5 - EBM Resources

Question 1

Describe the hierarchy of research evidence

Answer 1

Top to bottom:

• Systematic reviews*
• Critically-appraised topics*
• Critically-appraised individual articles*
• Randomized controlled trials**
• Cohort studies**
• Case-controlled studies, case series/ reports**
• Expert opinion
• = filtered info
• • = unfiltered info

Question 2

What are the 2 reasons for researching?

Answer 2

• “Just in time” research

- “Keeping up” information

Question 3

Where would you go to find out if research is currently being done on a question you have?

Answer 3

1. Clinical trial registration (clinicaltrials.gov)
   - Not mandatory to register, but if you want to be published in some big publications then must register
2. Abstracting publications -> EvidenceUpdates (plus.mcmaster.ca/ evidencealerts)

Question 4

Describe EvidenceUpdates

Answer 4

• Report sent daily/ weekly to inbox based on your discipline
• Gives abstract (brief summary of goals, methods, results, and conclusion)

Question 5

Where would you go to find results of studies?

Answer 5

• Abstracting (and interpretation) services:
  1. MyStudies
  2. ACP Journal Club (monthly evidence summary of new evidence; only posts abstracts and interpretations)
  3. Evidence-Based Medicine
  4. Essentials of Evidence Plus

Question 6

Where would you go to find systematic reviews and critically-appraised topics?

Answer 6

1. Cochrane (good for areas that you have a lot of involvement in; not a quick skim)
2. CADTH (common drug review = literature evaluation of new drugs for listing on provincial formularies; good for “keeping up” info)
3. Therapeutic Initiative (infrequent, but process is rigorous)

Question 7

Where would you go for help about how to talk to px about making decisions?

Answer 7

• Pharmacy toolkit -> patient decision aids
• Decision box good for primary care practice; can answer questions in pt friendly language
• Mayo Clinic shared decision making -> shows benefit of using a medication (similar to Framingham website)

Question 8

What are some medical “movements”?

Answer 8

• Choosing wisely manitoba.ca
• Choosing wisely.org
• Deprescribing.org

Question 9

What are some medical “news” services?

Answer 9

• theheart.org
• webMD
• Medscape
• Pharmacy Post

Question 10

What are some peer communities?

Answer 10

• Pharmacy Specialty Network (PSN) -> hospital pharmacy focused
• CSHP e-News Briefs -> coverage of events/ issues that impact on pharmacy in general and hospital care specifically

Question 11

What are some “Do’s” with researching?

Answer 11

• Whenever possible, do the critique yourself first (for RCTs), then look at critiques/ commentaries from reliable sources
• • Will help you to pick up on things you missed and get better at doing this by seeing how others do it
• Explore many resources and identify the most useful for your practice scenario
• Bookmark top resources

Question 12

What are some “Don’ts” with researching?

Answer 12

• Reinvent the wheel or conduct a complete analysis when someone you trust has created something already
• Use just one resource