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Evidence Based Literature Searching

What is Evidence-Based Practice?

Evidence-based practice is the practice of medicine which includes using the best evidence, clinical expertise, and patient values to make informed care decisions.

Shared decision making is a process that involves clinicians communicating information about treatment options, and patients and parents communicating the personal value they place on the trade-offs involved so that agreement on the best strategy for the patient can be reached.

Evidence-based decision making is a process in which care decisions are optimized by bringing all of these perspectives together.

How We Promote Evidence

Cincinnati Children’s believes in and practices evidence-based decision making (EBDM) as a way to achieve the best, safest care for children. 

Rapid Evidence Adoption to Improve Child Health (REACH)

Horizon scanning, evidence synthesis (e.g., rapid evidence reviews), embedding evidence and measuring and spreading evidence adoption are used to close the gap between evidence generation or publication and use of the evidence in decision making at the point of care.

Shared Decision Making (SDM)

Evidence-based tools are used to facilitate clinicians' communication about treatment options and patients / parents' communication about the personal value they place on the trade-offs involved. The goal is to reach agreement on the best strategy for a patient when there are two or more medically reasonable options differing in ways that are important to families.

Evidence Evaluation Tools & Resources (LEGEND)

We collaborated with groups from nursing (patient services), allied health (occupational therapy / physical therapy), hospital medicine and our medical research library to develop the LEGEND (Let Evidence Guide Every New Decision) system, standardizing EBDM education and evidence evaluation for the institution. This system includes tools and resources for proceeding through the evidence evaluation process, including critically appraising individual studies, grading the body of evidence and judging the strength of recommendation statements.

Evidence-Based Care Recommendations

  • Best evidence statements: We use best evidence statements to improve recommendation development and streamlined evidence reviews to improve revision processes.
  • Evidence-based care guidelines: We develop and disseminate high-quality processes and products, primarily evidence-based guidelines.

This content is provided by the Anderson Center for Health Systems Evidence. Learn more or view the original content at the Anderson Center EBDM website

1. Ask

🔍 Formulate a clear, answerable clinical question.
Use the PICO format:

  • Patient/Problem
  • Intervention
  • Comparison
  • Outcome

Example: In elderly patients with hypertension (P), does a low-sodium diet (I) compared to medication alone (C) reduce blood pressure (O)?


2. Acquire

📚 Search for the best available evidence.
Use databases like PubMed, CINAHL, Scopus, Cochrane Library, or clinical guidelines to find high-quality research relevant to your question.


3. Appraise

🧠 Critically evaluate the evidence for validity, impact, and applicability.

  • Is the study design appropriate?
  • Are the results statistically and clinically significant?
  • Can the findings be applied to my patient?

4. Apply

💡 Integrate the evidence with clinical expertise and patient values.
Consider the patient's preferences, your clinical judgment, and the context of care when applying the evidence.


5. Assess

🔄 Evaluate the outcome and your performance.

  • Did the intervention improve patient outcomes?
  • Was the process efficient and effective?
  • What can be improved next time?

                                                  

Based on the EBM Pyramid. Copyright © 2006–2011. Trustees of Dartmouth College and Yale University. All Rights Reserved. Produced by Jan Glover, David Izzo, Karen Odato and Lei Wang.

CCHMC Evidence Collaboration: James M. Anderson Center for Health Systems Excellence | Center for Professional Excellence
Edward L. Pratt Research Library |  Occupational Therapy & Physical Therapy | Hospital Medicine