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PHCY 6250: Drug Literature Evaluation: EBP Models

Use this guide to explore drug and pharmacy information from the library print and electronic collections and reliable databases and information from the web.

What is evidence based practice?

Evidence based practice is:

"the integration of best research evidence with clinical expertise and patient values." (Sackett, David L., et al., Evidence-based medicine: how to practice and teach EBM. New York: Churchill Livingstone, 2000. p. 1)

The Three Parts of Evidence Based Practice

Triple Venn Diagram connecting Clinical Expertise, Evidence, and Patient Preferences.

 

The triangle at the intersection represents EBP.

Image by Jenny Garcia, W.R. Coe Library, University of Wyoming

Types of Clinical Questions

Students are expected to have more background questions as they build their personal knowledge base.

As they become more knowledgeable about their field and patient care, they have fewer background questions and have more Foreground questions.

The most complex question is the PICO question, which is used for Informed Decision-Making.

Image from Spoetnic, Laika, Grand Rounds Vol. 6, No. 2. Laika's MedLibLog, https://laikaspoetnik.wordpress.com/2009/09/29/grand-rounds-vol-6-no-2/

Levels of Evidence

Pyramid diagram. Bottom-to-top: Editorials, expert opinion. Case series, case reports. Case-control studies. Randomized controlled trials. Systematic reviews.

Hierarchical order of the types of resources based on highest level of credibility.

From Library of Health Sciences-Chicago, University of Illinois at Chicago, http://ebp.lib.uic.edu/pharmacy/node?page=6

EBP Process

Looping cycle diagram. ASK (PICO) points to Acquire (Search Literature) points to Appraise (Valid Results?) points to Apply (Clinical Practice) points to Assess (Patient Improvement?) points to ASK (PICO).

This graphic demonstrates the 5 steps of evidence-based practice. It provides an approach for working through a questioning and evaluating process for making informed decisions. 

Image by Jenny Garcia, W.R. Coe Library, University of Wyoming

6-S Pyramid

Hierarchical diagram. Bottom-top: Studies. Examples: original journal articles (sources include Cochrane Center Register of Controlled Trials, Published Clinical Queries, MEDLINE). Syntheses. Examples: systematic reviews (sources include Cochrane Database of Systamtic Reviews and DARE (Kochrane Database of Abstracts of Reviews of Effects). Synopses: evidence-based journal abstracts (sources include ACP Journal Club, Evidence-Based medicine.) Summaries: evidence-based textbooks (sources include online summary publications such as Dynamed and Clinical Evidence.) Systems. Examples: computerized decision-support systems (e.g. electronic health records).

•Straus S(1), Haynes RB. Managing evidence-based knowledge: the need for reliable, relevant and readable resources. CMAJ. 2009 Apr 28;180(9):942-5. doi: 10.1503/cmaj.081697.