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Medical Professionals NHS Library Guide

This guide is for Medical Professionals working for St George's University Hospitals NHS Foundation Trust

Finding the Evidence

 

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.

  • Books: find out how to search for print and electronic books; how to find a book in the library, and how to access eBooks.
  • Journals, databases, finding articles & papers: See our list of best bets databases, how to search for journals using the A-Z Journals list and how to configure Google scholar or PubMed to display full text articles available with OpenAthens.
  • Literature searching - explore the principles of effective literature searching, with tips and techniques to ensure successful searching.

 

Why Evidence-Based Healthcare?

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.

Evidence-based practice 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

Defining a question

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

Literature Searching

Infographic - step by step