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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 > 70 Pembroke Place > Liverpool > L69 3GF > > Tel: 0151-794-8143 > Fax: 0151-794-8067 > Mobile: 07968 851325 > > email: [log in to unmask] > website: www.npc.co.uk > > ----------------------------------------------------------------------- > ----- > DISCLAIMER: This e-mail may contain confidential and/or proprietary > information some or all of which may be legally privileged. It is for > the intended recipient only. If any addressing or transmission error > has misdirected this e-mail, please notify the author by replying to > this e-mail and destroy any copies. If you are not the intended > recipient you must not use, disclose, distribute, copy, print, or rely > on this e-mail. > > -----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)