EBP: Acquire - sources

Question 1

Primary literature

Answer 1

clinical research studies and reports, both published and unpublished.

Question 2

Primary literature examples

Answer 2

New England Journal of Medicine, JAMA, Lancet

Question 3

Secondary literature

Answer 3

references that either index or abstract the primary literature

Question 4

Secondary literature examples

Answer 4

MEDLINE, Cochrane Library

Question 5

Tertiary Sources

Answer 5

provide summarized information to provide quick summary of a topic

Question 6

Tertiary sources examples

Answer 6

textbooks, review articles in journals, drug databases

Question 7

EBP Pyramid

Answer 7

Summaries and Guidelines > pre-appraised research > non-preappraised research

Question 8

Non-preappraised research

Answer 8

• original research articles
• studies provide basis of all other evidence-based info
• more up to date
• helps answer focused clinical question

Question 9

Where to find non-preappraised research

Answer 9

PubMed, Cochrane Central Register of Controlled Trials, EMBASE

Question 10

Two types of pre-appraised research

Answer 10

Synopsis: one-page summary of individual studies
Synthesis: study that combines evidence and summarizes results from multiple studies

Question 11

Define Synopsis

Answer 11

structured snapshot of an original article with additional expert commentary (ie: cliff’s notes)

Question 12

Synopsis examples

Answer 12

ACP Journal Club, EBM Journal

Question 13

Define Synthesis

Answer 13

Systematic reviews

Combines clinical evidence to answer a focused clinical question

Question 14

Synthesis examples

Answer 14

Cochrane, PubMed (filter: systematic reviews), EMBASE (filter: systematic reviews)

Question 15

Traditional review

Answer 15

• Narrative review, review article, or overview
• covers entire clinical topic
• DOES NOT answer focused clinical question
• may include opinion pieces
• might look similar to textbook chapter or summary

Question 16

Summaries

Answer 16

• similar to traditional review
• integrate and summarizes all important info about a clinical problem
• based on comprehensive reviews process

Question 17

Summaries example

Answer 17

UpToDate, DynaMed

Question 18

Search from Top to Bottom of pyramid

Answer 18

Summaries -> pre-appraised -> non-preappraised

Question 19

PubMed

Answer 19

Maintained by the NCBI at the NLM

access to MEDLINE database

Question 20

PubMed search

Answer 20

Keyword: limits to exact keywords
MeSH: medical subject headings. NLM vocab for indexing articles
Clinical queries: applies pre-set filters to quickly connect clinicians with evidence-based clinical literature

Question 21

PubMed search techniques

Answer 21

Filters, Boolean operators (AND, OR, NOT - OR gets more results)
Wildcard Operator (*)
Quotes return EXACT search term

Question 22

Appraise

Answer 22

taking the acquired info and critiquing it by systematically reviewing its relevance, validity, and application to your specific clinical question

Question 23

What does appraise ask

Answer 23

• what are the results
• are the results valid
• will the results help to answer my clinical question

Question 24

Apply

Answer 24

integrate evidence with our clinical expertise and patient values and circumstances

Question 25

What does apply ask

Answer 25

• does this apply to my pt?
• is it feasible
• is the outcome appropriate
• does this align with my pts values and preferences

Question 26

Act

Answer 26

Implement your plan: recommendations, follow-up, communication
Evaluate the outcome: assess your own performance of EBP