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KIN 480: Therapeutic Exercise (Samuel)

This guide supports library instruction for KIN 480 course.

Xan Goodman, Nursing, Integrated Health Sciences & Public Health Librarian

Xan Goodman, Nursing, Integrated Sci & Public Health Librarian's picture
Xan Goodman, Nursing, Integrated Sci & Public Health Librarian
Contact:
Lied Library
Office 1184
702-895-2233

AMA Assistance

A Selection of Databases for Evidence-Based Searching

Here are some good places to start your research.

Summary of the Five Steps of Evidence-Based Questioning

  1. Ask: Convert the need for information into an answerable question.
  2. Find: Track down the best evidence with which to answer that question.
  3. Appraise: Critically appraise that evidence for its validity and applicability.
  4. Apply: Integrate the critical appraisal with clinical expertise and with the patient's unique biology, values, and circumstances.
  5. Evaluate: Evaluate the effectiveness and efficiency in executing steps 1-4 and seek ways to improve them both for next time.

 

Attribution: UNC Health Sciences Library

Formulating the Question

Think about the keywords for each of the PICO parts of the clinical question.

Sample Question: Is prophylactic physical therapy for patients undergoing upper abdominal surgery effective in preventing post-operative pulmonary complications?

The PICO parts with keywords for this question would look like this:

Parts of the Question Clinical Scenario Keywords
Patient Population patients undergoing upper abdominal surgery upper abdominal surgery
Intervention prophylactic physical therapy prophylactic physical therapy
Comparison (if any) no prophylactic physical therapy none
Outcome prevent post-operative pulmonary complications prevent pulmonary complications
Type of Study RCT Randomized Controlled Trial

#3 Appraise: Evidence Hierarchy and Evaluation Criteria

Hierarchy of evidence for clinical questions (Booth & Brice, 2004)

Always start an EBPT search looking for the highest level of evidence. If a meta-analysis is not available on the topic, look next for systematic reviews without statistical synthesis, next for randomized control trials, next for controlled comparison or case control studies, etc.

  • Meta-analyses: Methods of synthesizing the data from more than one study, in order to produce a summary statistic
  • Systematic Review: [tries] to answer a clear question by finding and describing all published, and if possible, unpublished work, on a topic. [It] uses explicit methods to perform a thorough literature search and critical appraisal of individual studies and uses appropriate statistical techniques to combine these valid studies (Booth & Brice, 2004).
  • Randomized Controlled Trial (RCT): are also called 'randomized clinical trial.' They involve the random assignment of subjects to groups   that are then given different interventions to assess the effects of the interventions.
  • Controlled Comparison or Case Control Study: is an observational study in which the cases have the issue of interest
  • Descriptive Surveys: studies aimed at describing certain attributes of a population, specifying associations between variables, or searching out hypotheses to be tested, but which are not primarily intended for establishing cause-and-effect relationships or actually testing hypotheses.
  • Case Studies: describe a particular service or event, often focusing on unusual aspects of the reported situation or adverse occurrences, commonly have exploratory, descriptive, or explanatory purposes.

Evaluation Criteria:

  • Credibility (Internal Validity)
  • Transferability (External Validity)
  • Dependability (Reliability)
  • Confirmability (Objectivity)

 

Credibility: looks at truth and quality and asks, "Can you believe the results?"

Some questions you might ask are: Were patients randomized? Were patients analyzed in the groups to which they were (originally) randomized? Were patients in the treatment and control groups similar with respect to known prognostic factors?

 

Transferability: looks at external validity of the data and asks, "Can the results be transferred to other situations?"

Some questions you might ask are: Were patients in the treatment and control groups similar with respect to known prognostic factors? Was there a blind comparison with an independent gold standard? Were objective and unbiased outcome criteria used? Are the results of this study valid?

 

Dependability: looks at consistency of results and asks, "Would the results be similar if the study was repeated with the same subjects in a similar context?"

Some questions you might ask are: Aside from the experimental intervention, were the groups treated equally? Was follow-up complete? Was the sample of patients representative? Were the patients sufficiently homogeneous with respect to prognostic factors?

 

Confirmability: looks at neutrality and asks, "Was there an attempt to enhance objectivity by reducing research bias?"

Some questions you might ask are: Were 5 important groups (patients, care givers, collectors of outcome data, adjudicators of outcome, data analysis) aware of group allocations? Was randomization concealed?

#4 Apply: Using Evidence in Clinical Practice

Guidelines for applying evidence in clinical practice can be found in the classic text:

Guyatt, G., Rennie, D., Meade, M., and Cook, D. (2008) Users' guides to the medical literature: a manual for evidence-based clinical practice (2nd ed.). New York, NY: McGraw-Hill Professional.

Chapters in this guide are organized by type of clinical question: therapy, harm, diagnosis, and prognosis.

Other good resources for both appraisal and applying evidence in clinical practice can be found on these two websites:

#5 Evaluate Your Performance as a EBPT Practitioner

Ask yourself:

  1. Did you ask an answerable clinical question?
  2. Did you find the best external evidence?
  3. Did you critically appraise the evidence and evaluate it for its validity and potential usefulness?
  4. Did you integrate critical appraisal of the best available external evidence from systematic research with individual clinical expertise in personal daily clinical practice?
  5. What were the outcomes of your application of the best evidence for your patient(s)?

KIN 480 Library Workshop Questions

1) ​I don’t know how to import my search from Google Scholar to RefWorks? Here is a video you can watch that will show you how to add references from Google Scholar to RefWorks.

2) Do I delete files after I import them into RefWorks? How do I submit an interlibrary loan? No, once your file is imported into RefWorks it is there for you to edit as you need. If you delete the file you will no longer have access to the reference.

3)How do I retrieve articles for which I requested a PDF?  If you request an article using interlibrary loan, a link to the pdf of the article will be sent directly to your email account. If you are retrieving PDF files from the UNLV libraries, make sure to check your downloads folder, because most likely this is where PDF files that you download will be found.

Here are instructions on how to set up an Interlibrary Loan (ILLiad) account

ILLiad Interlibrary Loan

Setting up an ILLiad Account to borrow articles or books the library does not have.

  1. Go to ILLiad account page
  2. Click the First Time Users button, 
  3. Complete the following required fields:
    1. First Name
    2. Last Name
      1. RebelCard Barcode – this is the long number on the back of your RebelCard it begins with, 21147*********
  4. E-Mail Address  - enter an e-mail address with a unlv extension this is required to use the service
  5. Status – from the drop down menu select your status
  6. Department – from the drop down menu select your department:
  7. Delivery Location –select ILL
  8. Choose a username
  9. Choose a password
  10. Choose a password hint
  11. Hit the Submit Information button

You will be notified by e-mail once your ILLiad account is created.You must have your RebelCard activated to create an ILLiad account.

4)How do I print the full text PDF file from RefWorks? To print the PDF file from RefWorks there is a print icon in RefWorks if you select that icon and your PDF file is loaded in RefWorks you can print your article.

5)How do I add the bibliography from other sites? I’m not sure what you mean. There might be other sites similar to RefWorks and the process to add or create a bibliography will differ with each site.

6)How do I use interlibrary loan? You use interlibrary loan whenever you find an article online and are asked to pay for it. Or you use interlibrary to request a copy of an article or book that the library does not have. See instructions above on how to set-up an interlibrary loan (ILLiad) account.

7)Why didn’t I know about this sooner? I don't know .I’ve been at UNLV for almost 5 years, tell your colleagues about me.

8)How do I use Google Scholar? There are a lot of good tutorials about Google Scholar, try doing a Google search, or arrange an appointment with me to learn more.

9)What is the best databases for my particular needs? I recommend taking a look at the Finding Articles and Databases on the Kinesiology subject guide. There is also a list of  other recommended databases for this subject area. If you need help please contact me.

10)How do I access articles when off campus? To access articles off campus you will use your ACE account to logon to the University Library website to view articles.

11)How do I transfer PDF files into RefWorks? This guide has instructions and videos to help you with learning how to transfer files into RefWorks.

12)​How do I use PubMed? PubMed has a good set of tutorials to help you understand the basics. Try the tutorials. If you find that you need more help make an appointment with me.

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