HSD 610: Human & Social Dimensions in Science & Technology Colloquium
2001: Public Alarm in Healthcare
Studies show it takes an average of 17 years to implement clinical research.
JAMIA 2001;8:398-399
Answerable Question
"A prudent question is one half of wisdom" Francis Bacon
Evidence-based Searcher
The bar is high when searching for best evidence and defending interventions that impact people's lives.
- Knows with reasonable certainty that best evidence was not missed by conducting a rigorous and systematic search across multiple databases.
- Conducts efficient & productive search using three major search strategies across professional databases that are vetted and transparent.
Use Three Major Search Strategies
Use all three major search strategies because each one has its advantages and disadvantages and you want to know with reasonable certainty that you are not missing best evidence.
Keyword Search Strategy enters keywords representing your PICO elements that are searched for in the journal citation's title and abstract. Advantage - retrieves all articles with your keywords appearing somewhere in the title and abstract. This is a good snap shot of the database and how much interest there is in your topic. Disadvantage - can not lmit to those articles where your terms are major topics or articles where a different synonym is used for your topic ,and you might retrieve hundreds of citations with no efficient way to find the most relevant.
Keyword Search limited to words in the article title enters keywords representing your PICO elements only in the journal citation's title. Advantage - Retrieveing journal ciations with your keywords appearing in the article title increases chances that your PICO elements will be major topics and will be related within the PICO framework of population and intervention. Disadvantage - you may not retrieve articles when the author uses a different synonym for the PICO element than you do. Always try out different synomyns representing your PICO elements when performing a Title search.
Subject Heading Search Strategy (in Pubmed called MeSH - Medical Subject Headings) enters subject headings representing PICO elements and retrieves journal citations where your PICO elements are major topics. Advantage - retrieving journal citations where your PICO elements are the major topic and are related in the PICO framework of population and intervention. Using subject headings also avoids missing aritcles that use other synonyms because aritcles discussing a PICO topic are tagged with the same subject heading regardless of the author's choice of synonyms to describe the PICO element. Disadvantage - MeSH headings may not yet be assigned to your topic and there can be various delays in indexing articles with the MeSH subject headings.
Top Evidence Based Practice Databases
CINAHL: Cumulative Index to Nursing and Allied Health Literature. Leading research from publications in the fields of nursing and allied health from 1982 to the present.
ClinicalTrials.gov: Contains approximately 11,300 clinical studies sponsored by the National Institutes of Health, other federal agencies, and private industry on a wide range of diseases and conditions.
Cochrane Library: Provides access to reliable information compiled by the Cochrane Collaboration, an international network of individuals and institutions committed to preparing, maintaining, and disseminating systematic, up-to-date reviews of the effects of health care.
National Guideline Clearinghouse (NGC): A public resource for evidence-based clinical practice guidelines. The NGC is an initiative of the Agency for Healthcare Research and Quality and the U.S. Department of Health and Human Services.
PubMed: The primary database of information in the medical and health sciences fields.
Websites
AHRQ: The Agency for Healthcare Research and Quality's (AHRQ) mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. Information from AHRQ's research helps people make more informed decisions and improve the quality of health care services.
American Nurses Assn. (ANA) - has developed a Research Toolkit to help provide evidence-based care that promotes quality health outcomes for individuals, families, communities and health care systems. The toolkit offers an introduction to research and evidence-based practice. It provides access to numerous resources to translate evidence into practice and to support nurse researchers.
Formulating a PICO Question
Duke University | Tutorial | PICO | http://www.hsl.unc.edu/services/tutorials/ebm/Question.htm
P = Population w/ (health condition of interest)
I = Intervention
C = Comparison
O = Outcome
Sample PICO Question
In the elderly at risk of falling, is tai chi effective in reducing risk and preventing falls compared to those not practiciing tai chi?
In cancer patients, does exercise therapy manage fatigue more effectivenly compared with not exericse therapy?
PICO and Sample PubMed Search
| Search | Add to builder | Query | Items found | Time |
|---|---|---|---|---|
| #5 | Add | Search ((#1) OR #2) OR #4 | 175 | 08:50:01 |
| #16 | Add | Search ((#1) OR #2) OR #4 Filters: Evaluation Studies | 5 | 08:49:58 |
| #15 | Add | Search ((#1) OR #2) OR #4 Filters: Controlled Clinical Trial | 7 | 08:49:52 |
| #14 | Add | Search ((#1) OR #2) OR #4 Filters: Comparative Study | 14 | 08:49:46 |
| #13 | Add | Search ((#1) OR #2) OR #4 Filters: Multicenter Study | 11 | 08:49:40 |
| #12 | Add | Search ((#1) OR #2) OR #4 Filters: Validation Studies; Multicenter Study | 11 | 08:49:27 |
| #11 | Add | Search ((#1) OR #2) OR #4 Schema: all Filters: Validation Studies | 0 | 08:49:27 |
| #10 | Add | Search ((#1) OR #2) OR #4 Filters: Validation Studies | 0 | 08:49:26 |
| #9 | Add | Search ((#1) OR #2) OR #4 Filters: Clinical Trial | 49 | 08:48:12 |
| #8 | Add | Search ((#1) OR #2) OR #4 Filters: Randomized Controlled Trial | 36 | 08:48:06 |
| #7 | Add | Search ((#1) OR #2) OR #4 Filters: Systematic Reviews | 38 | 08:47:58 |
| #6 | Add | Search ((#1) OR #2) OR #4 Filters: Meta-Analysis (Limits by Study Designs) | 9 | 08:47:46 |
| #4 | Add | Search accidental falls [mh] AND tai ji [mh] (Subject Heading Search) | 88 | 08:47:11 |
| #3 | Add | Search falling [ti] tai [ti] (Keyword Search - limit to TITLE) | 6 | 08:46:20 |
| #2 | Add | Search falling tai (Keyword Search - switched synonym) | 54 | 08:45:47 |
| #1 | Add | Search falls tai (Keyword Search) | 166 | 08:45:35 |
MeSH Subject Headings for Policy, Technology
A course or method of action selected to guide and determine present and future decisions.
Year introduced: 2011
A course or method of action selected, usually by a government, to guide and determine present and future decisions on population control by limiting the number of children or controlling fertility, notably through family planning and contraception within the nuclear family.
Year introduced: 1992
The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures.
Year introduced: 1980
A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions.
Year introduced: 1978
Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.
Year introduced: 1980
Governmental guidelines and objectives pertaining to public food supply and nutrition including recommendations for healthy diet and changes in food habits to ensure healthy diet.
Year introduced: 1995
A course or method of action selected, usually by an organization, institution, university, society, etc., from among alternatives to guide and determine present and future decisions and positions on matters of public interest or social concern. It does not include internal policy relating to organization and administration within the corporate body, for which ORGANIZATION AND ADMINISTRATION is available.
Year introduced: 1991
A course of action or principle adopted or proposed by a government, party, business, or individual that concerns human interactions with nature and natural resources.
Year introduced: 2011
United States Office of National Drug Control Policy
A component of the Executive Office of the President established by the Anti-Drug Abuse Act of 1988. The Office establishes policies, priorities, and objectives for national DRUG AND NARCOTIC CONTROL. The goals of the program are to reduce illicit drug use, manufacturing, and trafficking, drug-related crime and violence, and drug-related health consequences.
Year introduced: 2008
Decisions for determining and guiding present and future objectives from among alternatives.
Year introduced: 1998
Control of drug and narcotic use by international agreement, or by institutional systems for handling prescribed drugs. This includes regulations concerned with the manufacturing, dispensing, approval (DRUG APPROVAL), and marketing of drugs.
Year introduced: 1968
The guidelines and policy statements set forth by the editor(s) or editorial board of a publication.
Year introduced: 2003
Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.
Year introduced: 1998
Technology MeSH
The application of scientific knowledge to practical purposes in any field. It includes methods, techniques, and instrumentation.
Year introduced: INDUSTRIAL ARTS was see under TECHNOLOGY 1967-1978
Technology Assessment, Biomedical
Evaluation of biomedical technology in relation to cost, efficacy, utilization, etc., and its future impact on social, ethical, and legal systems.
Year introduced: 1980
Pollution prevention through the design of effective chemical products that have low or no toxicity and use of chemical processes that reduce or eliminate the use and generation of hazardous substances.
Year introduced: 2009
The application of technology to the solution of medical problems.
Year introduced: 2000
The application of scientific knowledge or technology to pharmacy and the pharmaceutical industry. It includes methods, techniques, and instrumentation in the manufacture, preparation, compounding, dispensing, packaging, and storing of drugs and other preparations used in diagnostic and determinative procedures, and in the treatment of patients.
Year introduced: 1968
Systematic identification, development, organization, or utilization of educational resources and the management of these processes. It is occasionally used also in a more limited sense to describe the use of equipment-oriented techniques or audiovisual aids in educational settings. (Thesaurus of ERIC Descriptors, December 1993, p132)
Year introduced: 1996
Spread and adoption of inventions and techniques from one geographic area to another, from one discipline to another, or from one sector of the economy to another. For example, improvements in medical equipment may be transferred from industrial countries to developing countries, advances arising from aerospace engineering may be applied to equipment for persons with disabilities, and innovations in science arising from government research are made available to private enterprise.
Year introduced: 1995
The application of scientific knowledge or technology to the field of radiology. The applications center mostly around x-ray or radioisotopes for diagnostic and therapeutic purposes but the technological applications of any radiation or radiologic procedure is within the scope of radiologic technology.
Advanced technology that is costly, requires highly skilled personnel, and is unique in its particular application. Includes innovative, specialized medical/surgical procedures as well as advanced diagnostic and therapeutic equipment.
Year introduced: 1980
United States Office of Technology Assessment
An office established to help Congress participate and plan for the consequences of uses of technology. It provided information on both the beneficial and adverse effects of technological applications. The Office of Technology Assessment closed on September 29, 1995.
Year introduced: 1988
National Center for Health Care Technology (U.S.)
A center in the PUBLIC HEALTH SERVICE which coordinates and administers a program of research, demonstrations, and evaluations of medical technologies and assessments of health care technology.
Year introduced: 1991(1982)
The technology of transmitting light over long distances through strands of glass or other transparent material.
Year introduced: 2009 (1970)
Techniques using energy such as radio frequency, infrared light, laser light, visible light, or acoustic energy to transfer information without the use of wires, over both short and long distances.
Year introduced: 2011
Observation and aquisition of physical data from a distance by viewing and making measurements from a distance or receiving transmitted data from observations made at distant location.
Year introduced: 2011
The field of dentistry involved in procedures for designing and constructing dental appliances. It includes also the application of any technology to the field of dentistry.
Laboratory and other services provided to patients at the bedside. These include diagnostic and laboratory testing using automated information entry.
Year introduced: 1996
Investigative and diagnostic methods and procedures based on the photoacoustic effect, which is the generation of SOUND WAVES from the absorption of ELECTROMAGNETIC RADIATION.
Year introduced: 2012
Reproductive Techniques, Assisted
Clinical and laboratory techniques used to enhance fertility in humans and animals.
Year introduced: 2002
The specialty related to the performance of techniques in clinical pathology such as those in hematology, microbiology, and other general clinical laboratory applications.
Year introduced: 2012 (1966)
The field of information science concerned with the analysis and dissemination of medical data through the application of computers to various aspects of health care and medicine.
Year introduced: 1987
American Recovery and Reinvestment Act
Public Law No: 111-5, enacted February 2009, makes supplemental appropriations for job preservation and creation, infrastructure investment, energy efficiency and science, assistance to the unemployed, and State and local fiscal stabilization, for fiscal year ending September 30, 2009.
Year introduced: 2010
The use of technology-based interventions to improve functional capacities rather than to treat disease.
Year introduced: 2002
Devices, not affixed to the body, designed to help persons having musculoskeletal or neuromuscular disabilities to perform activities involving movement.
Methods pertaining to the generation of new individuals, including techniques used in selective BREEDING, cloning (CLONING, ORGANISM), and assisted reproduction (REPRODUCTIVE TECHNIQUES, ASSISTED).
Year introduced: 1991
The in vitro fusion of GENES by RECOMBINANT DNA techniques to analyze protein behavior or GENE EXPRESSION REGULATION, or to merge protein functions for specific medical or industrial uses.
Year introduced: 2006 (1998)
An alkaloid, originally from Atropa belladonna, but found in other plants, mainly SOLANACEAE.
Year introduced: 1975
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