Evidence-based search
The development of knowledge in the health sector is strong, which makes great demands on all health professionals to keep abreast of new findings. Evidence-based medicine (EBM) and evidence-based health care (EBV) means you are intentionally using the best available scientific information, along with clinical experience and patient preference, when you treat and care for your patients.
Evidence-based healthcare follows four steps:
Formulate a question – a patient-related question that can be answered.
Information Search – search literature that answers the question.
Critical review – is the literature relevant and valid?
Apply the result – treat your patients based on current evidence.
1. Formulate a question
A clear question gets a clear answer. PICO External link. is a model that you can use to structure and clarify your question:
Population
Intervention
Comparison
Outcome
Population
Which patient category is relevant? Which ages? Men or women? With what diagnosis, which degree of disease and what risk factors or other diseases?
Intervention
What treatment method is relevant? Applied by which therapist, with what intensity and during what time?
Control
Compared to other method, placebo or no action?
Outcome
Mortality? Morbidity? Quality of life? Measured by what method?
Once you have divided the question into smaller constituents and picked out keywords, you need to find synonyms and subject headings for your terms. Use Swedish MeSH or SveMed+ to find medical subject headings:
- Swedish MeSH
External link.
In Swedish MeSH you can find medical subject terms, both in Swedish and English. - SveMed+
External link.
You can also use SweMed+ to get suggestions for MeSH terms.
2. Information search
Usually, the evidence-baced information search is based on the first two parts of PICO, population and intervention. Theese can, on the other hand, be divided into several parts. For example, if the population is "adolescents with alcohol abuse", then adolescents may form one part of the population and alcohol abuse another. Splitting the search into different parts in this way is called building block strategy. This means that, with the help of OR, you combine all synonyms, subject headings and free text into one block. Then you combine your blocks with AND, see the example below:
Block 1:
("Virtual reality therap*" OR "Virtual reality glasses" OR "virtual reality technolog*" OR "virtual goggles" OR "VR goggles" OR Virtual Reality [Mesh] OR Virtual Reality Exposure Therapy [Mesh])
Block 2:
("panic attack*" OR Phobic Disorders [Mesh] OR Panic Disorder [Mesh] OR Anxiety [Mesh] OR Anxiety Disorders [Mesh])
Block 1 and block 2:
("Virtual reality therap*" OR "Virtual reality glasses" OR "virtual reality technolog*" OR "virtual goggles" OR "VR goggles" OR Virtual Reality [Mesh] OR Virtual Reality Exposure Therapy [Mesh]) AND ("panic attack*" OR Phobic Disorders [Mesh] OR Panic Disorder [Mesh] OR Anxiety [Mesh] OR Anxiety Disorders [Mesh])
Suitable databases and search sources:
Which databases to choose when searching, depend on which material you would like to find. In evidence-based information search, the SBU or Cochrane Library, is a good place to start. Then you can search for original articles in, for example, PubMed.
- SBU, Statens beredning för medicinsk och social utvärdering
External link.
Systematic reviews in Swedish. - Cochrane Library
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Systematic reviews in medicine and adjoining areas. - PubMed – Clinical Queries
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Select Clinical Queries below PubMed Tools to restrict the search to include only articles based on clinical studies and certain predefined methods. Here you will find original articles but also systematic overviews. - CINAHL with Full Text
External link.
Limit to Evidence-based practice or to a particular publication type. - OTseeker
External link.
Systematic reviews in occupational therapy and more. - PEDro
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Systematic reviews in, for example, physical therapy. - Trip
External link.
Searching for evidence-based resources available on the Internet, including material from SBU, Cochrane Library, HTA and PubMed. The search results are sorted and presented in hierarchical categories with a rather small selection of best evidence at the top.
3. Critical review
In order to evaluate relevance, validity and clinical benefit, the scientific quality of the articles must be examined, as the studies may contain systematic errors, bias. Performance errors can, for example, be due to incorrect data, interpretation errors or impact assessment errors. There are several different aids that you can use when reviewing your material, including on SBU External link. 's website. In the case of evidence grading, the international grading system GRADE is often
External link. used to assess the reliability of the scientific data. The PEDro database uses PEDroscale
External link. to evaluate the quality of clinical trials.
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4. Apply the results
Together with your clinical experience and the patient's needs, you need to decide whether the evidence in the scientific results are transferable to your patient. How generalizable are the results of the study? Are the benefits of the selected intervention greater than the disadvantages? Is the evidence strong enough?
Learn more about evidence-based care:
Bak Andersen, I., Matzen, P., & Vågen, Ö (2015). Evidence-based medicine . Lund: Student literature.
Fisher, AG (2009). Occupational therapy intervention process model: A model for planning and implementing top-down, client-centered, and occupation-based interventions . Fort Collins, Colorado: Three Star Press.
Herbert, R., Jamtvedt, G., Hagen, KB, Mead, JM, & Chalmers, I. (2011; 2012). Practical evidence-based physiotherapy (Second ed.). Edinburgh; Edinburgh: Elsevier, Churchill Livingstone; Elsevier, Churchill Livingstone.
Nordenström, J. Edgren, G. (2019). Evidence-based medicine in the footsteps of Sherlock Holmes (5, [ed.] Ed.). Stockholm: Nordic Medical Publications.
Willman, A. (2016). Evidence-based nursing: A bridge between research and clinical activities (4, [rev] ed). Lund: Student literature
Open course in evidence-based information retrieval
The university library's open course shows how you can search in SBU, Cochrane Library, PubMed, CINAHL, Trip, OTseeker and PEDro.
This is a free online course at advanced level that is open to everyone.
- Advanced level
- Online and open to all
- Not personal – answers from exercises are not saved
- Includes texts, videos, quizzes and interactive elements.
How does the course work?
This is a non-credit online course that is open to everyone. You can choose to go through the whole course in one go or select parts that you need more practice on. Remember that the course is not personal. This means that the tasks you answer will disappear when you close the web window, or take a longer break. The course is produced by the University Library.
- Evidence-based information retrieval
External link, opens in new window.
Select the link to start the course (in Swedish).
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