1. Evidence-Based MedicinevsResearch Methodology SohailBajammal October 6, 2011

2. Objectives What is EBM (EBCP)? How is it different from research? Why do we need to learn the skills of EBM? How to practice EBM?

3. What got me into EBM…. What is a double blind study? Two orthopaedic surgeons reading an ECG

4. Double blind in orthopaedics?

5. What is research? Systematic investigation towards increasing the sum of knowledge (Chambers 20th Century Dictionary)

6. Perspectives of Research Basic Science Social Health Problem “Trauma” Economic Legal Clinical Diagnosis Therapy Prognosis

7. Doing Research Methodology Research Evidence-Based Clinical Practice Using

8. EBM (EBCP) Research Evidence Patients’ Preferences Clinical Expertise Clinical Circumstances Haynes et al. BMJ 2002;324:1350

9. EBM & Critical Thinking “ثمنرقىفيالبحثوالمقاييسعلىالتدريجوالترتيب معانتقادالمقدماتوالتحفظفيالنتائج ونجعلغرضنافيجميعمانستقرئهونتصفحه استعمالالعدللااتباعالهوى ونتحرىفيسائرمانميزهوننتقده طلبالحقلاالميلمعالآراء” الحسنبنالهيثم

10. Steps of Practicing EBCP

11. How would you search for answers? Ask the audience Ask a friend Flip through a textbook Google it up! Search the literature

12. It depends on the question! How do I look like in the pictures in the newspapers? Friends & Audience Where to download the latest song? Google What is the blood supply to the femur? Textbook What are the effects of soft drinks on fracture healing? Journals

13. What’s wrong with textbooks? Excellent for the principles & basic knowledge Usually single authored chapters Likely biased, author’s opinion Not peer-reviewed Outdated (at least 4 years)  except the frequently updated online books (not PDF eBooks)

14. What’s wrong with googling?

15. What’s wrong with googling? Reliability & credibility of source Google Scholar is good

16. In: Glasziou P, Del Mar C: Evidence-based Practice Workbook: Bridging the gap between health care research and practice. Blackwell Publishing - BMJ Books. 2007. PP 3-13

17. In: Glasziou P, Del Mar C: Evidence-based Practice Workbook: Bridging the gap between health care research and practice. Blackwell Publishing - BMJ Books. 2007. PP 3-13

20. Usefulness of Information Hurwitz SR, Slawson DA, Shaughnessy A. Orthopaedic information mastery: applying evidence-based information tools to improve patient outcome while saving orthopaedists’ time. J Bone Joint Surg Am. 2000;82:888–895.

21. Satisficing ‘‘where busy clinicians will be satisfied with the information they can readily summon, while sacrificing quality for convenience” كبب وليّس ، يطلع كويس Carter BS, Leuthner S. Decision making in the NICU—strategies, statistics and ‘‘satisficing.’’ Bioethics Forum. 2002;18:7–15.

22. Before we move on, What are the differences between articles & books? Are all articles good? Are all journals good? How does an article look like?

23. How does an article look like?

24. Read the article titles  If relevant, read the abstract If you read the abstract & it’s relevant  get the full text

25. Journal Name, Volume, Issue, Pages Article Title Authors & Contact Info MeSH Terms Abstract When you search by keywords, you search in these areas

26. How does a full text article look like? Same information as abstract, PLUS Introduction Methods Results Discussion References

27. Where are articles stored? Articles are published in Journals Journals are published by Publishers Journals are indexed by Databases (e.g., MEDLINE, EMBASE) Instead of going to each publisher website & look for articles, you search for articles in a database There are many companies/websites that searches a database (e.g., Medline): PubMed, OVID

28. Database (e.g. MEDLINE) Journal of Medicine Journal of Medical Research Engineering Journal Business Journal Article 1 Article 1 Article 1 Article 1 Article 2 Article 2 Article 2 Article 2 Article 3 Article 3 Article 3 Article 3 Article 4 Article 4 Article 4 Article 4 Article 5 Article 5 Article 5 Article 5 Article 6 Article 6 Article 6 Article 6 Multiple Browsers (e.g., PubMed, OVID) Publisher: Springer Publisher: Mosby Publisher: ABC Publisher: XYZ

29. What we have talked about? What is EBM (EBCP)? How is it different from research? Why do we need to learn the skills of EBM? How to practice EBM?