W9 Literature Searching/Critiquing and Bias

Literature search supports EBVN

• Allow VNs to move beyond assumptions

• Ensure clinical decisions made on best evidence

• Support professional accountability

• Underpinning academic work

• Identifying gaps in knowledge/evidence

PICO

Population - Who being affected? Symptoms, age, gender

Intervention - What is being done? Screening, surgery, service

Comparison - Control group or comparison e.g. different treatment option

Outcome - What to achieve via study? What hope to change/measure

Efficient literature searching

Database selection (VetMed, Science direct enhance evidence retrieval from varied disciplines)

Iterative search strategy (repeated test/refining keywords, filters to optimize relevance of results)

Search documentation importance (Documenting databases, search strings, limits, results enhances transparency, replicability and academic integrity)

Literature Critiquing

Structured, consistent way to decide if and how to use piece of research

Hierarchy of evidence

Reliability and Validity

Small sample size - reduced reliability

Poor measurement tools - reduced validity

Frameworks for Critiquing Research EBVN

• Improves consistency

• Enhances validity of decisions

• Identifies methodical flaws and identification of bias

• Promotes critical thinking

• Improves transparency and justification

• Links evidence to practice

• Improves confidence in decision making

• Enable comparison between studies

CASP

Critical Appraisal Skills Programme

Critical appraisal tool that provides structured framework for assessing quality and validity of research studies

Caldwell & Henshaw (Caldwell et al. framework)

Flexible narrative critique framework, encourages deeper analysis and discussion

CASP strengths/limitations

Strengths

• Structured approach

  Improves critical thinking

  User friendly

  Versatile

  Promote consistency

  Widely recognised

Limitations

• Subjective interpretation

• Superficial use

• No clear score

• Focus on methodology

• Prior knowledge/training

• Time consuming

CASP vs Caldwell et al.

Types of Bias

Selection, sampling, recall, measurement, observer, confirmation, publication, reporting, attrition, confounding, performance, detection, design, funding

Ways bias can affect findings:

• Over/underestimate effect

• Produces misleading results

• Limits generalisability

• Reduces reliability (consistency)

• Reduces validity (accuracy)

Bias table

Bias table 2

PRISMA

Preferred Reporting items for Systematic Reviews and Meta-Analyses

To improve transparency, clarity and completeness of systematic reviews and meta-analyses