major milestones in the history of ethical issues in research

P A R T 2 : E V I D E N C E - B A S E D P R A C T I C E

6310-WEEK 2

OUTLINE OF WEEK 2

• Ethical issues • Evidence-based practice (EBP)

EVIDENCE-BASED PRACTICE

OUTLINE

One of the objectives of this course is for you to develop the skills you need to critically appraise published health sciences and health services research. This will help you to utilize research to support evidence-based practice. This week we will discuss • The definition of evidence-based practice • The sources of clinical evidence • The steps in the EBP process

EVIDENCE-BASED PRACTICE (EBP)

Definition: EBP “is the integration of best research evidence with clinical expertise and patient values”

• The need for EBP • Continuous advances in medical research • Delay in implementation of research findings into clinical

practice • Need for clinicians to stay current with changing therapies • Evidence that EBP keeps clinicians up to date

Sources: Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB. Evidence-based medicine: how to practice and teach EBM, 2nd ed. Edinburgh & New York: Churchill Livingstone, 2000. Boston University. Introduction to evidence-based medicine. http://medlib.bu.edu/tutorials/ebm/intro/

REVIEW “EVIDENCE-BASED PRACTICE: AN INTRODUCTORY TUTORIAL” AVAILABLE

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EVIDENCE

• EBP requires high-quality evidence to support it. To assess the quality of that evidence, a hierarchy of the levels of evidence (next slide) is used based on the methodological quality and rigor of the design and implementation. While randomized controlled trials (RCTs)and systematic reviews of their findings are at the top of the pyramid, note that in some cases the best evidence is one that is methodologically appropriate to answer the research question.

HIERARCHY FOR LEVELS OF EVIDENCE

Source: Polit DF, Beck CT. 2012. Nursing Research: Generating and Assessing Evidence for Nursing Practice. P. 28.

REVIEW “UNDERSTANDING LEVELS OF EVIDENCE” VIDEO

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EVIDENCE-BASED PRACTICE RESOURCES

WHERE TO BEGIN YOUR SEARCH?

RESOURCES SYSTEMATIC REVIEWS

• The Cochrane Library • Available at www.thecochranelibrary.com • It is an international collaboration that prepares

• Systematic reviews of the effects of healthcare interventions • A register of controlled trials • A methodology register • An abstracts database • Health technology assessment database • Economic evaluations database

RESOURCES GUIDELINES & BEST PRACTICES

• The National Guideline Clearinghouse is a program of the Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. It is a database of evidence-based clinical practice guidelines and related documents designed for nurses, physicians, and other health care providers.

RESOURCES OPEN ACCESS JOURNAL DATABASES

• Directory of Open Access Journals (DOAJ). Includes over 7,000 scientific and scholarly journals, covering all subjects and many languages.

• HighWire Press. Includes over 1,000 peer-reviewed journals and other scholarly content. Sponsored by Stanford University. Some articles are not free.

RESOURCES U.S. GOVERNMENT DATABASES

• Education Resources Information Center (ERIC): unlimited access to more than 1.4 million bibliographic records of journal articles and other education-related materials.

• PubMed Central (PMC): free full-text archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health's National Library of Medicine (NIH/NLM). • PubMed is the National Library of Medicine's Web interface. It

comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. • Citations may include links to full-text content from PubMed Central

and publisher web sites.

RESOURCES SPECIALTY SEARCH ENGINES

• Google Scholar: Searches scholarly content across many disciplines and sources: articles, theses, books, abstracts and court opinions, from academic publishers, professional societies, online repositories, universities and other web sites.