Plus
• Primary Care Electronic Library
• SUMSearch
• TRIP Databse (Turning Research Into Practice)

Consumer Resources

• MEDLINEplus
• Informed Health Online
• Bandolier Healthy living

Step 3: Critically appraise the literature for validity and applicability.

• Users' Guides to Evidence-Based Practice
• EBM Toolbox

Other Resources:

• ClinicalTrials.gov
• Bandolier Evidence-Based Health Care
• Health and Psychosocial Instruments (HaPI)
• Tutorials:
  • Introduction to Evidence-Based Medicine (Duke University Medical Center Library and Health Sciences Library, University of North Carolina at Chapel Hill)
• Directories:
  • Netting the Evidence: : A ScHARR Introduction to Evidence Based Practice on the Internet
  • Evidence Based Medicine (EBM) Toolkit (New York University School of Medicine. The Frederick L. Ehrman Medical Library)
  • Nesbit guide to evidence based resources (University of Rochester, Edward G. Miner library)
  • Resource Guide for Evidence-Based Practice (University of Alberta Libraries
• Web of Science (to link articles by citation)

Need some help? Contact: Laura Banfield
Health Sciences Library, HSC-2B33
Tel: (905)525-9140, ext. 20239
Email: banfie@mcmaster.ca