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Evidence-based practice is the integration of a clinician's expertise supported by evidence-based research and informed by a patient's values and preferences.
"What is Evidence-Based Practice?"
by Duke University Medical Center is licensed under CC BY-NC-SA 4.0
Evidence-based resources are comprised of research studies and randomized controlled trials, critically appraised topics and articles, and systematic reviews that are used directly in the creation of clinical practice guidelines.
The evidence pyramid, pictured below, depicts the theoretical level of the quality of evidence for each type of resource.
![Image of the Evidence Pyramid. Depicts the theoretical hierarchy of quality in information types as they pertain to evidence based medicine. The highest in the hierarchy are Clinical Practice Guidelines. Second in the hierarchy are Systematic Reviews. Third in the hierarchy are Critically-Appraised Topics [Evidence Syntheses]. Fourth in the hierarchy are Critically-Appraised Individual Articles [Article Synopses]. Fifth in the hierarchy are Randomized Controlled Trials (RCTs). Sixth in the hierarchy are Cohort Studies. Seventh in the hierarchy are Case-Controlled Studies and Case Series / Reports. Eighth, and lowest in the hierarchy, are Background Information and Expert Opinions.](https://libapps.s3.amazonaws.com/accounts/40487/images/pyramid_final.jpg)
You will usually begin your research with a clinical scenario:
Mark McGee – a 70-year-old male – is concerned about his bad breath. You tell him that he wouldn’t have much to be concerned about if he only brushed his teeth. He doesn’t believe you and says, “show me the evidence!”
Then you should use PICO, synonyms, & boolean operators to create a well-defined search question and search strategy.
These slides are derived from content that originally appeared in University of Michigan Library's Dentistry Research Guide: guides.lib.umich.edu/dentistry, accessed 15 Oct. 2021. This content is protected by a Creative Commons Attribution 4.0 license.
The PICO model helps you create an answerable question from a clinical scenario by identifying search terms & their relationships so that you can conduct an effective literature search.
Based on the clinical scenario:
Not all of these terms will be used directly in the search, but it's good to be aware of all potential search terms.
Here's the question that you'll base your search on.
Does toothbrushing, in comparison with doing nothing [i.e., what the patient is currently doing], decrease bad breath in older male adults?
Synonyms, words that mean the same thing or are closely related to each other, can help expand your search appropriately.
For this search, the synonyms are:
| bad breath |
halitosis |
| toothbrushing |
oral hygiene |
You could also use terms such as mouth rinses or toothpaste.
Boolean operators such as AND & OR are used to connect synonyms & concepts.
Here are the terms (also known as a "search strategy") that will be used to search the database:
(bad breath OR halitosis) AND (toothbrushing OR oral hygiene)
Bad breath & halitosis are synonyms for one concept, so they're connected by OR & placed within parentheses.
Using the search options described above will focus your search results to information under the category of evidence-based medicine. This includes articles from evidence based practice journals, articles about evidence based practice, research articles (including systematic reviews, clinical trials, meta analysis, qualitative studies), commentaries on research studies, and case studies (if they meet the criteria of the use of research and/or evidence based practice terms).
More nuanced search results may be received by including the following phrases with your initial search concept:
"practice guideline"
"systematic review"
"meta-analysis"
"critically appraised topics"
"randomized controlled trial"
"cohort studies"
"case control studies"
Code from these LibGuides pages are a derivative of LibGuides code by UC Santa Cruz University Library, used under CC BY.
