Overview

Information Mastery:

How to Lower the Work of Your Information Searches

Information must have three attributes to make it useful in daily clinical practice: it must be relevant to everyday practice, it must be correct, and it should require little work to obtain it. Your goal while Navigating the Maze of evidence-based information sources is to remember the "Usefulness of Medical Information Equation" that conceptually relates these three attributes in this manner:

Relevance x Validity
Work

The major skills required to reduce the "Work" part of this equation are to:

1. Convert information needs into focused questions through problem definition.
• The PICO model is helpful in forming a good searchable clinical question that clearly states the Population (P), the Intervention (I), the Comparison, if any (C), and the Outcome (O).

1. • If you are going to spend your time searching and evaluating literature, you want an outcome that patients care about. When considering outcomes - it is important to focus on POEMS - Patient Oriented Evidence that Matters, rather than a DOE - Disease Oriented Evidence.

1.  
   • What do patients care about? Mortality, morbidity and the quality of life!

1. Track down the best evidence efficiently.
   • In database searching you want to maximize locating relevant retrieval with minimal time and effort. The search protocol pyramid below is a graphical representation of one model for doing this. The EBM information sources in this pyramid are placed from top to bottom according to the "Usefulness of Medical Information Equation" introduced above.
   • This model suggests that you start your search at the top with systematic reviews from the Cochrane Database of Systematic Reviews. Cochrane is small in the amount of information it currently contains, making it easier to search, but large in the validity and relevance of the information it contains for answering therapeutic questions.
   • Depending on the success of your search in Cochrane, you would work your way down the pyramid of resources in order of decreasing relevance/validity and increasing work, until you find an answer.
   • Journal articles form the base of the pyramid because they represent large amounts of "unrefined" information, and the burden of determining the validity and relevance is up to the user. The work part of the "Usefulness Equation" is also very high for journal articles as it may require a lengthy MEDLINE database search to locate them.

Searching For the Evidence: A Search Protocol