Health Libraries Australia

ANZIIL
Australian & New Zealand Institute for Information Literacy Symposium
7-8 July 2003

Research in industry case studies

Health Sciences Libraries

 Health Libraries Australia

Research in industry case studies

Evidence Based Practice (EBP)

and Health Libraries

Greg Fowler

Health Sciences Libraries

 Evidence Based Practice

What is EBP?
Where did it come from?
How do you do it?

What has EBP meant for

Librarians?
 Evidence Based
Medicine > Health Care > Practice
Sackett et al (1996) defined Evidence Based Medicine as

"the conscientious, explicit and

judicious use of current best evidence
in making decisions about the care of
the individual patient. It means
integrating individual clinical expertise
with the best available external;
clinical evidence from systematic
research".
 Evidence Based
Medicine > Health Care > Practice
For McKibbon et al (1995) EBM is:
an approach to health care that promotes the collection,
interpretation, and integration of valid, important and
applicable patient-reported, clinician-observed and
research-derived evidence. The best available evidence,
moderated by patient circumstances and preferences, is
applied to improve the quality of clinical judgements.

Silagy & Haines (1998) argue Evidence-based health care:

takes account of evidence at a population level as
well as encompassing interventions concerned
with the organisation and delivery of health care.
 Evidence Based Practice 2

EBP is about creating a work environment that

enables the job to be done effectively by
consciously and explicitly integrating:
professional expertise
informed patient / customer / population
choice
the best available research evidence.

EBP is the extension of these underlying

principles to more diverse work practices than
clinical decision making and in organisational
structures other than health care.
 Evidence Based Practice 3

EBP has now been applied by a wide range of human

service, public safety and public health service
providers. This includes those working in crime
prevention, corrections, education, social care and
human resource- management (Trinder et al 2000).

EBP is a professional and organisational strategy that

overlaps with:
Continuous professional development & quality
improvement
Life long & organisational learning
Knowledge management & Information literacy
 EBP at the micro level

The Processes of Evidence Based Practice

ASK (question formulation)
FIND (information seeking)
APPRAISE (critical awareness)
ACT (applicability)
EVALUATE (could I do it better?)
Finding & Appraising Evidence
Evidence hierarchy
RCTs & Systematic Reviews
Case, cohort, pre-test/post test studies with controls
Expert opinion (extended anecdote)

Cochrane Collaboration & its Library

www.cochrane.org
Campbell Collaboration
www.campbellcollaboration.org
Social, Psychological, Educational, and Criminological
Trials Register (C2-SPECTR)
Register of C2 Systematic Reviews of Interventions and
Policy Evaluation (C2-RIPE)
Finding & Appraising Evidence 2

More tools for health care and health librarians

CATs, Poems, Best Bets, Clinical Evidence,
UptoDate, Guidelines & HTA
ADEPT, CASP, CriSTAL, SEEK, TRIP & SIGN
www.nettingtheevidence.org.uk

What has EBP meant for

Librarians?
 EBP for Libraries

Training, training & more training

Resource development
What are search filters & Role change

Research & Policy participation

 Training

Training customers & Library staff

new emphasizes & new tools

changing practitioners needs & student
curriculum
boundaries e.g decision support systems,
critical appraisal skills in research
methodologies & clinical epidemiology.
Finding new CPD opportunities
Resource development & Role change

NHS, Cochrane & EBM courses & tools

www.nelh.nhs.gov.uk
www.phru.org.uk/~CASP/

Clinical Librarians & The Informationist

Current Australian research
Research & Policy participation

Evidence Based Library Science

International EBlib conferences, www.eblib.net,
Health Information and Libraries Journal, Journal of
the Medical Library Association
www.pubmedcentral.gov, Hypothesis MLA
Research Section newsletter
www.research.mlanet.org

Advocacy for
Information infrastructure
Information literacy
Organisational and cultural change
 Research Issues for Libraries

Research agenda which questions

Research methods controlled,

triangulated or both

Research responsibilities
Research Agenda
There are really only 2 questions

Whats happening ?
Explorative questions

What works ?
Predictive and Effectiveness questions
Research Methods 1
for what works

Outcome measures
E.g. Quantifiable competencies, attitudes,
knowledge/skills, behaviour

Controlled trials
RTCs & Systematic Reviews

Cohort Studies
Prospective or historical, with or
without controls & Pre -test/Post-
test with follow up and rich
qualitative components
Research Methods 2
for whats happening

Qualitative methods
Focus groups, ethnographic studies,
naturalistic observation, nominal group
processes, historical analysis

Surveys
Open & closed, standardized
instruments, sampling issues,
triangulation
Research Responsibilities
Institutions
Universities, State libraries

Associations
ALIA, consortia, networks

Personal professionalism
Participation, reading the literature, reflecting on
practice
 Greg Fowler
Health Libraries Australia
Research & Innovation
Portfolio
g.fowler@library.uq.edu.au
ALIA 0408710443
Memberships
now due !!!

Health Sciences Libraries