Introduction to Health Informatics and EBP Process

Health Informatics

The understanding, skills, and tools that enable the sharing and use of information to deliver healthcare and promote health.

CanMEDS Framework

A framework that defines roles for medical professionals including scholars.

EBP process

Define the problem → Find evidence → Appraise the evidence → Apply results → Evaluate change → Redefine problem.

PICO

An acronym that helps structure clinical research questions.

PICO definition

Patient/Problem/Population, Intervention, Comparison/Control, Outcome.

P in PICO

The patient group or problem being addressed.

I in PICO

The main intervention being considered.

C in PICO

The comparison or alternative to the intervention.

O in PICO

The outcome to be measured or affected.

PICO example 1 clinical scenario

Are patient education programs effective in increasing exercise in people aged 65+ with high blood pressure?

Scenario 1 keywords

Patient education, exercise, high blood pressure.

Clinical Queries

A useful tool for refining searches for clinical evidence.

Clinical Queries filters

Filter by therapy, narrow scope, age limits, publication years.

MESH

Medical Subject Headings.

MESH terms for Scenario 1

Patient Education = Patient Education, Exercise = Exercise, High Blood Pressure = Hypertension.

MESH terms usefulness

They standardize terminology across studies and improve search precision.

PICO example 2 clinical scenario

Should prophylactic antibiotics be given for mammalian/dog bites?

Scenario 2 PICO synonyms

P = dog bite, canine bite, mammal bite; I = antibiotics, prophylactics; C = no antibiotics; O = wound infection.

Search strategies for quality results

Use of synonyms, spelling variants, MESH terms, and applying filters (e.g., age or recent publications).

Simple vs advanced search results

Simple search = 260 results, Detailed search = 533 results, Question format = 657 results.

MESH terms for dog bite study

Dog = Dogs / Canis familiaris; Antibiotic = Anti-Bacterial Agents, Antibiotic Prophylaxis; Wound Infection = Wound Infection.

Critical appraisal purpose

To assess whether the research is valid and relevant to the clinical question.

Dog bite antibiotic research conclusions

1) Routine antibiotics are indicated, especially in high-risk patients; 2) Routine antibiotics are not indicated, except in specific high-risk subgroups.

Patient groups benefiting from antibiotics for dog bites

Patients over 50, with puncture wounds, bites to hands, face, or with immunocompromised status.

Goal of applying evidence from appraisal

To inform clinical decision-making and improve patient outcomes.

EBP

Evidence-Based Practice.

EBP process outcome

Best patient outcomes guided by best research evidence, patient preferences, and clinical expertise.