Module Components

• Learning Activities

Topics

• Steps in the Development of a Search Strategy
• Types of Evidence in theLliterature
• Summarizing Your Search
• Commonly Used Reviews
• Search Strategies
• Resources for EBP
• Additional Training Available at Health Sciences & Human Services Library
• Module 7 Self-Review

NRSG 790 - Methods for Research and Evidence-Based Practice

Module 7: Searching for and Retrieving Evidence

TYPES OF EVIDENCE IN THE LITERATURE

Categorizing evidence is helpful when making decisions about evidence. Evidence is usually categorized as:

1. Primary or secondary
2. Peer reviewed or not peer reviewed
3. Scholarly, trade or popular (Schmidt & Brown, 2009)

Primary sources present original information by the author or authors responsible for creating them. An example of a primary source is a peer-reviewed research article that contains the original data and analysis from the research study without any outside evaluation or interpretation. Other primary sources include dissertations, technical reports and conference proceedings. See PubMed for an example of a primary study on the impact of a pediatric asthma clinical pathway.

Secondary sources offer an analysis, synthesis are an interpretation of primary sources. Examples of secondary sources are review articles, commentaries, or summaries. See PubMed for an example of a secondary study on the effectiveness of pediatric asthma clinical pathways.

Peer reviewed or refereed judging refers to scholarly papers published in peer reviewed journals, which undergo rigorous evaluation by experts and editors. Some examples of peer reviewed journals are Nursing Research, Journal of the American Academy of Nurse Practitioners, and Journal of Advanced Nursing.

Trade publications are written by professionals within a discipline but are written with a more casual tone. Examples: American Journal of Nursing; RN Magazine

Popular literature is written to inform or entertain the general public. Examples Parents Magazine; National Geographic

6-S Model The 6S Hierarchy of Evidence Based Resources is a useful model for guiding clinical decision making.The model proposes 6 layers of evidence sources. The search for evidence based resources should begin at the highest possible layer. The categories of EBM resources described here are corresponding to layers of 6S model of EBM resources.

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Dicenso, A., Bayley, L., & Haynes, R.B. (2009). Accessing pre-appraised evidence: Fine-tuning the 5S model into a 6S model. Evidence-Based Nursing, 12(4), 99-101.

1. Studies refer to individual original research journal articles that present the entire report of one study on one aspect or management of a health problem.
2. Synopses of single studies are a brief summary of high quality studies. Evidence-based abstraction journals such as Evidence Based Nursing. Evidence-based abstraction journals such as Evidence Based Nursing. Synopses refer to brief structured abstracts that alert physicians to important new evidence in readable format. They present results of a primary study or a synthesis that addresses a focused clinical question. This category is particularly helpful when time is a valuable commodity. It provides clinicians opportunities to maintain clinical proficiency.
3. Syntheses provide greater value than individual studies. They look at all available evidence on a given topic, follow explicit methodologies to identify evidence, assess value and determine overall benefit/harm as well as provide a degree of certainty about the syntheses.
4. Synopses of syntheses summarizes the results of high quality systematic reviews. The ACP Journal Club, and Evidence-Based Medicine.
5. Summaries provide concise and thorough evidence-based overviews of all aspects of patient care for a wide range of problems. UpToDate is an evidence based, peer reviewed information resource that is available. UpToDate provides topic reviews that include a synthesis of the literature, the latest evidence, and specific recommendations for patient care. Clinical Evidence is a decision-support resource that is an international peer reviewed journal that publishes systematic reviews on clinical conditions.
6. Systems refer to Computerized Decision Support Systems (CDSS) that provide on-site evidence while the clinician is interacting with the patient/medical record. CDSSs provide unbiased evidence-based information about the relative efficacy, safety, and cost of different therapeutic options that might help physicians practice more fiscally responsible care. CERNER is an example of a system which incorporates EBP.