NURS 505B Library SessionRachael Clemens Spring 2007

Agenda

• Welcome back

• Follow-up from last semester

• EBM + Cochrane Library

• Mechanics of full-text

• RefWorks

Follow-up

• Last semester you crafted a concept analysis paper. How did that go?

• What did you learn?

• What didn’t you learn?

Individual Clinical

Expertise

Clinical EvidenceEvidence

Based Practice

Patient Preferences /

Circumstances

Evidence-based medicine (EBM)

• The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients

Systematic Reviews and Meta-AnalysisRandomized Controlled Double-Blind Studies

Cohort StudiesCase Control Studies

Case SeriesCase Reports

Ideas, Editorials, OpinionsAnimal Research

In vitro (test tube) Research

Pyramid of Evidence

Systematic Review

• One of the greatest achievements of evidence-based medicine has been the development of systematic reviews and

meta-analyses, which summarize the best available evidence on a topic.

Systematic Review

1. A systematic review identifies an intervention for a specific disease or other problem in health care, and determines whether or not this intervention works.

Systematic Review

2. To do this authors locate, appraise and synthesize evidence from as many relevant scientific studies as possible.

Systematic Review

3. They summarize conclusions about effectiveness, and provide a unique collation of the known evidence on a given topic, so that others can easily review the primary studies for any intervention.

Systematic Review• Adheres to a strict design in order to make

them more comprehensive, thus minimizing the chance of bias, and ensuring their reliability.

• Contain all known references to trials on a particular intervention and a comprehensive summary of the available evidence.

Systematic Review Format

1. Objectives

2. Criteria for including studies

3. Search methods for identifying studies

4. Methods of review

5. Description of the studies

6. Results

7. Discussion

8. Potential conflict of interest

9. References

10.Add feedback

Where do you find these Systematic Reviews?

Systematic Reviews

• Medical and nursing journals

• PubMed / Medline

• CINAHL

• Cochrane Library

Cochrane Library

• Collection of several databases indexing evidence for healthcare decision-making

• Main product is the Cochrane Database of Systematic Reviews

• Began back in 1993

• International collaborative effort

British medical researcher who contributed greatly to the development of epidemiology as a science

He stressed the importance of using evidence from randomized controlled trials (RCT's) because these were likely to provide much more reliable information than other sources of evidence

Archibald Cochrane 1909 - 1988