Evidence-based Practice for Hinari Users Part B (Advanced Course Module 6) This module explains why HINARI users might want to start by searching evidence-based resources and highlights HINARI, as well as, freely available resources that support evidence-based practice. 01 March 2018

Table of Contents – Part B Hinari Resources (partial) Evidence-based Medicine Guidelines Essential Evidence Plus EBM Journals Internet Resources PubMed/Clinical Queries PubMed Filters PubMed Health Evidence Aid Other (Internet) Resources introduce you to Evidence-based Practice and related HINARI resources 01 March 2018

From the Reference sources list, we have opened the initial page of EBM Guidelines Evidence-Based Medicine. Also published by John Wiley, this resource is a collection of clinical guidelines for primary care combined with evidence-based research. You can Search by keyword or Browse database contents by EBM Guidelines, Evidence summaries, Pictures, Audio samples, Videos and Programs. 01 March 2018

Also included are links to the Evidence summaries. We have completed a keyword search for Influenza. The results page includes summaries of the key issues including Related resources and References and links to important websites. PRIMARY and SECONDARY HITS Also included are links to the Evidence summaries. 01 March 2018

We have displayed the 2nd Evidence summary We have displayed the 2nd Evidence summary. Each link contains a brief review of the study and notes the reference(s). 01 March 2018

By keyword, you can Search all or some of the databases. From the Reference Sources list, we have opened the initial page of Essential Evidence Plus. Also published by John Wiley, it includes access to Cochrane Library and also a series of databases and tools to access the EBM material. By keyword, you can Search all or some of the databases. 01 March 2018

We have opened the EBMG evidence summaries database that, via broad subject categories, has access to 4440 articles. 01 March 2018

We have opened the initial page of EBMG evidence summaries listing for Infectious disease. Material is listed by either a summary view or expanded view that includes a sentence describing each entry. 01 March 2018

We have opened Decision Support Tools that has 406 tools and calculators that assist in clinical decision making. 01 March 2018

Hinari Evidence-Based Journals (other journals may have EBM articles) Now browsed is the ‘E’ in the Hinari Journals collection title list and it notes several journals for evidence-based practice. Depending on publishers’ offer to countries, some of these journals may not be accessible. 01 March 2018

Conduct systematic reviews of the literature (Hinari) PubMed Conduct systematic reviews of the literature Limit to specific populations & publication types Utilize EBM built-in filters Set up and distribute alerts relating to evidence-based medicine 01 March 2018

Now search for evidence-based articles using PubMed Now search for evidence-based articles using PubMed. From the Hinari Content page, go to PubMed by clicking on Databases for discovery list Remember you must login to HINARI to have access to the full-text articles. In the HINARI Portal you can access PubMed from the Content page. Click on Databases for discovery. 01 March 2018

Open PubMed which is at the top of the Browse databases list. 01 March 2018

Open the Clinical Queries box Open the Clinical Queries box. This search tool assigns filters to keyword searches - to locate articles on Clinical Studies, Systematic Reviews and Medical Genetics. Note: for these PubMed applications, all individuals will have access to the free full text articles. The examples are from Hinari/PubMed searches and, for those properly logged in, will also include access to articles from Hinari participating publishers. 01 March 2018

On the PubMed Clinical Queries page, we have entered the pregnancy pregnancy complications AND developing countries search. 01 March 2018

Note the Category and Scope options for Clinical Queries Searches Etiology Diagnosis Therapy Prognosis Clinical Prediction Guides Scope Broad Narrow 01 March 2018

Note: you can go directly to PubMed Clinical Queries. The default search results for the Clinical Study Categories are Category: Therapy and Scope: Broad. Other options in the Category drop down menu are Etiology, Diagnosis, Prognosis and Clinical Prediction Guides. There are 1357 articles for Therapy: Broad and 165 articles for Systematic Reviews. Note: you can go directly to PubMed Clinical Queries. The direct link to PubMed Clinical Queries is http://www.ncbi.nlm.nih.gov/pubmed/clinical 01 March 2018

For the Scope option, we will enter Narrow and for the same pregnancy complications AND developing countries search. 01 March 2018

The Therapy (Category) and Narrow (Scope) pregnancy complications AND developing countries search has resulted in 145 citations. We now will click on the See all option (bottom of the page). Note that the results for Systematic Reviews and Medical Genetics also are displayed. 01 March 2018

We have displayed all 145 articles for this search including 80 Hinari and 80 Free Full Text articles. Remember - you can access the full-text articles by clicking on these Filters or changing the display from Summary to Abstract. Note that the specific search is listed in the Search box including the AND (Therapy/Narrow[filter]) for clinical studies categories and systematic reviews. Note: from a search results page, return to Clinical Queries by clicking on the PubMed.gov logo as this displays the initial PubMed Search page. 01 March 2018

After returning to the search results on the Clinical Queries page, we have clicked on the See all option for the systematic reviews results. The pregnancy complications AND developing countries AND systematic [sb] search resulted in 165 articles. 01 March 2018

Another tool from PubMed is using the Filters option – see the left-column. In the Article types filter list, click on Customize. Check the boxes for Meta-Analysis, Randomized Control Trial and Systematic Reviews Article types. Finally, click on the Show box. Filters can be activated from any search results page. Remember to clear them before beginning other searches. 01 March 2018

Note how the various Filters have been displayed under the Article types list. You now can use of the filters with the hypertension AND diet search. 01 March 2018

We have checked the Meta-Analysis box in the Article types section and entered hypertension AND diet in the PubMed Search box. The search Results number is 86. Note the Filters activated: Meta- Analysis line below the Results number. 01 March 2018

Now displayed are the results of a hypertension AND diet search with the Systematic Reviews Article types filter activated. The citations for this search include 109 Free Full text and 167 HINARI articles. 01 March 2018

Now displayed are the results of a hypertension AND diet search with the Randomized Controlled Trial Article types filter activated. The citations for this search include 371 Free Full text and 689 Hinari articles. 01 March 2018

Remember to clear the filters. The final displayed search are the results of a hypertension AND diet search with the Meta-Analysis, Systematic Reviews and Randomized Controlled Trial Article types filters activated. The citations for this search total 1598. Remember to clear the filters. 01 March 2018

In PubMed Health, there are links on how to receive current information on clinical effectiveness and systematic reviews plus how to set up MY NCBI email alerts for new Cochrane reviews in PubMed. 01 March 2018

Another useful tool is evidenceaid Another useful tool is evidenceaid. The Resources page contains links to numerous published systematic reviews that have relevance for natural disasters, humanitarian crises or major healthcare emergencies. It also includes five disaster-specific Special Collections. 01 March 2018

To learn more about EBM, go to the online tutorial Introduction to Evidence-Based Medicine. Tutorial is intended for any health care practitioner who needs a basic introduction to the principles of Evidence-Based Practice. Developed by Duke University Medical Center Library and Health Sciences Library/University of North Carolina/Chapel Hill. 01 March 2018

Additional Evidence-based Health Resources continued Trip Database – ‘a smart, fast tool for you to find high-quality clinical research evidence’ www.tripdatabase.com/ McMaster PLUS (Premium Literature Service): ‘a database created by the McMaster Health Knowledge Refinery; articles… selected from current medical literature’ (HKR)hiru.mcmaster.ca/hiru/HIRU_McMaster_PLUS_projects.aspx 01 March 2018

Bandolier Knowledge - Oxford University – ‘premier source of evidence based healthcare information in the UK and worldwide for healthcare professionals’ http://www.bandolier.org.uk/ EBM Librarian – ‘site offers a place to: share teaching materials and class handouts discuss issues and ask advice from colleagues share useful information about teaching EBM https://sites.google.com/site/ebmlibrarian/ Listed here are some freely available websites that are useful resources for finding clinical and public health evidence. 01 March 2018

Open Clinical: Clinical Practice Guidelines – ‘a "one-stop shop" tracking developments on advanced knowledge management technologies for healthcare such as point-of-care decision support systems, "intelligent" guidelines and clinical workflow’ www.openclinical.org/guidelines.html National Guidelines Clearinghouse - Agency for Healthcare Research and Quality: ‘a public resource for summaries of evidence-based clinical practice guidelines’ www.guideline.gov/ 01 March 2018

Evidence Alerts - McMaster University/DynaMed Plus – ‘access to current best evidence from research’ plus.mcmaster.ca/evidenceupdates/ 01 March 2018

Additional Clinical Practice Guidelines resources National Guideline Clearinghouse (USA) www.guideline.gov/ Open Clinical: Clinical Practice Guidelines www.openclinical.org/guidelines.html 01 March 2018

Review: 5 Steps to evidence-based health care Step 1 Ask: Formulate your question foreground clinical question PICO format population, intervention, comparison intervention, outcome Step 2 Access: Search for the evidence – highest quality studies are included in a systematic review types of studies evidence hierarchies  Here are some general comments to remember about evidence-based practice. We hope that this tutorial has led to a better understanding of what evidence-based practice is and how to efficiently find good evidence using HINARI resources. 01 March 2018

validity (internal & external) impact Step 3: Appraise the evidence - use criteria to evaluate the studies for: validity (internal & external) impact Step 4 Apply: Put the evidence into practice patient setting Step 5: Assess progress and performance yourself 01 March 2018

This is the end of Hinari Module 6 There is a Work Book to accompany this part of the module. The workbook will take you through a live session covering the topics included in this demonstration with working examples. Updated 2018 03 01 March 2018