ES/PH/SRA 625: Research Design and Evaluation

Evidence Based Practice

In a clinical environment, Evidence Based Practice (EBP) is a thoughtful integration of the best available evidence, coupled with clinical expertise.

Silagy and Haines (1998) describe evidence-based health care as an approach that 'takes account of evidence at a population level as well as encompassing interventions concerned with the organisation and delivery of health care'.

Reference:
Silagy, C & Haines, A 1998, Evidence-based practice in primary care, London, BMJ Books.

PICO Method

PICO Method

P: Patient, Problem or Population – What are the most important characteristics of the patient and their health status?

I: Intervention – What main intervention are you considering (medical, surgical, preventative)

C: Comparison – What are the alternative benchmark or goldmark standards being considered, if any?

O: Outcome – What is the estimated likelihood of a clinical outcome attributable to a specific disease, condition or injury?

T: Type of Question/Study – You can have questions of different types. They can be categorized as a diagnosis, prognosis, therapy, etiology/harm, or prevention question. What study design would best answer the question: randomized controlled trial; cohort study; case controlled study; case series; case series; case report etc.

Videos

Databases to find Articles

Types of Reviews

A literature review is a very practical part of the research process.  It's how you build on other research in the field - identify best practices and tools and learn what doesn't work.  I'm happy to help you find articles to build up your topic's literature review. Also, take a look at the literature reviews you find in scholarly articles you read to get a good idea of how to structure your own and find more articles.  

There are several different kinds of articles frequently found in the literature for medical and health sciences. 

  • Case report – a description of a particular service or event, often focusing on unusual aspects of the reported situation or adverse occurrences.
  • Case series – a description of more than one case.
  • Case-control study – An observational study in which the cases have the issue of interest  but the controls do not.
  • Cohort study – An observational study of a particular group over a period of time.
  • Randomized Controlled Trial – An experimental study in which users are randomly allocated to one of two or more options, where some get the option of interest and others get another option (e.g. a standard service).
  • Scoping review - A type of knowledge synthesis that uses a systematic and iterative approach to identify and synthesize an existing or emerging body of literature on a given topic. The key differences between systematic reviews and scoping reviews are differing purposes and aims. The purpose of a scoping review is to map the body of literature on a topic area. The purpose of a systematic review is to sum up the best available research on a specific question.
  • Systematic review – An approach that involves capturing and assessing the evidence by some systematic method, where all the components of the approach and the assessment are made explicit and documented.  Some systematic reviews include a meta-analysis (see below).
  • Meta-analysis - A method of synthesising the data from more than one study, in order to produce a summary statistic. 

Content Contributor: Booth A & Brice A (2004) Evidence Based Practice for Information Professionals: A Handbook. London: Facet Publishing.

Conducting Literature Searches

When conducting literature searches, you should know that the average time to complete is about 44 hours! (UNC Health Sciences Library).
When you design a search strategy to find all of the articles related to your research question. You will:
  1. Define the main concepts of your topic
  2. Choose which databases you want to search
  3. List terms to describe each concept
  4. Add terms from controlled vocabulary like MeSH
  5. Use field tags to tell the database where to search for terms
  6. Combine terms and concepts with Boolean operators AND and OR
  7. Translate your search strategy to match the format standards for each database
  8. Save a copy of your search strategy and details about your search

There are many factors to think about when building a strong search strategy for systematic reviews.

For PRISMA, there are specific items you will want to report from your search.  For this step, review the PRISMA-S checklist.

When designing and conducting literature searches, a librarian can help advise you on:

  • How to create a search strategy with Boolean operators, database-specific syntax, subject headings, and appropriate keywords 
  • How to apply previously published systematic review search strategies to your current search
  • How to test your search strategy's performance 
  • How to translate a search strategy from one database's preferred structure to another

 

EXAMPLE:

Help with Systematic Reviews

Citation Help Videos Using EndNote