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SEARCHING EVIDENCE THROUGH THE COCHRANE LIBRARY prepared by Literature Searching Team Library, Faculty of Medicine, UGM 2012.

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Presentation on theme: "SEARCHING EVIDENCE THROUGH THE COCHRANE LIBRARY prepared by Literature Searching Team Library, Faculty of Medicine, UGM 2012."— Presentation transcript:

1 SEARCHING EVIDENCE THROUGH THE COCHRANE LIBRARY prepared by Literature Searching Team Library, Faculty of Medicine, UGM 2012

2 2 Evidence-based medicine Evidence-based practice Types of clinical questions Formulating answerable clinical questions using PICO approach What to look for? Searching evidence through The Cochrane Library Other EBM resources OUTLINE

3 3 Evidence-based medicine (EBM) is the process of systematically reviewing, appraising and using clinical research findings to aid the delivery of optimum clinical care to patients. (Rosenberg W., Donald A. Evidence-based medicine: an approach to clinical problem solving, in BMJ 1995; 310: 1122-1126.) Evidence-based: conclusions based on best available evidence WHAT IS EVIDENCE BASED MEDICINE?

4 4 Clinical Expertise Each Individual Patient Best Available Resources ELEMENTS OF EVIDENCE BASED PRACTICE

5 5 FORMULATE CLEAR CLINICAL QUESTIONS* SEARCH FOR THE EVIDENCE* APPRAISE THE EVIDENCE APPLY THE RESULTS TO CLINICAL PRACTICE EVALUATE THE IMPACT ON PRACTICE * Focus of the session STEPS OF EVIDENCE BASED PRACTICE

6 6 Therapy or Intervention – treatments to patients that - do more good than harm - are worth the efforts and costs of using them Prognosis – patients likely clinical course over a time and complications of the disorder Etiology – causes or risk factors of disease Diagnosis - possible causes of patients clinical problems CLINICAL QUESTIONS CENTRAL ISSUES IN CLINICAL WORKS

7 7 Ask a question that you would like answered from the literature Example: Is artesunate better than quinine for treating children with severe malaria? ASKING A CLINICAL QUESTION

8 8 P: Patient, Population, Problem I: Intervention C: Comparison, Comparator O: Outcome PICO APPROACH

9 9 9 Type of question : THERAPY Reformatted question: In children with severe malaria is artesunate more effective than quinine in reducing malaria severity? REFORMATTING THE QUESTION USING PICO APPROACH P: children with severe malaria I: artesunate C: quinine O: reduction of malaria severity

10 10 FROM QUESTION TO SEARCH TERMS Search TermsAlternatives Patient children malaria infants Intervention artesunate Comparator quinine Outcome reduction of malaria severity

11 11 COMBINING SEARCH TERMS Note: Please refer to Module 1 (Introduction to Literature Search) for search tools to use in formulating a search phrase Combined search terms or search phrase for reformatted clinical question: In children with severe malaria is artesunate more effective than quinine in reducing malaria severity? will be: (child* OR infant*) AND malaria AND artesunante AND quinine

12 12 WHAT TO LOOK FOR? The paper where someone trustworthy has already answered our question!

13 13 PRIMARY RESEARCH VS SECONDARY RESEARCH Primary research research undertaken to address a question Secondary research research undertaken to find the existing primary research that addresses a question e.g. reviews (systematic, narrative) and meta- analyses

14 14 x v NARRATIVE REVIEW VS SYSTEMATIC REVIEW Narrative review A narrative review discusses and summarises the literature on a particular topic, without generating any pooled summary figures through meta- analysis. (http://www.nhs.uk/news/Pages/Newsglossary.aspx) Systematic review A systematic review is a critical assessment and evaluation of all research studies that address a particular clinical issue. (http://effectivehealthcare.ahrq.gov/index.cfm/glossary-of- terms/?pageaction=showterm&termid=7)

15 15 THE COCHRANE LIBRARY (TCL) A KEY EBM RESOURCE The Cochrane Library (named after Archie Cochrane) is a collection of databases in medicine and other healthcare specialties provided by the Cochrane Collaboration and other organisations. At its core is the collection of Cochrane Reviews, a database of systematic reviews and meta-analyses which summarize and interpret the results of medical research. The Cochrane Library aims to make the results of well-conducted controlled trials readily available and is a key resource in evidence-based medicine. (http://en.wikipedia.org/wiki/Cochrane_Library)

16 16 The Cochrane Database of Systematic Reviews (Cochrane Reviews) The Database of Abstracts of Reviews of Effects (DARE) The Cochrane Central Register of Controlled Trials (CENTRAL) The Cochrane Methodology Register (Methodology Register) Health Technology Assessment Database (HTA) NHS Economic Evaluation Database (NHS EED) CONTENTS OF TCL

17 17 THE COCHRANE LIBRARY Access is unlocked for subscribers Simple search option Advanced search option www.thecochranelibrary.com

18 18 Search boxes for search terms/phrases DISPLAY OF ADVANCE SEARCH OPTION Database in TCL Search tips to guide searches

19 19 SEARCHING THROUGH ADVANCED SEARCH OPTION PUTTING SEARCH PHRASE IN THE SEARCH BOX Search phrase: (child* OR infant*) AND malaria AND artesunate AND quinine Search in all text

20 20 SEARCH RESULT 46 records matched with the search phrase Click to display search results

21 21 DISPLAY OF SEARCH RESULTS There are 22 Cochrane Reviews, 2 Other Reviews, and 22 Trials (46 records) Click to view abstract Search phrase

22 22 DISPLAY OF ABSTRACT Options for full article in HTML and PDF format

23 23 DISPLAY OF FULLTEXT IN PDF FORMAT

24 24 OTHER EBM RESOURCES The following are some other EBM resources: BMJ Clinical Evidence – www.clinicalevidence.bmj.com/www.clinicalevidence.bmj.com/ National Institute for Health and Clinical Excellence - www.nice.org.uk/ www.nice.org.uk/ NHS Evidence - www.evidence.nhs.uk/www.evidence.nhs.uk/ National Guideline Clearinghourse – public resource for evidence- based clinical practice guideline – www.guideline.gov/www.guideline.gov/ AAOS Evidence-based Clinical Practice Guideline - www.aaos.org/research/guidelines/guide.asp www.aaos.org/research/guidelines/guide.asp PubMed Clinical Queries - http://www.ncbi.nlm.nih.gov/pubmed/clinical/ http://www.ncbi.nlm.nih.gov/pubmed/clinical/ Centre for Evidence-Based Medicine - www.cebm.net/www.cebm.net/

25 25 Access to full text of reviews in TCL is available within medical campus When you are off campus and need the full text reviews, please contact library staff END NOTES

26 26 This Power Point Presentation is compiled by Team of Literature Searching Library Faculty of Medicine, UGM.


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