finding relevant evidence to answer clinical questions dr samira alsenany
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Finding Relevant Evidence to Answer Clinical Questions dr samira alsenany. Answering Clinical Questions. Finding the right information to answer a given question often depends on the source of the information - PowerPoint PPT PresentationTRANSCRIPT
Finding the right information to answer a given question often depends on the source of the information
Searching for evidence that has already been appraised for the quality of the study methodology and the reliability of its findings is desirable
Pre-appraised literature
Dr SA 2012
Begin with a PICOT question
Determine the source from which the best evidence is available
Clinicians need peer-reviewed research
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Textbooks and journals
Consolidated resources
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Dr SA 2012
Which of the following sources of evidence is best able to inform a nurse’s clinical practice?
a. A well-designed randomized controlled trial (RCT)
b. A systematic review that encompasses multiple studies
c. Expert opinion of experienced and educated nurses
d. A case study that addresses an unique clinical scenario
Dr SA 2012
b. A systematic review that encompasses multiple studies
Rationale: Systematic reviews are considered to be higher on the hierarchy of evidence than expert opinion or individual RCTs and case studies.
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Online databases
Grey literature
Bibliographic versus full-text databases
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Librarians are a rich source of assistance
They are especially valuable when time is of the essence
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Keyword searching is searching using simple, everyday language
Controlled vocabulary systems, e.g., MeSH
Normally have a hierarchical structure that helps the searcher retrieve the more specific terms that fall under a general term
Most large bibliographic databases (MEDLINE, CINAHL, and PsycINFO) use a controlled vocabulary to describe the content of references
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Tell whether the following statement is true or false.
A controlled-vocabulary system may yield fewer hits than a keyword search, but these hits are more likely to be relevant to the clinical question.
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True
Controlled vocabulary systems exist to increase the relevance of search results while limiting the number of less-relevant hits.
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Combining search terms from within a PICOT question focuses the search results
Consider that different search engines process terms in the search box in different ways
Using the “limit” function is designed to help the searcher pare down the large results list
Manage inclusion and exclusion criteria carefully
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Managing citations
Saving searches
Organizing searches
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A collection of 6 different databases
“Gold standard” database is the Cochrane Database of Systematic Reviews (CDSR)
Systematic reviews are based on critical appraisal
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A comprehensive database of evidence-based clinical practice guidelines
Guidelines are systematically developed statements about a plan of care for a specific set of clinical circumstances involving a particular population
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MEDLINE - covers medicine, health, and the biomedical sciences
CINAHL – covers 13 nursing and allied health disciplines
EMBASE - major European biomedical and pharmaceutical database
PsycInfo – covers psychology, behavioral sciences, and mental health
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Which of the following online evidence sources is most likely to provide pre-appraised evidence?
a. CINAHL
b. MEDLINE
c. PubMed
d. Cochrane Library
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d. Cochrane Library
Rationale: The Cochrane Databases consist of systematic reviews that synthesize evidence from multiple peer-reviewed sources. CINAHL, MEDLINE, and PubMed may contain evidence at a synthesis level, but are more often sources of individual articles that a nurse must appraise.
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PubMed
Ovid
EBSCO
Any search for evidence must be followed by critical appraisal
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Dr SA 2012