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Evidence-Based Guidelines
Lynn Kysh, MLIS
kysh@usc.edu
Information Services Librarian
Norris Medical Library
Evidence Pyramid – Publication Types
Evidence-Based
Guidelines

Systematic
Review & Metaanalysis

Higher Quality of Information

Fewer Articles

Randomized Controlled
Trials
Cohort Studies
Case Control Studies

Lower Quality of Information

More Articles
Case Series, Case Reports
Agenda
• A note about guidelines
• Clinical Scenario: Prostate Cancer Screening
• Ask
• PICO

• Acquire
• PubMed
• National Guidelines Clearinghouse

• What about clinical information tools?
Evidence
(research)

Clinical
expertise

Patient
values
Guide to formulate a question
• Problem/Patient
• Intervention
• Comparison (if any)
• Outcome
Clinical Scenario
Your patient is a 50 year old African-American
Chief Executive Officer for a Los Angeles company
presents for his executive physical. His friend was
recently diagnosed with prostate cancer and he
wants to know if he should have a digital rectal
examination and/or PSA. How would you
respond?
Using PICO
•P
•I
•C
•O

50 y/o African American man
Digital rectal exam or PSA
No screening
Decrease morbidity and mortality related to
prostate cancer
Finding guidelines:
Use “Article Type” filter
National Guidelines Clearinghouse
• Guidelines Information
• Organization
• Process
• Evidence used
• Disclosures

• Comparison feature
But what about clinical information tools?
Are these EBM Resources?
• Opinions vary (and that’s
okay!)
• Appraise the information
• Check evidence ratings
• Follow links to evidence
• Check author information
Examined from UpToDate &
Dynamed articles on:
• erectile dysfunction
• fibromyalgia
• hypogonadism
• Psoriasis
• rheumatoid arthritis
• Crohn's disease

All articles from the UpToDate articles demonstrated a
conflict of interest. At times, the editor and author would have
a financial relationship with a company whose drug was
mentioned within the article.
Agenda
• A note about guidelines
• Clinical Scenario: Prostate Cancer Screening
• Ask
• PICO

• Acquire
• PubMed
• National Guidelines Clearinghouse

• What about clinical information tools?
Questions?
Lynn Kysh, MLIS
Information Services Librarian
kysh@usc.edu
(323) 442-1124
Thanks!
Lynn Kysh, MLIS
Information Services Librarian
kysh@usc.edu
(323) 442-1124

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Keck Year 2 Evidence Based Medicine - Guidelines

  • 1. Evidence-Based Guidelines Lynn Kysh, MLIS kysh@usc.edu Information Services Librarian Norris Medical Library
  • 2. Evidence Pyramid – Publication Types Evidence-Based Guidelines Systematic Review & Metaanalysis Higher Quality of Information Fewer Articles Randomized Controlled Trials Cohort Studies Case Control Studies Lower Quality of Information More Articles Case Series, Case Reports
  • 3. Agenda • A note about guidelines • Clinical Scenario: Prostate Cancer Screening • Ask • PICO • Acquire • PubMed • National Guidelines Clearinghouse • What about clinical information tools?
  • 4.
  • 6. Guide to formulate a question • Problem/Patient • Intervention • Comparison (if any) • Outcome
  • 7. Clinical Scenario Your patient is a 50 year old African-American Chief Executive Officer for a Los Angeles company presents for his executive physical. His friend was recently diagnosed with prostate cancer and he wants to know if he should have a digital rectal examination and/or PSA. How would you respond?
  • 8. Using PICO •P •I •C •O 50 y/o African American man Digital rectal exam or PSA No screening Decrease morbidity and mortality related to prostate cancer
  • 10. National Guidelines Clearinghouse • Guidelines Information • Organization • Process • Evidence used • Disclosures • Comparison feature
  • 11. But what about clinical information tools?
  • 12. Are these EBM Resources? • Opinions vary (and that’s okay!) • Appraise the information • Check evidence ratings • Follow links to evidence • Check author information
  • 13. Examined from UpToDate & Dynamed articles on: • erectile dysfunction • fibromyalgia • hypogonadism • Psoriasis • rheumatoid arthritis • Crohn's disease All articles from the UpToDate articles demonstrated a conflict of interest. At times, the editor and author would have a financial relationship with a company whose drug was mentioned within the article.
  • 14. Agenda • A note about guidelines • Clinical Scenario: Prostate Cancer Screening • Ask • PICO • Acquire • PubMed • National Guidelines Clearinghouse • What about clinical information tools?
  • 15. Questions? Lynn Kysh, MLIS Information Services Librarian kysh@usc.edu (323) 442-1124
  • 16. Thanks! Lynn Kysh, MLIS Information Services Librarian kysh@usc.edu (323) 442-1124