How to practice EBM; Finding the Evidence by 4pHbs4

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									How to practice EBP:
Finding the Evidence




September 2009
15th Oxford Workshop in Teaching
Evidence-based Practice
Session objectives

   Formulate an answerable question
   Turn an answerable question into a
    search strategy
   Apply the search strategy to
    PubMed & the Cochrane Library
Formulating an answerable
question


Patient / Problem / Population
Intervention
Comparison
Outcome
Scenario

              Tom, a smoker of 20
            years goes to his GP to
           ask for help with stopping
               smoking. He’s tried
             various methods in the
              past but nothing has
           worked so far, so asks the
            GP whether acupuncture
            might be a good option.
Answerable question

P: smoking
I: acupuncture
C: N/A
O: cessation

Answerable question?

Is acupuncture effective as a smoking
cessation technique?
Answerable question to
search strategy
         Using OR then AND
  to broaden then focus the search

   P             I             O
          and         and

smoker*     acupuncture     cessation
   or           or              or
smoking     acupressure       stop*
   or                           or
tobacco                       quit*
Combining terms with
or
Smoking or tobacco – either term can be
present



      smoking
                       tobacco
Combining terms with
and
Smoking and acupuncture – both terms
must be present




      smoking        acupuncture
Search strategy to
searching PubMed


Demonstration of a quick search on clinical
queries
Hands-on

   Formulate an answerable question
       Use your own question or one of the
        examples in your pack
       Record the search terms you’re using


   Run a quick search on PubMed
    Clinical Queries
    http://www.pubmed.gov
       Record the details of the article that
        ‘best’ answers your question
Further searching tips:
PubMed

   Step-by-step searching
   Subject searching - use MeSH
       Subject headings added to articles on
        Medline
       Search the MeSH Database
   Finding similar articles – use the
    ‘Related articles’ link
The Cochrane Library
   Specialist database including articles on
    clinical and cost effectiveness of
    interventions:
       Systematic reviews – Cochrane Database of
        Systematic Reviews & DARE
       RCTs – Central
       Economic evaluations - NHSEED

   Free access in the UK at
    http://www.thecochranelibrary.com
   Other countries check “access options” at
    http://www.cochrane.org
The Cochrane Library:

 Demonstration of a search in the
 Cochrane Library
Hands-on

   Take your answerable question:

       Run further searches on PubMed
        http://www.pubmed.gov
       Run a search on the Cochrane Library
        http://www.thecochranelibrary.com
Resources

   Cochrane Library
    http://www.thecochranelibrary.com
   PubMed
    http://www.pubmed.gov
   Other sources – CEBM web-site –
    EBM tools
   http://www.cebm.net
    Help
   PubMed
       Short online tutorials
       Quick guides to PubMed – basics, MeSH search and
        MyNCBI
        http://www.nlm.nih.gov/bsd/disted/pubmed.html

   The Cochrane Library
       Online tutorial – several languages
        http://www3.interscience.wiley.com/aboutus/demo/
       User guides – several languages
        http://www3.interscience.wiley.com/cgi-
        bin/mrwhome/106568753/HELP_Cochrane.html

								
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