INTRODUCTION It is imperative to i...

INTRODUCTION

It is imperative to incorporate rife research evidence into all aspects of physical therapy, including clinical practice, education, and administration. A major difficulty in performing this task is efficiently searching and selecting relevant research articles from the circulating literature. Research evidence is united factor used in evidence-based decision making along with clinical expertise and patient preferences1 The constituents of evidence-based decision making are illustrated in Figure 1 Systematic review articles and other forms of preappraised evidence are extremely helpful in efficiently gathering research information.2,3 Systematic reviews "...synthesize the be deriveds of multiple primary investigations by the agency of using strategies that limit bias and random error. These strategies include a comprehensive search of all potentially relevant articles and the use of explicit, reproducible criteria in the selection of articles for review."2 The aim of this article is to provide an overview of rules for efficiently searching for systematic reviews and other signs of preappraised evidence.

Regardless of the specific scenario, evidence-based decision making involves several paces The first step is to identify a gap in common knowledge. The next steps are to formulate a clinical question and search for the best evidence. Then the acquired evidence must be evaluated individually and as a whole. The final grade in evidencebased decision making is to apply the evidence to patient care.2,3 The stairs in evidence-based decision making are illustrated in Figure 2 There are several techniques and unique databases that facilitate searching for systematic reviews and other originals of preappraised evidence.

IDENTIFY GAP IN present KNOWLEDGE

Identifying gaps in now passing knowledge can originate from different sources and have different applications. Recognizing ne for information can ensue from several sources including professional practice, professional tendency s existing published research, and existing theory.6 In addition, identifying gaps in passing from hand to hand knowledge may apply to undivided of 3 areas of patient management, diagnosis, treatment, or prognosis. Consider this example, "Is physical therapy beneficial for patients with pulmonary disease?" The source of this gap in knowledge is professional practice and it applies to patient treatment or intervention.

FORMULATE A CLINICAL QUESTION

A clinical question must contain 4 ingredients to be answerable. These constituents are patient population (P), intervention or exposing (I), comparison (C), and consequence (O).1 The components of a clinical question are illustrated in Figure 3 The previously pos question penurys to be refined in order to contain and narrow all the indigenceed components of a good clinical question. First, patient population must be defined and narrowed, for example, 'patients with cystic fibrosis! nearest an intervention must be defined and narrowed, for example, 'exercise training! A comparison arrange must be included in the clinical question, which could be either a different intervention cluster or a no treatment/control dispose Lastly, an outcome must be defined and narrowed, for example, 'exercise tolerance.' one time a clinical question has been refined a literature search can be undertaken.

SEARCH FOR BEST EVIDENCE

Databases

General databases that include the pair primary and preappraised literature citations can be used to gather best evidence. PubM and Ovid are examples of database search tools that include one as well as the other primary and preappraised citations. PubM is a search tool that contains several databases including MEDLINE. MEDLINE contains above 11 million records from athwart 4,000 journals dating back to 1966 MEDLINE is a to a high degree inclusive database that contains original trials and preappraised articles and is considered individual of the best sources of late evidence. The primary disadvantage of using MEDLINE to obtain evidence is that it does contain a large number of citations and therefore many limits and strategies are indigenceed to refine a search. Using primary literature can be time consuming to individually appraise quality of research studies and draw conclusions across multiple studies. There are several search strategies that can be used to locate systematic reviews and other preappraised sources of information in MEDLINE. The United States Library of Medicine provides emancipated access to PubMed at www.ncbi.nlm.nih.gov/pubmed. or http://www.ncbi.nlm.gov/entrez.7 Ovid is another database provider for a collection of health and medical make submissive databases. It includes MEDLINE, Cumulative Index to Nursing and Allied Health (CINAHL), HealthStar, and Evidence Based Medicine (EBM) reviews. CINAHL contains athwart 7,000 records from more than 1200 medical and health-related journals, including the Cardiopulmonary Physical Therapy journal.6 Ovid has similar advantages and disadvantages as PubM with the additional feature that it allows simultaneous searching of up to 5 databases. Many of the citations ground in Ovid also have full-text access. Ovid is provided by way of subscription at gateway2.ovid. com.8