Evidence-based Practice for HINARI Users (Advanced Course Module 6 Part B) 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. 06 July 2017

Table of Contents – Part B Internet Resources PubMed/Clinical Queries PubMed Filters PubMed Health Evidence Aid Other (Internet) Resources introduce you to Evidence-based Practice and related HINARI resources 06 July 2017

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 06 July 2017

We now search for evidence-based articles using PubMed We now search for evidence-based articles using PubMed. From the main HINARI webpage, go to PubMed by clicking on Search inside HINARI full- text using PubMed. Remember you must login to HINARI to have access to the full-text articles. 06 July 2017

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. 06 July 2017

On the PubMed Clinical Queries page, we have entered the pregnancy pregnancy complications AND developing countries search. 06 July 2017

Note the Category and Scope options for Clinical Study Categories (left column) Etiology Diagnosis Therapy Prognosis Clinical Prediction Guides Scope Broad Narrow 06 July 2017

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 1528 articles for Clinical Study Catregory/Therapy/Broad road and 260 articles for Systematic Reviews. 06 July 2017

For the Scope option, use Narrow for the same pregnancy complications AND developing countries search. 06 July 2017

The Clinical Study Categories search Therapy (Category) and Narrow (Scope) pregnancy complications AND developing countries has resulted in 187 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. 06 July 2017

We have displayed all 187 articles for this search including 79 HINARI and 65 Free Full Text articles for the Clinical Studies Category. 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. 06 July 2017

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 260 articles. 06 July 2017

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. 06 July 2017

Note how the various Filters have been displayed under the Article types list. Now use the filters with the hypertension AND diet search. 06 July 2017

Check the Meta-Analysis box in the Article types section and enter hypertension AND diet in the PubMed Search box. The search Results number is 145. Note the Filters activated: Meta-Analysis line below the Results number. 06 July 2017

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 170 Free Full text and 271 HINARI articles. 06 July 2017

Now shown are the results of a hypertension AND diet search with the Randomized Controlled Trial Article types filter activated. The citations for this search include 501 Free Full text and 870 HINARI articles. 06 July 2017

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. 06 July 2017

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. 06 July 2017

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. 06 July 2017

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. 06 July 2017

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 06 July 2017

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. 06 July 2017

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/ 06 July 2017

Evidence Alerts - McMaster University/DynaMed Plus – ‘access to current best evidence from research’ plus.mcmaster.ca/evidenceupdates/ 06 July 2017

Additional Clinical Practice Guidelines resources National Guideline Clearinghouse (USA) www.guideline.gov/ Open Clinical: Clinical Practice Guidelines www.openclinical.org/guidelines.html 06 July 2017

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. 06 July 2017

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 06 July 2017

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 2017 07 06 July 2017