|Literature Searches Form Core Steps in the EBM Process|
|University of Wisconsin Ebling Library, Intro to EBM|
A good question:
[cited from Forming Questions in Nursing LibGuide, McMaster University by Laura Banfield]
Is your clinical question a background or a foreground question?
Clinical foreground questions are at the heart of Evidence-Based Medicine. A useful framework to develop your foreground question is to plug in four question components, known by the acronym, PICO. PICO stands for: P=Patient/Population/Problem; I = Intervention or exposure; C=Comparison; O=Outcome.
Next, determine what type of PICO question you wish to ask by identifying its underlying objective. The objective of most PICO questions falls into one of these categories or domains: therapy; diagnosis; prevention; prognosis; harm/etiology. The domain type will provide a structure to format your question and focus your search.
1. To conduct an effective search, use your PICO question to:
Finding the Evidence 1 video tutorial (CEBM)
Turning search terms into a search strategy video tutorial (CEBM)
2. Focus on which research methods and study designs to include. Different research methodologies are better suited to answer different kinds of questions.
For more information about study design, see this CEBM webpage.
University of Wisconsin, Ebling Library, EBM Guide
This evidence pyramid graphically depicts the study design types in the medical literature relative to the strength of their evidence. The higher the layer on the pyramid, the greater the strength of the evidence in the study type.
Using your clinical question and search strategy worked out in the prior steps, "Start at the Top of the Evidence Pyramid and Work Down (Database Search Tips, VCU)." The study types in the higher levels yield a smaller volume of research relative to those in the lower layers. If your search results at the higher levels are too few, search again targeting a study type from a suitable lower layer.
For more guidance, see this handout.
Start your database search broad, then focus:
if there are too many results, use limits/filters of the database (Publication/Study Types, Gender/Sex, Language, Etc)
If there are too few results, add an additional concept or term
(cited from Database Search Tips, VCU Nursing Research Guide by Roy Brown)
Relevant Databases to Search
For Meta analyses and systematic reviews, search in:
For Randomized Control Trials, Cohort Studies, Case Control Studies, search in:
From Duke University Medical Center Library and University of North Carolina at Chapel Hill Health Sciences Library.
From the University of Illinois at Chicago
From Ohio State University Libraries
From Virginia Commonwealth University
The Centre promotes evidence-based health care and provide support and resources to anyone who wants to make use of them. Includes the EBM Toolbox, an assortment of materials which are very useful for practitioners of EBM, and EBM Teaching Materials, including PowerPoint presentations.Evidence-Based Medicine
A reference guide on Evidence-based practice including a selective list of additional EBM websites developed and maintained by Duke University Medical Center Library.
A network for students interested in evidence-based health care.
A UK based site