I think this would be true for primary care
probably not in a specialist field where you have more context and
background knowledge because you are dealing with a much narrower set
of facts/situations
Lesley
On 25 Oct 2006, at 13:16, Underhill Jonathan wrote:
> Interesting stuff
>
> I actually think a slide based on this link:
>
> http://www.healthsystem.virginia.edu/internet/library/collections/ebm/
> pyramid.cfm
>
> may be more useful for practising clinicians (or students who want to
> be able to apply this to their working lives). Here we start at the
> top of the information pyramid with sources such as Cochrane and NICE
> (where we 'trust' their methodology) and if we find the answer to our
> clincial question we can stop there. Even if a new paper has been
> published, how do we know it changes our practice without having the
> time and effort to locate it (takes too long), appraise it (cant do
> it) and then put it into the context of the rest of the evidence.
>
> If the first step doesnt answer it, then 'drill' down to the next
> level, and so on. The last port of call for busy clinicians looking
> for information on common condiitions should be Medline (as you
> usually end up with too much information and not enough time to assess
> its relevance and validity)
>
> Thoughts?
>
>
> Cheers (8(|)
>
> Jonathan
>
> ---------------------------------------------------------------------
> Jonathan Underhill MRPharmS
> Assistant Director, Education and Development
> National Prescribing Centre
> The Infirmary
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> Liverpool
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>
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> email: [log in to unmask]
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>
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> -----Original Message-----
> From: Evidence based health (EBH)
> [mailto:[log in to unmask]] On Behalf Of Jo Hunter
> Sent: 25 October 2006 12:19
> To: [log in to unmask]
> Subject: Re: searching in EBM
>
> I absolutely agree - without recognising what constitutes a "good" or
> even appropriate primary study for your search question it would be
> difficult to appraise a secondary source, which itself summarises and
> evaluates primary studies. It would be slightly foolhardy to assume
> that their methods are always completely unbiased. Also it may be
> necessary to search for primary studies that have been written after
> any secondary source(s) that you find, in case anything new has been
> discovered since.
>
> Bibliographic databases (Medline, Embase etc..) support the use of a
> search strategy more effectively than a search engine, and focus on
> studies - both primary and secondary - that have been published in
> academic journals. Forgive these obvious points, but I'd certainly go
> to the bibliographic databases and tripdatabase.com before a search
> engine if time is an issue.
>
> It's difficult to be prescriptive about resources, as that depends on
> the nature of your search question. Perhaps searching in EBM is too
> complex for a single slide?!
>
> Best wishes,
> Jo
>
> *******************************
> Jo Hunter
> Clinical Outreach Librarian
> (Emergency and Acute Care, Gastroenterology, Geratology, Paediatrics)
> Oxford University Health Care Libraries John Radcliffe Hospital
> [log in to unmask] [log in to unmask]
> 01865 740363
>
>
>
>>>> Rob Mullen <[log in to unmask]> 25/10/2006 04:50 >>>
> I certainly agree with the points raised by Dr. Basu. My first
> reaction is that the slide is rather too complex for a PowerPoint
> presentation. If your intention, though, is to use it as a handout to
> which your students can refer, I think that might be more appropriate.
>
> You've certainly "opened a can of worms", to use some English slang,
> in referring to "the most useful medical information". Many people,
> and I definitely include myself, will want to engage in a prolonged
> discussion of what that most useful information is, before we can even
> get to the point of strategies to locate it. In my field, we typically
> don't find our traditional paper textbooks terribly useful because of
> the lengthy periods between updates and because they tend to reflect
> the perspective of a single or small group of individuals rather than
> a rigorous and objective assessment of all of the scientific evidence.
>
> My group tends to start out, in teaching EBM, with a focus on primary
> studies, particularly how one can find and assess them. We certainly
> acknowledge and encourage utilization of secondary sources when
> available, but we think that's best done only after a thorough
> grounding (or, more pragmatically, at least some exposure to) working
> with individual primary studies. Certainly, the reality of clinical
> life often makes reliance on these secondary sources - and thank
> goodness for them - a necessity, but I would be reluctant to use them
> as a jumping-off point.
>
> Best Wishes,
>
> Rob
>
>
> Rob Mullen
> Director
> National Center for Evidence-Based Practice in Communication Disorders
> American Speech-Language-Hearing Association Rockville, Maryland,
> United States
>
> ________________________________
>
> From: Evidence based health (EBH) on behalf of Dr. Carlos Cuello
> Sent: Tue 10/24/2006 6:37 PM
> To: [log in to unmask]
> Subject: searching in EBM
>
>
>
> I would like some feedback about this slide. Is for my class on how to
> find
> the most useful medical information in my EBM courses.
>
> Comments are welcome.
>
> Carlos Cuello, MD
> Evidence-Based Medicine Group
> Tecnologico de Monterrey
> Escuela de Medicina, Campus de la Salud
> Morones Prieto 3000 pte. Col. Doctores 64710
> Monterrey NL, México
>
>
Lesley Kay
Consultant Rheumatologist and Honorary Senior Lecturer
Freeman Hospital
Newcastle upon Tyne
NE7 7DN
0191 233 6161 x 37867 (Carole)
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