Week 2 Module 1- Searching for Evidence, Evaluating Evidence, Types of Evidence

While formulating your PICO question, what two things will you be doing?

Find a measurement tool for your outcome

Find evidence to answer our question

What are sources of evidence?

Books

Non-peer reviewed journals and professional magazines

Peer-reviewed journals

Electronic bibliographic databases

INTERNET

What are things to consider when evaluating a book to use when formatting your PICO question?

May or may not be peer-reviewed

Credentials of the author(s)

Reputation of the publisher

Reputation of the author of the preface

Reviews of the book from reputable sources

Target audience

Quality, currency, extent of citations

The vast majority of literature that supports the evidence behind your question should be…

Peer-reviewed

When looking at a peer reviewed piece of literature, what should you evaluate?

Type

Journal quality

Significance of findings

Novelty of approach

Relevance for real-world application

What are some different types of peer-reviewed articles?

Short reports or technical notes

Editorials

Systematic reviews and meta-analyses

Book and tech reviews, response to authors

Research articles

What are some search strategies you can use when looking for literature?

Spend a lot of screen time

Narrow and rework search terms

Identify key authors, search publication history

Identify key journals, search their website

Find a key article or systematics review and use their references to guide future literature searches

What can be used to identify the quality of the literature you have found?

Critical appraisal forms

What are critical appraisal forms?

Systematic procedures for assessing evidence and its relevance for a purpose; helps organize thinking in terms of appraisal topics

What is a critically appraised topic (CAT)?

A short, strictly formatted summary of an article or articles and a statement of relevance of the results for a particular field; useful for clinical decision-making

What are questions you should try to answer when doing a critical appraisal?

Was the sample used in the study appropriate to its research question?

Was the data collected appropriately?

Was the data analyzed appropriately?

Can I transfer the results of this study to my own setting?

Does the study adequately address potential ethical issues?

Was what the researchers did clear?

What is looked at in a quantitative appraisal?

Levels of evidence

Phases of research

Critical appraisal tools used

What are the different levels of evidence?

Level 1- meta-analysis of a homogenous RCTs, Randomized Control Trial

Level 2- Meta-analysis of Level 2 or heterogenous Level 1 Evidence Prospective comparative study

Level 3- Review of Level 3 evidence, Case-control study, Retrospective cohort study

Level 4- uncontrolled cohort studies, case series

Level 5- expert opinion, case report, personal observation

Foundational Evidence- animal research, In Vitro research, ideas, speculation

What are the phases of a clinical trial? (Of a drug trial)

Phase I: evaluate safety, determine safe dosage, identify side effects

Phase II: test effectiveness, further evaluate safety

Phase III: confirm effectiveness, monitor side effects, compare to other treatments, collect information

Phase IV: provide additional information after approval including risk, benefits, and best use

How many trial drugs move on from phase I to phase II?

70%

How many trial drugs move on from phase II to phase III?

33%

How many trial drugs move on from phase III to phase IV?

25-30%