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Information Mastery: Navigating the Maze
The Pyramid

Pyramid

Types of EBM Information Sources Available, with Examples

(ranked according to the "Usefulness of Medical Information
Equation")

The Secrets of the Pyramids

Search Protocol:

  • The pyramid above is a graphical representation of how to
    search efficiently for the best evidence. The examples of EBM
    information sources in this pyramid are placed from top to bottom
    according to the "Usefulness of Medical Information" equation
    illustrated below:
Usefulness = Relevance x Validity
? Work
  • This model suggests that you start your search at the top of
    the pyramid 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 and Alerting Tools:

  • With the ever-growing number of pre-validated information
    sources available, clinicians now need two tools to help them
    identify information that is highly relevant and valid: an
    Alerting Tool and Searching
    Tool
    .
  • A good Alerting Tool would notify the
    clinician whenever new relevant information becomes available. An
    example of such a tool would be Daily
    InfoPOEMs
    - a companion product to
    InfoRetriever (a searching tool) from
    the company InfoPOEMs: The Clinical Awareness
    System
    .
  • A good Searching Tool would search multiple
    databases or sources of information simultaneously and present
    the results in an easy-to-use format based on relevance and
    validity.
  • The pyramids below illustrate several such Searching
    Tools
    . Not all search tools are equal, and when using
    one it helps to evaluate it by asking the following questions:
    1. Does it search information sources that have a high
      usefulness score (higher on the pyramid)?
    2. Does it search multiple information sources
      simultaneously?
    3. Does it rank its search results according to usefulness (top
      of pyramid sources listed first)?
    4. Does it answer the highest percentage of questions in the
      least amount of time?

Pyramid

Search Tool: Ovid's Evidence-Based Medicine Reviews
(EBMR)

(sources ranked according to the "Usefulness of Medical
Information Equation")

Search Tool: InfoRetriever

(sources ranked according to the "Usefulness of Medical
Information Equation")

Pyramid

Search Tool: TRIP Database

(sources ranked according to the "Usefulness of Medical
Information Equation")

Pyramid

Search Tool: SUMSearch

(sources ranked according to the "Usefulness of Medical
Information Equation")

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