Finding Evidence in Pub Med

SFGH’s Barnett-Briggs Medical Librarians Joy Graham and Terri Mason

October 2, 2008

What is the Best Evidence?

• It's the best you can find considering the constraints you're under:

• Available time. • Environmental factors• Skill level and/or prior experience with

a given resource.

EBM PYRAMID OF EVIDENCE

1. Ask an answerable question.2. Search for evidence.3. Assess the evidence.4. Apply the evidence.

Simple as 1- 2- 3- 4

• P=patient• I=intervention• C=comparison• O=outcome(s)

1. Ask an answerable question in PICO format

2.Find the Evidence• Journal literature:PubMed

• Critically appraised topics: Cochrane

• Overview: Dynamed

• Guidelines: http://www.guidelines.gov

Consider:• Study Design• What were the results?• Validity (closeness to the truth)• Will they help care for my patient?

3. Assess the evidence

4. Apply the evidence

Finding evidence in PubMed

Secret Weapon #1: Clinical Queries

Finding evidence in PubMed

Secret Weapon #2: Limits>Publication types>RCT

Clinical Scenario: 65 year old man hospitalized for acute Crohn’s disease has been receiving conventional corticosteroid therapy as prescribed by his physician. You would like to find evidence to show that enteral nutrition enriched with glutamine results in improvement in inflammatory bowel symtoms and shorter LOS.

Let’s go sleuthing!

P=I=C=O=

PICO?

Questions?

Contact Information: Joy Graham, Barnett Briggs Library Manager, 415-206-6639, jgraham@sfghdean.ucsf.edu

Terri Mason, Barnett Briggs Library Coordinator, Education & Information Services, 415-206-6638 tmason@sfghdean.ucsf.edu