Evidence-based Medicine Toolkit

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18 Evidence-based Medicine ToolkitSearching the internetYou might like to begin searching the internet using a specializedsearch engine which focuses on evidence-based sources. Two suchservices are TRIP (see above) and SUMSearch (http://sumsearch.uthscsa.edu/searchform45.htm) which search other websites foryou, optimizing your search by question type and number of hits.AskMedline is a new service which allows you to search Medlineusing the PICO structure: http://askmedline.nlm.nih.gov/ask/pico.phpEnter your patient’scharacteristics hereSpecify the intervention,comparison and outcomeSelect the Medlinepublication typeAsk Medline interface
Finding the evidence 19Search enginesGeneric internet search engines such as Google are very effectivesearch tools, providing you with a relevance-ranked list of hits.Some hints to help you get the most out of search engines:• Use multiple terms to increase the specificity of your search;• Google automatically truncates search terms and ignores commonwords such as ‘where’ and ‘how’• Use quotes to indicate phrases (e.g. ‘myocardial infarction’);• Use the minus sign to show terms you don’t want to find (e.g.hospital –drama if you want to find hospitals but not hospitaldramas)• Use the advanced search if you want better results;• Be prepared to look at more than the first page of results.However, you should be wary of relying on internet search enginesbecause:• relevance ranking is based on characteristics of the web page,not on an assessment of what it’s about (as is the case withMeSH);• it is not comprehensive;• you cannot compile complex searches as in bibliographic databases;• many large web sites contain ‘deep content’ which is notindexed by search engines.Can this web site help you to answer your question?There are many large web sites which provide detailed informationabout health care topics; sometimes you may be asked to recommenda site for a patient to read up on their condition. But howcan you tell when a site is any good?1 Is the site accessible to disabled users?2 Is the design clear and transparent?3 Can you use it effectively?4 Are the objectives of the site and its provider clearly stated?5 Are there any conflicts of interest?6 Is it up to date?7 Does the site report a content production method which includessystematic searching, appraisal and evaluation of information(Badenoch 2004)?
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Selected evidence-based healthcare
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