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Introduction to Evidence-Based Practice

This tutorial was developed by staff at Duke University Medical Center Library and the Health Sciences Library at the University of North Carolina at Chapel Hill. It is used with permission by Loyola Notre Dame Library.

The Literature Search

Acquiring the Evidence

 

ACQUIRE
the evidence
3. Select the appropriate resource(s) and conduct a search

 

In the previous section, we learned how to construct a well-built clinical question. Using that question, we will move on to the literature search.

 

For our patient, the clinical question is:

In patients with type 2 diabetes and obesity, is bariatric surgery more effective than standard medical therapy at increasing the probability of remission of diabetes? It is a therapy question and the best evidence would be a randomized controlled trial (RCT). If we found numerous RCTs, then we might want to look for a systematic review.

 

 

Constructing a well-built clinical question can lead directly to a well-built search strategy. Note that you may not use all the information in PICO or well-built clinical question in your MEDLINE strategy. In the following example we did not use the term “male.” We also did not include the word therapy. Instead we used the Clinical Query for Therapy or the publication type, randomized controlled trial, to get at the concept of treatment. However, you may consider the issue of gender later when you review the articles for applicability to your patient.

 

PICO

Clinical Question

Search Strategy

Patient / Problem obese, diabetes type 2, male

diabetes type 2, obesity

Intervention stomach stapling (gastric bypass surgery; bariatric surgery) bariatric surgery
Comparison (if any) standard medical care  
Outcome remission of diabetes; weight loss; mortality  
Type of Question therapy (see below)
Type of Study RCT Clinical Query – Therapy/narrow
or
Limit to randomized controlled trial as publication type