Evidence-Based Healthcare is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient." (Sackett, 1996).
Finding high quality evidence is a priority for health care practitioners. The library provides access to a wide-range of print and electronic resources for NHS staff. This guide details the benefits of using Evidence Based Healthcare (EBH) practice to support your decision making,
Why Evidence-Based Practice?
Population-based outcome studies have found that therapies that are evidence-based have more positive effects on patient care than opinion-based healthcare. For example, heart attack survivors prescribed aspirin or beta-blockers have lower mortality rates than those who aren’t prescribed these drugs.
EBH comprises of 5-steps:
Step 1. A decision needs to be made arising from a patient’s care or service development.
Step 2. You formulate a focused question, accounting for your population group, problem, intervention and any comparisons or outcomes.
Step 3. You identify the appropriate resources to search for the best evidence - here’s where the library can help the most.
Step 4. Critically appraise the evidence -the library can help you here too!
Step 5. Implement in practice, if applicable.
When starting out you will want to spend some time specifying your question. A well formulated clinical question will focus the search and will find more relevant literature.
The PICO framework is one process for answering clinical and heath related questions. PICO is an acronym which stands for:
P - Patient
I - Intervention
C - Comparison
O - Outcome
The framework is helpful in articulating the participants, interventions, comparisons and outcomes relevant to the question. The framework will form the basis of the search strategy design.
The following PICO variations allow for search design adjustments which can include study type or timeframe if they are significant to your topic.
| PICOS |
Patient, Intervention, Comparison, Outcome, Study design |
| PICOT | Patient, Intervention, Comparison, Outcome, Time |
| PICOST | Patient, Intervention, Comparison, Outcome, Study design, Timeframe |
The following frameworks introduce other factors for analysis such as social or economic factors:
| ECLIPSE | Expectation, Client group, Location, Impact, Professionals SErvice - Health policy / management information |
| EPICOT | Evidence, Populations, Interventions, Comparisons, Outcome, Timeframe - Effect of treatments |
| MIPS | Methodology, Issues, Participants |
| PECO | Population, Exposure, Comparison, Outcome |
| PESTEL | Political, Economic, Social, Technological, Environmental and Legal Factors - Strategic management and strategic analysis |
| SPICE | Setting, Population, Intervention, Comparison, Evaluation - Qualitative evidence |
| SPIDER | Sample, Phenomenon of interest, Design, Evaluation, Research type - Qualitative and mixed methods research studies |
A short tutorial from the Centre for Evidence-Based Medicine, Oxford University explaining how to use PICO to formulate a search question.
Video explaining how to use AND, OR boolean operators
Video created by Health Education England KFH LKS https://youtu.be/N258crAefSo
