Using the Biomedical Using the Biomedical Library & It’s Resources:Library & It’s Resources:Becoming Efficient Information Becoming Efficient Information
ManagersManagers
Physical TherapyPhysical Therapy
Fall 2008Fall 2008
Clista ClantonClista Clanton
Information Services LibrarianInformation Services Librarian Education CoordinatorEducation Coordinator Contact Information:Contact Information:
Phone: (251) 414-8210Phone: (251) 414-8210 Fax: (251) 460-7638Fax: (251) 460-7638 Email: Email: [email protected]
Baugh Biomedical Library – Campus SiteBaugh Biomedical Library – Campus Site Primarily supports the academic health Primarily supports the academic health
sciences (College of Medicine, College of sciences (College of Medicine, College of Nursing & Allied Health)Nursing & Allied Health)
University of South Alabama:University of South Alabama:
Biomedical Biomedical LibraryLibrary Sites Sites
University of South Alabama:University of South Alabama:Biomedical Library SitesBiomedical Library Sites
University Medical Center siteUniversity Medical Center site Primarily supports the clinical medicine Primarily supports the clinical medicine
specialties-collection concentrates on patient specialties-collection concentrates on patient care and treatmentcare and treatment
University of South Alabama:University of South Alabama:Biomedical Library SitesBiomedical Library Sites
Children’s and Women’s Hospital siteChildren’s and Women’s Hospital site Primarily supports obstetrics, gynecology, and Primarily supports obstetrics, gynecology, and
pediatrics – which is reflected by the library’s pediatrics – which is reflected by the library’s collection.collection.
What is Evidence Based Practice (EBP)What is Evidence Based Practice (EBP)
A process by which you: (1) ask clinical questions that can be answered through research and other evidence sources; (2) find the best evidence to answer these clinical questions; (3) appraise the validity of the evidence to support answers to clinical questions; (4) integrate the evidence with clinical expertise and patients’ perspectives; and (5) evaluate the effectiveness of carrying out all of the above.
Short definition: “the integration of best research evidence with clinical expertise and patient values.”1
1Sackett, DL. Evidence-based medicine: how to practice and teach EBM. New York: Churchill-Livingston, 2000.
Evidence Based Practice (EBP)Evidence Based Practice (EBP)
Research Evidence
Evidence-based practice moves beyond the anecdotal treatment modes of the past toward the future of objective, data driven, scientifically researched practice regimes.
• Meta-analyses• Systematic Reviews• Clinical Trials• Other types of research studies (both quantitative and qualitative)
The Medical LiteratureThe Medical Literature Primary – original Primary – original
researchresearch Experimental (an Experimental (an
intervention is made or intervention is made or variables are manipulated)variables are manipulated)
Randomized Control TrialsRandomized Control Trials Controlled trialsControlled trials
Observational (no Observational (no intervention or variables intervention or variables are manipulated)are manipulated)
Cohort studiesCohort studies Case-control studiesCase-control studies Case reportsCase reports
Secondary – reviews Secondary – reviews of original researchof original research ReviewsReviews Meta-analysisMeta-analysis Systematic reviewsSystematic reviews Practice guidelinesPractice guidelines Decision analysisDecision analysis Consensus reportsConsensus reports Editorial, commentaryEditorial, commentary
Evidence Pyramid
Case Series/Case Reports
Case Control Studies
Cohort Studies
Randomized Controlled Trial
Systematic Review
Meta-analysis
Animal Research
Real world factors that decide Real world factors that decide clinician’s approach to the literature:clinician’s approach to the literature:
Clinician’s awareness that new information is availableClinician’s awareness that new information is available Perception that current options are unacceptable or Perception that current options are unacceptable or
didn’t workdidn’t work Availability of familiar sourcesAvailability of familiar sources Perceived likelihood that an answer can be foundPerceived likelihood that an answer can be found Fear of liability if the correct approach is not followedFear of liability if the correct approach is not followed Time available to search for the answerTime available to search for the answer
Green ML, Ciampi MA, Ellis PJ. Residents’ medical information needs in clinics: are they being met? Am J Med. 2000; 109:218-23.Ely JW, Osheroff JA, Ebell MH, et al. Analysis of questions asked by family doctors regarding patient care. BMJ. 1999;319:358-61.Ebell MH, Shaughnessy AF. Information mastery: integrating continuing medical education with the information needs of clinicians. J Cont Ed Health Prof. 2003;23:S53-62.
Patient-Centered Patient-Centered Information ManagementInformation Management
Usefulness of any information source =
Relevance X Validity
Work
Slawson DC, Shaughnessy AF. Teaching evidence-based medicine: Should we be teaching information management instead? Acad Med 2005;80:685-689
Information ManagementInformation Management
Focuses on using currently available Focuses on using currently available information tools to remain up to dateinformation tools to remain up to date With new valid informationWith new valid information That is relevant to the care of patientsThat is relevant to the care of patients Is accessible while taking care of patientsIs accessible while taking care of patients