ASSIGNMENT ON SOURCES OF EVIDENCE

Abhijeet Rai
ROLL NO -180563001
SYSTEM ID - 2018010933
SUBMITTED TO- DR. ADIL ALI ANSARI

SUBJECT- EVIDENCE BASED PRACTICE [EBP

SOURCES OF EVIDENCE
 

WHAT ARE SOURCES OF EVIDENCE

Research evidence has assumed priority over other sources of evidence in the delivery of
evidence-based health care. Evidence is published across a variety of sources, including
scienti c or academic journals, books, conference proceedings, websites, and news
reports. Academic publications in scienti c journals are generally considered to be of higher
quality due to the independent, peer-review process. There are a number of ways to
determine the quality of a journal, though these measures are not necessarily a good proxy
of the quality of individual articles within the journal. A central principle in evidence
translation is that all evidence must be critically appraised, regardless of its source.

It includes-

a) Filtered resources- Clinical experts and subjects specialist pose a question and then
synthesise evidence to state conclusion based on available research. These sources are
helpful because the literature has been searched and results evaluated to provide an
answer to clinical education.

b) Un ltered resources [Primary literature]- It provides most recent information e.g.,

MEDLINE, CINAHLetc. provides primary and secondary literature for medicine.

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 c) Clinical experiences- Knowledge through professional practice and life experiences

makes up the second part in evidenced based, person-centered care.

d) Knowledge from patients- Evidence delivered from patients’ knowledge of

themselves, their bodies and social lives.

e) Knowledge from social context- Audit and performance data, Patients stories and
narratives, knowledge about the culture of the organisation and individuals within it.

f) Social and professional networks.

g) Information from feedback.

h) Local and National policy.

DIFFERENT KIND OF SOURCES

1) PUBMED- [ DATABASE+ SEARCH ENGINE] It is a user-friendly search interface that

provides free online access to the MEDLINE database of published academic literature.
O ers advanced options, such as the ability to ‘build’ comprehensive search strategies or
to limit search results by age group or article type. Clinical Queries is a special feature that
allows you to lter results to speci c clinical study categories such as aetiology, diagnosis,
therapy, or prognosis. Study abstracts can be freely viewed but obtaining the full article still
usually requires a paid subscription.

2) CINAHL- Cumulative Index to Nursing and Allied Health Literature database covers
the literature of nursing, physical therapy, occupational therapy, nutrition and dietetics, and
other health related professions. It includes citations to books, book chapters, and
dissertations. Access to CINAHL is by paid subscription only.

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3) GOOGLE SCHOLAR- [SEARCH ENGINE] Basic search interface that is fast gaining
popularity for quick and comprehensive clinical searches. Generally, performs well in head-
to-head comparisons with major academic databases and may provide greater access to
free full-text articles. Improvements in recent iterations address some previous criticisms,
though shortcomings remain and it should not be used in isolation for systematic review
searches. In addition to peer-reviewed publications, also retrieves ‘grey literature’ (i.e.,
documents not catalogued by commercial publishers, like nonpeer reviewed articles,
theses and dissertations, and academic books). While this can broaden the search results,
bear in mind that some of the articles retrieved through this platform may not have gone
through a stringent peer-review process.

4) APTA’s HOOKED ON EVIDENCE- American Physical Therapy Association provides

database of scienti c literature to promote evidence-based practice. Evidence based
practice includes the integration of best available evidence, clinical expertise and patient’s
values and circumstances related to patient and client management, and health policy
decision- making. The physical therapy profession recognizes the use of evidence-based
practice as central to providing high-quality care and decreasing unwarranted variation in
practice.

5)ORYGEN EVIDENCE FINDER- It provides access to the best available evidence for the
prevention and treatment of mental ill-health in young people. The Evidence Finder is a
shared initiative with headspace that is freely available. It is a comprehensive research
database of all controlled intervention studies and systematic reviews published in youth
mental health since 1980.links to abstracts are provided, with full-text articles freely
available in some cases, updated (usually annually) with the latest research.

LEVELS OF EVIDENCES
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The Levels of Evidence Pyramid can be utilised to weigh the quality of di erent types of
evidence when engaging in evidence translation, with the highest level of evidence at the
top.

DIFFERENT KIND OF STUDIES IN SCIENTIFIC EVIDENCE

1)Meta-Analysis-A review team compiles aggregate-level data in each primary study, and in
some cases, data are solicited from each of the primary studies. Although di cult to
perform, individual patient meta-analyses o er advantages over aggregate-level analyses.
These mathematically pooled results are referred to as meta-analysis. Combining data from
well-conducted primary studies provide a precise estimate of the “true e ect.” Pooling the
samples of individual studies increases overall sample size, enhances statistical analysis
power, reduces con dence interval and thereby improves statistical value.

2)Systematic Review-Systematic reviews draw on multiple randomised controlled trials to

draw their conclusions, and also take into consideration the quality of the studies included.
Reviews can help mitigate bias in individual studies and give us a more complete picture,
making them the best form of evidence.

3)Randomized Controlled Trials-Subjects are randomly assigned to a test group, which

receives the treatment, or a control group, which commonly receives a placebo. In ‘blind’
trials, participants do not know which group they are in; in ‘double blind’ trials, the
experimenters do not know either. Blinding trials helps remove bias.

4)Cohort Studies-A cohort study is similar to a case-control study. It involves selection of a

group of people sharing a certain characteristic or treatment (e.g., exposure to a chemical),
and compares them over time to a group of people who do not have this characteristic or
treatment, noting any di erence in outcome.

5)Case Control Studies-Case control studies are retrospective, involving two groups of
subjects, one with a particular condition or symptom, and one without. They then track
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 back to determine an attribute or exposure that could have caused this. Again, these
studies show correlation, but it is hard to prove causation.

6)Case Report or Case Series-A case report is a written record on a particular subject.
Though low on the hierarchy of evidence, they can aid detection of new diseases, or side
e ects of treatments. A case series is similar, but tracks multiple subjects. Both types of
study cannot prove causation, only correlation.

7)Animal and Cell Studies-Animal research can be useful, and can predict e ects also seen
in humans. However, observed e ects can also di er, so subsequent human trials are
required before a particular e ect can be said to be seen in humans. Tests on isolated cells
can also produce di erent results to those in the body.

8)Literature Review- It can be just a simple summary of the sources, but it usually has an
organizational pattern and combines both summary and synthesis. A summary is a recap of
the important information of the source, but a synthesis is a re-organization, or a reshu ing,
of that information. It might give a new interpretation of old material or combine new with
old interpretations, or it might trace the intellectual progression of the eld, including major
debates and depending on the situation, the literature review may evaluate the sources and
advise the reader on the most pertinent or relevant.

10)Cross-Sectional Study-A cross-sectional study is de ned as a type of observational

research that analyses data of variables collected at one given point in time across a
sample population or a pre-de ned subset. This study type is also known as cross-
sectional analysis, transverse study, or prevalence study. Researchers often use it to
understand outcomes in the physical and social sciences and many business industries.

STRATEGY TO SEARCH FOR EVIDENCE [PICO FRAMEWORK]

1. Population of interest

2. Intervention or Exposure

3. Comparison that’s important or relevant to consider

4. Outcome of interest.

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REFERENCES

1. Orygen Reference Guide

2. Types of studies and research design review article