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INLS210-096 Evidence-based Information Practice

Discussion Board


 

Evidence-based practice discussion board
As you learn more about evidence-based practice, this board allows us to share news and articles we've found with one another.

I'll start - I have several current awareness email services to which I subscribe. This morning's update includes reference to the following cite. I thought it might be of interest, because it really highlights the fact that there is STILL controversy in medicine's application of EBM!

Carol

Frederieke G Schaafsma, Jos H Verbeek, Carel T Hulshof, and Frank J van Dijk
Caution required when relying on a colleague's advice; a comparison between professional advice and evidence from the literature.
BMC Health Serv Res, August 31, 2005; 5(1): 59.         
        
BACKGROUND: Occupational Physicians rely especially on advice from colleagues when answering their information demands. On the other hand, Evidence-based Medicine (EBM) promotes the use of up-to-date research literature instead of experts. To find out if there was a difference between expert-based practice and EBM we compared professional advice on occupational health topics with best evidence from the literature. METHODS: We asked 14 occupational physicians to consult their usual information sources on 12 pre-conceived occupational health problems. The problems were presented in the form of case vignettes which contained sufficient clinical information to be used by the occupational physicians for the consultation of their experts. We had searched the literature for the best available evidence on the 12 problems, which made it possible to answer the clinical questions with a clear yes or no. RESULTS: The cases could be used by the occupational physicians as arising from their own practice. All together the occupational physicians consulted 75 different experts. Almost half of the consulted experts were near colleagues, 10% were industrial hygienists, 8% medical specialists and the rest had a varied background. Fifty three percent (95% confidence interval 42% to 65%) of all professional advice was not in line with the research literature. In 18 cases (24%) professional advice explicitly referred to up-to-date research literature as their used source. These cases were substantially less incorrect (17%) than advice that had not mentioned the literature as a source (65%) (difference 48%, 95% Confidence Interval from 27% to 69%). CONCLUSIONS: Advice that occupational physicians routinely get in their daily practice differs substantially from best evidence from the literature. Occupational physicians who ask professional advice should always ask about the evidence of this advice.

PMID: 16131405

 

Evaluating the quality of research publications

Dr. Claudia Gollop told me about this new study today - it's available full-text. There are very few studies of this kind right now.

Evaluating the quality of research publications: A pilot study of school librarianship
Laurel A. Clyde
Faculty of Social Science, The University of Iceland, Iceland

Abstract
Evaluation of research quality is becoming more important in the field of library and information science, as in other fields. This pilot study is a preliminary attempt to address issues associated with determining the quality of the published research in one area of library and information science, specifically school librarianship. The main aims were (1) to test the extent to which experienced evaluators agreed in their rankings of published research articles on the basis of quality and (2) to investigate the approaches to evaluation used by the experienced evaluators. A qualitative, naturalistic research design was used. On the basis of a comprehensive literature review, four approaches to evaluation were identified; they were generally supported through an analysis of the responses of the experienced evaluators. However, although the majority of the evaluators agreed on the article ranked lowest, basic statistical analyses showed less agreement about the other articles. Although subject knowledge (of the field of school librarianship in this case) may have some influence on the evaluations, cluster analysis suggests that there may be differences in the value perceptions of the evaluators that also carry weight. More research would be needed to gain a better understanding of these value perceptions and their relationship, if any, to the four approaches to evaluation that were identified through the literature.

Journal of the American Society for Information Science and Technology
Volume 55, Issue 13 , Pages 1119 - 1130
Published Online: 13 Jul 2004

 

 Literature searches: look before you leap

Although this article is ostensibly about lit searching, it also issues a call for evidence-based practice by medical librarians. I've included an extract from the article so you can see what I mean. You'll find a link to full text in the bibliography, under Evidence-based Library & Information Practice.

Summerskill W. (2005 Jul). Literature searches: look before you leap. Lancet,366(9479):13-14,

Abstract:        
Focuses on the skill required to make literature searches for contemporary health care. Information from a study by Brian Haynes* and colleagues on refining different search approaches which have been incorporated in PubMed; How to avoid superficial results in searching; View that health-care librarians and infomaticists have search skills that clinicians should consider when searching for information to make decisions or plan research; An example of search strategy in Ovid format for MEDLINE.

Extract: Health-care librarians have been providing literature searches for a generation, yet clinicians seem reluctant to recognise their special skills. In the meantime, clinical teams have grown to include numerous professions allied to health, but rarely librarians or informaticists. Is this the result of arrogance, ignorance, or lack of effectiveness? Perhaps such attitudes reflect a lack of interest or opportunity on behalf of health-care librarians to participate in research, to show their value in searching and other aspects of evidence provision.

Evidence is a two-edged sword. As champions of evidence-based practice, librarians need to apply the same rigour in evaluating their contributions to health outcomes as they would apply to other interventions. After 30 years of studies involving the interventions of clinical librarians, their effectiveness is still uncertain. The time has come to study their value in well-designed trials.

* R. Brian Haynes is one of the pioneers in EBM. He has worked with Guyatt and Sackett, and is one of the authors of Evidence-based Medicine: How to practice and teach EBM, the 'bible' of that initiative. His bio page: http://www.fhs.mcmaster.ca/ceb/who/faculty/haynes.htm

 

Readiness of U.S. Nurses for Evidence-Based Practice: Many don't understand or value research and have had little or no training to help them find evidence on which to base their practice.

Pravikoff DS, Tanner AB, Pierce ST. (2005 Sep). Readiness of U.S. Nurses for Evidence-Based Practice: Many don't understand or value research and have had little or no training to help them find evidence on which to base their practice. AJN, 105(9):40-51.

OVERVIEW: Evidence-based practice is a systematic approach to problem solving for health care providers, including RNs, characterized by the use of the best evidence currently available for clinical decision making, in order to provide the most consistent and best possible care to patients. Are RNs in the United States prepared to engage in this process? This study examines nurses’ perceptions of their access to tools with which to obtain evidence and whether they have the skills to do so. Using a stratified random sample of 3,000 RNs across the United States, 1,097 nurses (37%) responded to the 93-item questionnaire. Seven hundred sixty respondents (77% of those who were employed at the time of the survey) worked in clinical settings and are the focus of this article. Although these nurses acknowledge that they frequently need information for practice, they feel much more confident asking colleagues or peers and searching the Internet and World Wide Web than they do using bibliographic databases such as PubMed or CINAHL to find specific information. They don’t understand or value research and have received little or no training in the use of tools that would help them find evidence on which to base their practice. Implications for nursing and nursing education are discussed.

Available online at http://www.nursingcenter.com/library/journalarticleprint.asp?Article_ID=599256


Editorial comment leading off the issue in which the above is published:

Are nurses finding the evidence?

In this issue, Diane S. Pravikoff, Annelle B. Tanner, and Susan T. Pierce report the findings of a survey of randomly selected nurses showing that nurses prefer asking their colleagues for answers to clinical questions and searching the Internet and World Wide Web rather than using databases such as PubMed or CINAHL (see page 40). The respondents said they didn’t understand or value research and had little or no training in synthesizing research findings.

Of course, it’s not only research that supplies valid evidence for practice. But health care institutions must create the systems and the time needed for nurses—and patients—to analyze existing research, consensus by expert clinicians, quality-improvement studies, and anecdotes and case studies.
Evidence-based publishing.

At AJN submissions undergo double-blind peer review and once accepted, articles also undergo rigorous editing because we have the resources to do so—as well as the desire to provide our readers with clear and accurate information. Our editors check references and facts, make sure that authors represent study findings accurately, and question authors about studies not included in the paper. Authors are sometimes surprised by this process; some find it onerous, and some see it as disrespectful of their expertise, even when we explain that we are attempting to make sure all articles are accurate, clear, and interesting.

The frequency with which we detect plagiarism (unintentional and intentional), incorrect references, inaccurate interpretations of study findings, and the failure to include major studies confirms that we must engage in this kind of editing if nurses and others are to trust what they read in these pages.

Available online at http://www.nursingcenter.com/library/journalarticleprint.asp?Article_ID=599256

 

2005 EBL conference in Brisbane, AU

We'll probably be seeing some of the papers cited repeatedly... take a look at the topics. There are some that appear to be primarily theoretical, but there are others in areas like customer services, teaching literacy skills, and 'just in time' library consultation service.

Main site:
http://conferences.alia.org.au/ebl2005/

Papers & posters:
http://conferences.alia.org.au/ebl2005/conferencepapers.html

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