Here are some good places to start your research.
Attribution: UNC Health Sciences Library
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|
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.
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?
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:
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.
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.