PhD-Nursing students Furthering your research and information skillsOctober 9, 2012

Ana Patricia Ayala

anap.ayala@utoronto.ca

Instruction and Faculty Liaison Librarian

Gerstein Science Information Centre

Goals of the session

1. Further/ develop your research skills

2. Achieve efficient and comprehensive searches

3. Determine the type of studies best suited for your topic

4. Critically appraise information

5. Discover tools to manage your citations

6. Practice!

Finding the evidence

1. Choose the right database(s) and search them individually!

2. Search concepts separately3. Find and use subject headings

– ALWAYS check Scope note, full tree

4. Also use keyword or textword (if necessary)5. Combine using OR / AND as appropriate6. Apply filters/limits7. Revise – Research is an iterative process8. Export to RefWorks or your citation management

of choice

Identifying your information needs

• Big Picture vs. research questions

• Big-picture questions:– Who, what, when…

– (e)Books, EBM resources

• Research questions:– Narrow, more complex questions

– Use PICOT/ PIE tools to help you focus your research

– Journal articles, literature reviews, guidelines

– Article databases

PICO Structure

P Patient/Population/Problem - what sorts of participants, from where, with what features?

I Intervention/Issue - what sort, dose, administered by whom, with what level of expertise, where, and with what sorts of monitoring?

C Comparison - what sort, dose, administered by whom, with what level of expertise, where and with what sorts of monitoring?

O Outcome - both good & bad, of what sort, determined when, defined how, ascertained & adjudicated by whom?

T Type of Study – systematic reviews, RCT, CT, retrospective study, cohort study, case control, etc.

“T” is optional and depends on your individual research needs!

PIE structure – Qualitative research

P Patient/Population/Problem - what sorts of participants,

from where, with what features?

I Intervention/Issue - what sort, dose, administered by whom,

with what level of expertise, where, and with what sorts of monitoring?

E Evaluation – what types of studies where used to evaluate this? Did

the implementation work? systematic reviews, retrospective study, cohort study, case control, mixed methods, use qualitative filters

Type of Question and the Ideal Type of Study

• Therapy : RCT

• Prevention : RCT > Cohort Study > Case Control

• Diagnosis : Prospective, blind controlled trial comparison to gold standard

• Prognosis : Cohort Study > Case Control > Case Series/Case Report

• Etiology/Harm : RCT > Cohort Study > Case Control

• Cost analysis : Economic analysis

Note: Meta-analyses and systematic reviews, when available, often provide the best answers to clinical questions.

Systematic Reviews

• Synthesis of all high quality research on a topic, carried out using very rigorous and repeatable methods

• Cochrane Library is most well known source.

• Other sources include: PubMed Clinical Queries, TRIP database, DARE, Joanna Briggs Institute, MEDLINE, among others– Access via Gerstein

• See examples of methods sections in the Cochrane Library

Weak search

Satisfactory search

Comprehensive search

Comprehensive search - continued

• Search multiple databases

• De-duplicate in RefWorks / Endnote

• Systematic Reviews:

– Each synonym on separate line (100+ line searches)

• Expand / Focus

• Revise

• Redo!

Harvest subject headings

Databases of interest

• Medline (OVID) / PubMed• CINAHL• EMBASE• PsycInfo• HAPI• Cochrane Library• ProQuest Dissertations

and the list goes on…

Critical appraisal of the evidence

When appraising a resource, it needs to meet the following three requirements:

1. Quality (the methodology should include trials that are randomized and double blind to avoid selection and observer bias)

2. Validity (trials need to mimic clinical practice, or used in clinical practice, with outcomes that make sense)

3. Reliability (trials that are credible and repeatable)

Critical appraisal - continued

• Another aspect to consider when appraising evidence is: "How does this inform my practice?"

• Different types of articles are critically appraised using different criteria. For example, critical appraisal of a therapy article would be different to critically appraising a prognosis article.

• There are a number of checklists / tools available to assist you in undertaking critical appraisal of evidence.

Managing your citations and references

• Save your searches / set-up alerts when possible

• Export to citation management software

• Organize citations by folders / subfolders

• De-duplicate as necessary

Questions?

THANK YOU