Evidence Based Practice

INLS 705

Better performance in medicine

DiligenceDo rightIngenuity

Goals

What is

evidence-based medicine? evidence-based healthcare?evidence-based clinical practice?EBM?

Purpose of EBM

• Emphasizes evidence from clinical research• New rules and skills for learning and

awareness

EBM process

• Assess the patient• Ask a question• Acquire resources• Evaluate and appraise the information• Apply to the patient• Evaluate your performance

Lifelong learning

Why is EBM necessary?

Opponents of EBM

Ask PICO question• PATIENT/PROBLEM In school children with active head lice

• INTERVENTION is wet combing • COMPARISON or malathion lotion • OUTCOME a more effective treatment in eliminating live head lice?

Common types of questions

TherapyDiagnosisPrognosisHarm/Etiology

Activity

• Here are some recent NY Times articles on health

• Phrase a PICO question that comes to your mind

• Share

Health evidence from research

Types of research designs - 1

Types of research designs - 2

Hierarchy of evidence

Appropriate research design

Example resources

Summaries of the primary evidence ACP Journal Club UpToDate Clinical Evidence POEMs and InfoRetriever eMedicine DynaMed Evidence Matters

Databases MEDLINE Cochrane Library EBM Reviews (Ovid)

Electronic textbooks and libraries Harrisons MD Consult STAT!Ref

Meta-Search Engines TRIP: Turning Research into Practice SUMSearch

Roles for information professionals

Learn more about EBM?

INLS 890-03W: Evidence Based Medicine

Information synthesis

Sharing information

• Open movements– Open access– Open courseware

• Web 2.0: podcasts, etc.

Generation

Percentage of knowledge transmitted

1 90%

2 81%

3 73%

4 66%

5 59%

6 53%

7 48%

8 43%

9 39%

10 35%

What a waste!

Transparent Convenient Universal tailored to personal needs

Mashups, GIS, visualization

Writing concisely

In a Station of the Metroby Ezra Pound

The apparition of these faces in the crowd;Petals on a wet, black bough.

Ernest Hemingway

Tips

• Headings in MS Word

• Spreadsheets for writing

• Pretend you’re talking to your friend about the key points

Readings

Readings

Portal to good EBM resources

http://www.mclibrary.duke.edu/subject/ebm?tab=contents