Where is the evidence for evidence-based practice?
“As the volume of valid evidence expands, so does the demand for each chiropractor to develop the expertise necessary to appraise and apply the best evidence so as to achieve the best possible outcomes.” (From the Institute of Evidence-Based Chiropractic’s website, www.chiroevidence.com.)
Coined in 1992 by the Evidence-Based Medicine Working Group,(1) the phrase “evidence-based” is here to stay. Most would agree that patients deserve the best clinical experience and judgement, combined with careful appraisal of the latest literature. But how is a busy clinician going to find the time to locate and retrieve the necessary literature? Here are five tips to help you get started.
1: SEARCH THE INDEX TO CHIROPRACTIC LITERATURE
Created by librarians, the Index to Chiropractic Literature (ICL) [www.chiroindex.org] is free, easy to search and up-to-date. For articles published in peer-reviewed chiropractic journals, this is one-stop shopping. Links to full text are included where available; most journals require a subscription.
Some advice:
• read the Search Tips
• view the PowerPoint presentation
• use quotation marks to search phrases, in All Fields (see Figure 1)
• check out Further Resources for links to organizations, databases, key documents and more
2: SEARCH PUBMED
From the U.S. National Library of Medicine, PubMed (www.pubmed.gov) is the free
version of MEDLINE and is a vital source for chiropractors.
Some advice:
• view the tutorials and read the help screens
• use Single Citation Matcher for targeted searches
• use Clinical Queries to search by clinical study category
• search MeSH (Medical Subject Headings) for the correct terminology
• set up automatic search alerts using My NCBI
3: SUBSCRIBE TO ETOCS
eTOCs are e-mailed tables of contents.
• Set up alerts with your favourite journals and receive notices of new issues by e-mail
4: JOIN MAILING LISTS
Organizations and individuals create mailing lists and online newsletters to help you discover new resources and to provide a forum for sharing practice tips.
(See “Resources” below for examples.)
5: BEFRIEND A LIBRARIAN
“But where is the article?” is the question I hear most often. Besides helping you acquire search skills beyond Google, librarians offer advice on how to get your hands on full text, which usually requires payment. Get familiar with your nearest college or university library and make a librarian your best friend.
RESOURCES
Index to Chiropractic Literature (ICL): www.chiroindex.org
ICL Search Tips: right sidebar
ICL PowerPoint presentation:
see What’s New?
ICL Further Resources:
top right navigation bar
PubMed: www.pubmed.gov
PubMed Tutorials, Single Citation Matcher, Clinical Queries, MeSH database and My NCBI — left sidebar
eTOCs: see ICL’s Directory of Peer-Reviewed Journals in Chiropractic – www.chiroindex.org/publications_peer.php FCER newsletter: www.fcer.org/subscribe.htm
Spinedocs: www.health.groups.yahoo.com/group/spinedocs
CE_Chiro: www://health.groups.yahoo.com/group/
CE_Chiro
Chiropractic libraries: www.chiroindex.org/resources.php#Libraries%20and%20Colleges
Reference:
1. Evidence-based medicine. A new approach to teaching the practice of medicine. Evidence-Based Medicine Working Group. JAMA 1992; 268: 2420-2425.
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