ebp step 2: rapid access to the best evidence dr sue wells effective practice, informatics &...
TRANSCRIPT
![Page 1: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/1.jpg)
EBP Step 2: Rapid Access to the best evidence
Dr Sue Wells
Effective Practice, Informatics & Quality Improvement
Section of Epidemiology and Biostatistics
School of Population Health
![Page 2: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/2.jpg)
Using PubMed to find research evidence in quickest possible time-
future proof your searching!
PubMed 101
Get this lecture ppt from CECIL and on “Normal View” find all the step-by step instructions
![Page 3: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/3.jpg)
Medline widely available on different platforms eg, OVID or PubMed
produced in USA. (National Library of Medicine)
premier electronic source for biomedical literature
contains mostly US/UK journals 4000 / 10,000 published worldwide http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?DB=pubmed
![Page 4: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/4.jpg)
Tip Number 1
PUBMED!
![Page 5: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/5.jpg)
PubMed – Free Internet version of Medline
![Page 6: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/6.jpg)
Go straight to the INDEX- MeSH
![Page 7: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/7.jpg)
MeSH 1
Medline Subject Headings (MeSH terms) are assigned to each article.
Provide consistent way to retrieve articles MeSH “a controlled vocabulary organised in a tree structure”
index = like chapter headings in a text book– Major Subject Headings (eg Leg)
• Subject Headings (eg knee)– Subheadings (eg cruciate ligament)
Each new paper is “tagged” by NLM librarians using MeSH terms representing the key things about each study (eg rct ligament surgery)
![Page 8: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/8.jpg)
CLINICAL SCENARIOA 65 yr old woman with stable angina and on HRT for 8 years comes to see you. She has read a magazine article about the possible harms of Hormone Replacement Therapy (HRT) on heart disease. She
Is a non-smoker. Has a BMI of 25 Has no menopausal symptoms
Should her prescription for HRT be stopped?
![Page 9: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/9.jpg)
Reframe into PECOT question
Among postmenopausal women with angina or
other coronary heart disease (P),
Does hormone replacement therapy (HRT) (E),
Compared to no HRT (C) ,
affect the risk of further CHD events (eg
MI, bypass surgery) (O)
over the next 5 years (T) ?
![Page 10: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/10.jpg)
HRT EXAMPLE
Break the question into the following components
Participants
Exposure Comparison
Outcome Time
angina orcoronary heart disease ANDPost-menopausal
Hormone replacement therapyORHRT
No HRT Coronary heart disease events
5 years
AND AND AND
![Page 11: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/11.jpg)
![Page 12: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/12.jpg)
![Page 13: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/13.jpg)
![Page 14: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/14.jpg)
![Page 15: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/15.jpg)
![Page 16: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/16.jpg)
MeSH 2
Explode retrieves all articles with that MeSH term or a term beneath it on the tree
eg explode “leg” retrieves all articles tagged with either leg, hip, thigh, knee, ankle, foot
Restrict (or Focus) restricts search to those articles where the specified MeSH term is the major focus.
Previous indexing -Subject Headings change over time – may need to check “old” headings as well as MeSH term
![Page 17: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/17.jpg)
![Page 18: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/18.jpg)
![Page 19: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/19.jpg)
![Page 20: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/20.jpg)
![Page 21: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/21.jpg)
![Page 22: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/22.jpg)
![Page 23: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/23.jpg)
![Page 24: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/24.jpg)
![Page 25: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/25.jpg)
![Page 26: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/26.jpg)
![Page 27: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/27.jpg)
![Page 28: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/28.jpg)
![Page 29: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/29.jpg)
![Page 30: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/30.jpg)
![Page 31: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/31.jpg)
![Page 32: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/32.jpg)
![Page 33: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/33.jpg)
![Page 34: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/34.jpg)
![Page 35: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/35.jpg)
![Page 36: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/36.jpg)
![Page 37: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/37.jpg)
Introducing PubMed TABS
HISTORY– Gives you a summary of what you have searched, limits or filters used and number of articles retrieved
![Page 38: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/38.jpg)
![Page 39: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/39.jpg)
LIMITS
Limits your search eg; to particular
study types, population groups
studied, or language
![Page 40: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/40.jpg)
![Page 41: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/41.jpg)
![Page 42: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/42.jpg)
![Page 43: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/43.jpg)
![Page 44: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/44.jpg)
![Page 45: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/45.jpg)
Helpful tip- clear limits or every
search from now on will have them!
![Page 46: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/46.jpg)
![Page 47: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/47.jpg)
“Clinical Queries” searches for you by applying a filter for specific
study types
![Page 48: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/48.jpg)
![Page 49: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/49.jpg)
Highlight the search terms, copy (Ctrl-C) and paste (Ctrl-V)
into Clinical Queries dialogue box
![Page 50: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/50.jpg)
![Page 51: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/51.jpg)
![Page 52: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/52.jpg)
SENSITIVITY
Sensitivity is calculated by
Results of a sensitive search
RCT’s required (blue)
Results of a specific search
number studies foundtotal number of relevant
studies
![Page 53: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/53.jpg)
![Page 54: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/54.jpg)
![Page 55: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/55.jpg)
![Page 56: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/56.jpg)
![Page 57: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/57.jpg)
Your Assignment
![Page 58: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/58.jpg)
What if the question is not about an intervention?
![Page 59: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/59.jpg)
Scenario You are a 2nd year house surgeon at Whangarei-its night time.
16yr old brought in by Mum with signs & symptoms of acute appendicitis
Ring surgeon on call, up to theatre and remove a normal appendix
Find patient has PID – gonorrhea Disappointed in your mistake you wonder if a CT scan would be have been useful as a diagnostic test. You decide to search PubMed.
![Page 60: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/60.jpg)
Reframe into PECOT question
Among adolescents and adults who are admitted
acutely with signs and symptoms suggestive of
appendicitis (P),
Will a computerised tomography scan help to
differentiate (O) between those who
have acute appendicitis (E),
Compared to those with other diagnoses (C) ,
At the time of admission (T) ?
![Page 61: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/61.jpg)
Appendicitis Example
Break the question into the following components
Participants
Exposure Comparison
Outcome Time
Adolescents and adults
Acute Appendicitis
Not acute appendicitis
CT Scan One point in time
AND AND
![Page 62: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/62.jpg)
GO TO MeSH
![Page 63: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/63.jpg)
![Page 64: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/64.jpg)
![Page 65: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/65.jpg)
![Page 66: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/66.jpg)
![Page 67: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/67.jpg)
![Page 68: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/68.jpg)
![Page 69: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/69.jpg)
![Page 70: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/70.jpg)
![Page 71: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/71.jpg)
![Page 72: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/72.jpg)
![Page 73: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/73.jpg)
![Page 74: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/74.jpg)
![Page 75: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/75.jpg)
![Page 76: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/76.jpg)
Still too many to scroll through? – what
could I do now??
![Page 77: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/77.jpg)
![Page 78: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/78.jpg)
![Page 79: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/79.jpg)
![Page 80: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/80.jpg)
OK- what if you have a really tricky question and it doesn’t
map to a MeSH term.............????
![Page 81: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/81.jpg)
Should interventional radiologists or general surgeons be using antibiotic or antiseptic-impregnated central venous lines to prevent line-associated sepsis?
![Page 82: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/82.jpg)
Reframe into PECOT question
For patients requiring a CVP line (P),
Does an antibiotic or antiseptic-impregnated
central venous line (E),
compared to a non-drug impregnated one
(C) ,
prevent line-associated sepsis (O)
over the time of use (T) ?
![Page 83: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/83.jpg)
CVP line example
Break the question into the following components
Participants
Exposure Comparison
Outcome Time
Any hospitalised patient
antibiotic or antiseptic-impregnated central venous line
“Plain” CVP line
InfectionSepsisdeath
Over time of use
AND AND
![Page 84: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/84.jpg)
MeSH- type in CVP line
![Page 85: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/85.jpg)
![Page 86: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/86.jpg)
![Page 87: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/87.jpg)
![Page 88: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/88.jpg)
![Page 89: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/89.jpg)
![Page 90: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/90.jpg)
Scroll down to
“Display”
![Page 91: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/91.jpg)
Click on
Click on drop-down menu
![Page 92: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/92.jpg)
Find “Citation”
![Page 93: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/93.jpg)
![Page 94: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/94.jpg)
MeSH terms “tagged” to
this publication
Catheterization, Central Venous
![Page 95: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/95.jpg)
![Page 96: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/96.jpg)
![Page 97: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/97.jpg)
What about the other options?
Send to search box with OR Send to Search box with NOT
![Page 98: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/98.jpg)
Boolean AND
ANDChildren aged 2-15
Asthma
![Page 99: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/99.jpg)
Boolean OR
Asthma Bronchitis
Green area = Asthma or Bronchitis
![Page 100: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/100.jpg)
Boolean NOT
Asthma not drugs
Drug therapy
Yellow circle = AsthmaWhite Circle = Drug therapy
![Page 101: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/101.jpg)
![Page 102: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/102.jpg)
PubMed Single Citation Matcher Quick way to find a
single paperA consultant mentions in passing a randomised trial published in the Lancet in 2001 looking at prevention of deep vein thrombosis on long flights. You want to find a copy of the paper.
![Page 103: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/103.jpg)
Use Single Citation Matcher tool-put in journal name, year and title words
![Page 104: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/104.jpg)
![Page 105: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/105.jpg)
Saving citations / printing off articles
PMID:11377600 OVID platform 11377600.ui
![Page 106: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/106.jpg)
![Page 107: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/107.jpg)
Organisation of Evidence
Adapted from Haynes RB (2001). Evidence-Based Mental Health 4:37-38.
Evidence-based guidelines eg NZGG
![Page 108: EBP Step 2: Rapid Access to the best evidence Dr Sue Wells Effective Practice, Informatics & Quality Improvement Section of Epidemiology and Biostatistics](https://reader035.vdocuments.net/reader035/viewer/2022062312/551bea15550346b9588b626d/html5/thumbnails/108.jpg)
Megasearch engines eg TRIP, SumSearch (just google!)
one stop shops for Evidence based information multi-database search includes
– Evidence-based synopses (eg EBM journals), – global guidelines, – E-textbooks, medical images, – Patient Information Leaflets, – Systematic reviews, Health Technology
assessments,– Core general medical journals, specialist
journals ·etc very dependent on spelling, very dependent on
appropriate terms Use MeSH terms!!!! without [MeSH]