Evidence based medicine - how to find the evidence

FY2 May 2015

Library Services, Information Services

Find out more, visit http://library.sgul.ac.uk

Karen John-Pierre

NHS Liaison Librarian

kjohn@sgul.ac.uk

020 8725 5433

Why this session?

• FP Curriculum 2012- FY2 Outcomes

– Maintaining good medical practice

– Finds and interprets evidence relating to clinical questions

– Demonstrates the use of literature, guidelines and experience…

3April 15, 2023

What are we doing today?

Session 1 Aim and objectives

• What are NHS Healthcare databases?• Planning searches• Accessing the NHS databases• Searching databases effectively• Saving results and locating papers

Session 2 Aim and objectives

• A brief overview of critical appraisal • Tips on useful tools

Library Services, Information Services

Find out more, visit http://library.sgul.ac.uk

© Colin Kinner (Flickr: Question mark sign) [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons

• NHS Healthcare Databases give access to article references from reliable, peer reviewed health-related journals

• You can search the following databases by clinical topic:– Medline– Embase– PsycINFO – CINAHL– Amed – BNI– HMIC

• All available via NHS OpenAthens, from anywhere

• Provide links to NHS e-journals content

Library Services, Information Services

Find out more, visit http://library.sgul.ac.uk

What are the NHS Healthcare databases?

Why should I use these databases?

• Access to reliable information• Saves you time• Access to full text articles • Able to save searches/set up alerts• Search from anywhere with internet access

Library Services, Information Services

Find out more, visit http://library.sgul.ac.uk

Image © Jisc http://www.jisc.ac.uk/sites/default/files/styles/710px-wide/public/data-base-teaser.jpg?itok=L1rBaUP4 CC BY-NC-ND 2.0 UK

Planning a Search

Image © Susan Ness © http://susannesspace.blogspot.co.uk/2012_08_01_archive.html[CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)],

1.Focus your topic

2.Identify keywords

3.PICO

PICO - focusing your question1) Patient/problem

2) Intervention/Exposure

3) Comparisons

4) Outcomes

Activity 1- Plan your search

Image © Nina Aldin Thune  [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/)], via Wikimedia Commons

Accessing the databases

• To access NHS resources you will need a

NHS OpenAthens username and password

• Self-register for one at http://openathens.nice.org.uk

• Easiest access via the St George’s Library homepage: http://library.sgul.ac.uk

Library Homepage>NHS Staff >Find articles

Library Services, Information Services

Find out more, visit http://library.sgul.ac.uk

Locating Journals articles- 6 things

1. Link from your search results where possible

2. NHS A-Z journals list (NHS Journals on NHS webpage)

3. Check Library Journals list for university journals. (Journals from homepage)

4. Check Library Catalogue or Hunter for print versions

5. Web searches for any Open Access content

6. Interlibrary loans (Quota of free requests)

Tip! Ask for a university network login to get in-library access to uni journals

What is Critical Appraisal?‘Critical appraisal is the assessment of evidence by systematically reviewing its relevance, validity and results to specific situations’

• Chambers, R (1998)

What is Critical Appraisal

Critical Appraisal is not:• Negative dismissal of a piece of research• Assessment of results alone• Based entirely on detailed statistical

analysis• To be undertaken by expert researchers

only

Critical appraisal is…

• Balanced assessment of strengths of research against its weaknesses

• Assessment of research process and results

• Consideration of quantitative and qualitative aspects of research

• To be undertaken by all health professionals as part of their work

Why bother?

• Published research is not always reliable

• Only an estimated 2% is judged clinically relevant (Altman)

• Patients are better informed and come to us having read material on the web or in the media

Why bother?

Systematic Reviews and Meta-analysis

Cohort studies

RCTS

Case control studies

Levels of evidence

How to do critical appraisal?

• Checklists are available that ask simple questions

• There are different checklists for different types of studies (systematic reviews, RCTs etc)

• These checklists help you focus on the most important aspects of the article

CASP checklists

• Are the results valid?– Is the research question focused?– Was the method appropriate?– How was it conducted, e.g. randomisation, blinding, recruitment

and follow up?

• What are the results?– How was data collected and analysed?– Are they significant?

• Will the results help my work with patients?

www.casp-uk-net

Where to get further help

Research Enquiries Desk Mon-Fri 11am-4pm

Contact your NHS librarian• training courses• one to one sessions • help sheets on library website• CARES literature search service

Karen John-Pierre Cathryn PeppardNHS Liaison Librarian Support Librarian (NHS)Ext 5433 Ext 5433kjohn@sgul.ac.uk zali@sgul.ac.uk