KN431 Aug26 Library Session
- 1. KN 431 LIBRARY SESSION August 26, 2015
- 2. Finding Research Define your question Plan your search Find the evidence Evaluate the literature Stay organized Jamie Dwyer, MLS Librarian/”Research Coach” jamied@uic.edu
- 3. Define your question using PICO Patient/Population/Problem Intervention Comparison (if available) Outcome(s) *View PICO: Developing the Answerable Clinical Question (video under “View PICO Lecture”) http://researchguides.uic.edu/content.php?pid=232200&sid=1921075
- 4. PICO Model Example 1 • Patient/Population/Problem • Patients after knee replacement • Intervention • CPM therapy • Comparison • (No CPM therapy) • Outcome • Optimal range of motion What is the effectiveness of continuous passive motion therapy (CPM therapy) following knee replacement in achieving optimal range of motion?
- 5. PICO Model Example 2 P (patient/problem/population) Stroke patients I (intervention you are considering; drug, surgery, counseling treatment plan…) Virtual reality (VR) occupational therapy C (comparison; alternative to intervention; not always a comparison) Non-VR (or no comparison) O (outcomes; what you hope to accomplish, measure, prove, etc.) Therapeutic effectiveness rehabilitation http://libguides.greenriver.edu/content.php?pid=48934&sid=755695 Research Question: Are virtual reality programs an effective, alternative tool for rehabilitation of stroke victims?
- 6. PICO Model Examples In underweight refugee children (P), will tube feeding (I) safely restore weight and increase maximum energy intake (O)? Is elective adult male circumcision (I) more effective than sexual education (C) in reducing HIV acquisition (O) in an urban Ugandan setting (P)? Will a public awareness campaign on the dangers of indoor air pollution due to cooking with biomass fuels in poorly ventilated spaces (I) lower the number of respiratory infections (O) in poor households in Bangladesh (P)?More PICO information from UIC http://researchguides.uic.edu/content.php?pid=232200&sid=1921075
- 7. Find PICO in the Title Can exercise increase fitness and reduce weight in patients with schizophrenia and depression? http://www.ncbi.nlm.nih.gov/pubmed/25120495 Meeting physical activity guidelines is associated with reduced risk for cardiovascular disease in black South African women; a 5.5-year follow-up study. http://www.ncbi.nlm.nih.gov/pubmed/24886324 Do soccer and Zumba exercise improve fitness and indicators of health among female hospital employees? A 12-week RCT. http://www.ncbi.nlm.nih.gov/pubmed/24151956 Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial. http://www.ncbi.nlm.nih.gov/pubmed/20679559
- 8. PICO Model: Background Questions • General knowledge • Who/what/when/where/how/why • Disorder/test/treatment/other aspect of health care • Example: What is continuous passive motion therapy (CPM therapy)? Do you PICO? Probably not- consult a textbook, review article, book You might have to ask some background questions before you can formulate a PICO question.
- 9. PICO Model: Background Questions • General knowledge • Who/what/when/where/how/why Where to look: Textbooks Access Physiotherapy (Access Medicine, etc.) Rehabilitation Reference Center UpToDate
- 10. PICO Model: Foreground Questions • Specific knowledge affecting clinical decisions • “Seek evidence to answer a need for clinical information related to a specific patient, intervention, or therapy” (Hunter College guide) • Example: What is the effectiveness of continuous passive motion therapy (CPM therapy) following knee replacement in achieving optimal range of motion? Do you PICO? Yes! Primary medical literature
- 11. PICO Model: Foreground Questions • Specific knowledge affecting clinical decisions • “Seek evidence to answer a need for clinical information related to a specific patient, intervention, or therapy” (Hunter College guide) Where to look: PubMed Cochrane CINAHL Additional Databases
- 12. Levels of Evidence (& Meta Analyses)
- 13. PICO Model: Type of question/problem • By focusing on one of the following aspects you can really narrow your search to relevant sources. It also affects the type of study you might seek out (more on this in a few slides). •Diagnosis •Etiology •Therapy •Prognosis •Prevention
- 14. Preferred Study Types for PICO Questions Type of Question Type of Study/Methodology Therapy: information needed about treatments (effectiveness, cost, etc.) Double-Blind Randomized Controlled Trial Diagnosis: information needed about a diagnostic test (sensitivity, accuracy, etc.) Controlled Trial Prognosis: information needed about the course of the disease over time, expected complications, etc. Cohort Studies Case Control Case Series Etiology/Harm: information needed about causes of disease or contributing factors of disease Cohort Studies Prevention: information needed about the prevention of disease (immunization, social factors, etc.) Randomized Controlled Trial Cohort Studies Quality Improvement: information needed about clients’ and health professionals’ experiences and concerns Randomized Controlled Trial
- 15. Sample search: PICO Is resistance training more effective than wearing knee braces to reduce pain caused by patellar tendinosis in female volleyball players? P- Female volleyball players w/patellar tendinosis I- Resistance training C- Knee braces O- Reduction of pain
- 16. Sample search: PICO Worksheet Is resistance training more effective than wearing knee braces to reduce pain caused by patellar tendinosis in female volleyball players? Circle the key concepts of your question. (#2 on PICO worksheet)
- 17. Plan your search Preliminary searching Clinical tools (Rehabilitation Reference Center, UpToDate, etc.) General reference resources (Wikipedia, Textbooks) Identify synonyms & related terms Beware of jargon Look for controlled vocabulary (database terms) Fill in the chart on your PICO handout (#3)
- 18. Sample search: Key concepts & terms Key Concep ts Resistan ce training Knee braces Patellar tendinosi s Volleyba ll (Pain reductio n) (Female) Synony ms/Rela ted terms Strength training Externa l orthose s Patellar tendinopat hy Indoor volleyball (decreas e in pain) (women) Eccentric exercises Knee strap Jumper’s knee Beach volleyball Concentri c exercises Patellar strap
- 19. Find the Evidence Library databases PubMed EMBASE Cochrane Library PEDro CIRRIE Rehabilitation & Sports Medicine Source Boolean Operators AND, OR, NOT
- 20. Boolean Refresher depression exercise OR Depression OR ExerciseDepression AND Exercise AND depression exercise Depression NOT Exercise NOT depression exercise • Searching with AND combines terms. It gives you results that satisfy both search terms (only where the two overlap). Some databases use + for AND. • Searching with OR “means more”! It gives you everything available for each term, including when they overlap. Some databases use | for OR. • Searching with NOT excludes an entire term, including any overlap between terms. Some databases use – for NOT.
- 21. Sample search: Database exploration Search for “Patellar tendinosis” AND volleyball AND “resistance training” Complete Database worksheet and prepare to report back to the group.
- 22. Evaluate the literature Critical Appraisal Tools PEDro GRADE CEBM CASP PRISMA Who, What, When, Where, Why, How Currency, Relevance, Authority, Accuracy, Purpose http://guides.nyu.edu/appraisal
- 23. Stay organized Save your searches! Use a spreadsheet to track database, search terms, number of results, etc. Set up search alerts Use a citation manager RefWorks, Zotero, EndNote Save article citations & build bibliographies
- 24. Questions?
Editor's Notes
- #4: PICO can be used to formulate a research question to help you find relevant search results. It is most often used in clinical settings but can be applied elsewhere. It’s just an acronym; you’re probably already formulating research questions with these criteria!
- #13: The quality of evidence rises as you work your way up the pyramid. Depending on your topic, the highest level of evidence may vary.
- #18: Look in Rehabilitation Reference Center for “patellar tendinosis”. Also look wherever else you’d like with a partner and come up with related terms.