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Health Sciences Research: Evidence-Based Practice

Overall guide to library resources for College of Health & Human Services

What is Evidence-Based Practice?

Evidence-based practice (EBP) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. [...] integrating individual clinical expertise with the best available external clinical evidence from systematic research." - from the National Library of Medicine

EBP is based on:

  1. Patient Values
  2. Clinician Expertise
  3. Best Available Evidence

EBP Resources

Use the following resources to learn more about evidence-based practice and systematic reviews.

If you have questions about additional EBP and systematic review resources, or about applying these methods within your major, contact your Health Sciences Librarian.

EBP Evidence

Sources of scientific evidence in EBP are often shown as a pyramid:

Pyramid illustration of types of evidence. The base of the pyramid is background information and expert opinion. The next three levels are defined as unfiltered information. They include, moving up the pyramid, case-controlled studies, case series, and reports. The next three levels, moving up to the peak of the pyramid, are defined as filtered information. Moving up, the layers are critically-appraised individual articles and article synopses, critically-appraised topics or evidence syntheses and guidelines, and finally, at the peak, systematic reviews.

Background information comes from books, expert opinion, reputable introductory websites, etc.

Unfiltered information comes from single research studies (typically peer-reviewed journal articles found in databases such as CINAHL and PubMed). Textbooks, encyclopedias, or informational websites such as MedlinePlus are other examples.

Filtered information includes pre-appraised summaries of the latest scientific evidence. Examples are ADA Oral Health Topics, systematic reviews from Cochrane Library, and Dynamed. Some filtered information sources may also used as background information if they are short and concise.

(Click image for original source material from the University of Minnesota.)

Other Frameworks

Alternative question frameworks may be used for topics that don't fit PICO / PICOTT. See the following list from UNC Chapel Hill for more. 

Forming Focused Questions with PICO: Other Question Frameworks

NOTE: Always consult with your instructor before implementing alternative frameworks.

Steps in EBP

 

EBP involves 5 steps, which may vary in order and definition by discipline:

  1. Ask a focused question.
  2. *Acquire [search for] evidence.
  3. Appraise [critically evaluate] evidence.
  4. Apply evidence to your question.
  5. Assess your process and proposed answer.

Library Research comes into play for Steps 1-3.

*Note: Searching for evidence is an iterative process, meaning you'll need to repeat the steps multiple times, and your questions or theories may change as you progress in your research.

(Original Image Source: UC Davis Library)

The PICO Framework - Developing a Focused Question

The terms PICO or PICOTT are often used to describe a designated framework for research that involves coming up with a focused question or statement and conducting searches based on its core components.

  • P - Patient / Population / Problem - key characteristics of patients like yours
  • I - Intervention - exposure, treatment, prognostic factor; what you want to do
  • C - Comparison - alternative (if any)
  • O - Outcome - what you want to happen (often excluded from searches)
  • [*T - Type of Question - therapy, diagnoses, harm, prevention, etc.]
  • [*T - Type of Study - systematic review, randomized controlled trial, etc.]

Example: Write a sentence describing what you are looking for in your research. If you had an ideal article on your topic, what might the title be? Then pick 2-3 words or brief phrases to search as keywords. 

*Types of Question and Study Design:

  • Clinical Examination: Prospective (blind comparison to Gold Standard)
  • Diagnostic Testing: Prospective (blind comparison to Gold Standard)
  • Prognosis: Cohort Study > Case Control > Case Series
  • Therapy: randomized controlled trial (RCT)
  • Etiology/Harm: RCT > Cohort Study > Case Control > Case Series
  • Prevention: RCT > Cohort Study > Case Control > Case Series
  • Cost: Economic Analysis

You can specify type of question or study using Boolean operators or other OneSearch filters.

Note: RCTs may be unavailable for your topic. They are expensive to conduct and might be unethical if they entail undue harm to humans or animals. You may have to use "best available" evidence.

Searching for Evidence

Use the following resources to find evidence for your research. This list includes both filtered and unfiltered sources, as well as resources not available through WKU Libraries. Remember to log in with your WKU NetID / Password and use Interlibrary Loan if needed. 

Some sources may allow you to filter by source or question type, while others may require you to specify in your keyword search (ex. dry needling AND systematic review).