I’ve just returned from the first EBP Residential Workshop for Librarians in Brisbane. It was an intensive 2.5 days led by expert teachers Connie Schardt (Duke University NC USA). The first day concentrated on study design, evidence
resources and searching techniques – and the day was split into large group lectures and smaller group workshops. Luckily for me, I ended up in Connie’s group. The most useful game we had during that day was ‘put the evidenceresource where it belongs on the Haynes pyramid‘ – something many of us plan to replicate with the resources we have access to. The other was – name that study design! Some things I noted from day 1:
- Intention to Treat (ITT): the aim of keeping people in the allocated groups
- Case report: good for identifying new diseases but con in that there is no control
- Case control: starts from the outcome and looks backward to exposure. Pro – outcome is already there and you don’t have to expose people to to harm; Con – cofounders (comorbidities) and recall (self report). It is also difficult to choose the control group
- Cohort: exposure already there and is longitudinal – this is a prospective study (looks forward)
- Randomised control trial: randomised to reduce cofounders (bias) so everyone has an equal chance of being in the intervention/placebo group (experimental design for interventions). Pro – control for bias, exposure and efficacy; Con – expensive, takes time and has ethical issues
- Meta-analysis and systematic reviews: Pro – find evidence for general questions, summaries and validates small studies; Cons – heterogenous, publication bias, time and updating, search cut-off dates
- Exposure + Outcome together = Cross-sectional study: this study occurs at one point in time and considers diseases and other variables
- Diagnosis studies require the test compared to the current gold standard at the same time. These test sensitivity (how good is it in picking up disease) and specificity (how good is it in confirming the absence of disease)
- Qualitative studies examine outcomes and behaviour: Con – poorly understood, small samples, lack of objectivity and generalisability; Pro – considers the human experience (motivations etc), important to nurses
- Prognosis consider risk factors
- How do you present search results to clients? Do you use reference management software and include readily available full text? You can put link to full text in reference managers
- Cochrane = comprehensive / PubMed = can search concisely using highest level evidence
- Using terms in PubMed maps to MeSH (automatic mapping – can see this in ‘details’. Turn this off by using “..” or truncation
- MeSH will not bring up in-process citations
- New MeSH headings
- Comparative Study (MeSH term) or use ‘versus’ OR ‘vs’ in title/abstract – and don’t forget about floating subheadings
- Can use searching number # to put in Clinical Queries
- You can use Poll Everywhere (free clicker system) for teaching!
Some of these points I knew already but it was totally worthwhile seeing how everything fit in re: study designs and search strategies. It was a fairly humid day and everyone had slept with the windows open. Dinner was a BBQ and then a group of us went on a walk. Total darkness came on at 8pm and everyone was tired (most people also woke up at 5.30am like me).
I’ll write about Day 2 in my next post.