Textbooks
Principles of Research Design and Drug Literature Evaluation, Second EditionPublication Date: 2019
Drug Information: a Guide for Pharmacists, 7th EditionPublication Date: 2022
Basic & Clinical Biostatistics: Fifth EditionPublication Date: 2019
Help for Journal Club
These sources include critically appraised articles- usually original research studies, but also meta-analyses and systematic reviews. You will be able to access the full original research article (or meta-analysis/systematic review) and read critical comments from faculty and researchers on the original study's design and conduct, collection of data, methods used to analyze the data, and results/conclusions.
Because of the way they are created, critically appraised articles can help you develop your critical appraisal skills, and provide help with creating journal club presentations.
- ACP Journal Club (Annals of Internal Medicine )Previously a stand-alone journal, the ACP Journal Club has been incorporated as a section of Annals of Internal Medicine. It publishes critical reviews of other articles written by experts in the field- it's like having a journal club meeting.
Holdings: May 2008-present - RxSelect (formerly Pharmacist's Letter)Evidence-based, timely summaries of drug information and policies for immediate impact on patient care. Pharm D students receive free access to RxSelect, a product from Pharmacist's Letter (PL). Sign up for RxSelect access using this page. The USC Libraries also buy a subscription of PL for staff and faculty pharmacist use.
Definition and Steps of the EBP process
Whether you call it Evidence-Based Medicine (EBM), Evidence-Based Practice (EBP), or Evidence-Based Pharmacy (EBP), the principles are the same. For this guide we will use EBP to mean all of the above.
STEPS of Evidence-Based Practice
- ASK. Create a focused, searchable clinical question.
- ACCESS. Search for the evidence.
- APPRAISE your results critically.
- APPLY results to your patient.
- ASSESS. Evaluate the effects of Step 4, reformulate and repeat process if necessary. Also look at your process and correct/improve as necessary.
This page will walk through the steps and link relevant resources to each step.
Ask: Creating Searchable Clinical Questions
The EBP practitioner must identify questions from a clinical scenario. Clinical scenarios are usually complicated and contain too many factors to be searched effectively. Most searches in information resources use 1 to 3 concepts. The PICO model is used in EBP to assist in identification of key concepts, words, and phrases.
P: patient, problem, or population
I: Intervention
C: Comparison
O: Outcome
Once you have used PICO to identify key words and concepts, you can construct a focused clinical question. This question will guide you as you search for and evaluate literature in steps 2 and 3.
An Evidence Pyramid
Evidence-Based Summaries
- UpToDate This link opens in a new windowAn evidence-based resource covering multiple medical specialties. Includes topic monographs, patient education, practice updates, drug interactions, guidelines, and medical calculators. To obtain CME, create a personal profile and log in.
- BMJ Best Practice This link opens in a new windowEvidence-based overviews of medical topics, continually updated. Includes calculators and patient handouts. Create personal account to claim CME credits.
Guidelines
- ECRI Guidelines Trust This link opens in a new windowFind summaries of high-quality guidelines from state, federal, and international agencies. Requires free registration. Similar to National Guideline Clearinghouse.
- CINAHL Complete This link opens in a new windowPrior to searching, use the Publication Type limit of Practice Guidelines.
- Guidelines.co.uk This link opens in a new windowSummaries of guidelines and recommendations from United Kingdom governmental agencies and European and global professional groups. Includes links to full-text of guidelines. Registration is not required to access guidelines.
- National Institute for Health and Clinical Excellence (NICE) This link opens in a new windowGuidelines for United Kingdom (UK) National Health Services (NHS).
Professional groups, non-profit organizations, and government agencies often develop guidelines and make them available freely on their websites. Search or browse groups like the World Health Organization, U.S. Centers for Disease Control and Prevention, U.S. Veterans Health Administration, or U.S. Preventive Services Task Force. Use Google to find additional groups focused on your specialty.
National Guideline Clearinghouse ceased in July 2018. There is no replacement product with the scope and depth of NGC. Use one or more of these sources to identify and access full-text guidelines.
Systematic Reviews and Meta-Analyses
- Cochrane Database of Systematic ReviewsThe Cochrane Database of Systematic Reviews provides access to full-text systematic reviews.
- PubMed@USC This link opens in a new windowUse the Systematic Review or Meta-Analysis filter to limit your results to these study types.
Original Studies
- PubMed@USC This link opens in a new windowUse the filters to limit your search to Randomized Controlled Trials and Case Reports.
Add key words or MeSH terms to your search to search for Cohort Studies and Case Series.
Appraise the Evidence
These books and guides provide overviews of the EBP process as well as assistance with interpreting results provided in articles and calculating results from data presented in articles.
- Centre for Evidence-Based Medicine at Oxford UniversityClick on "EBM Tools" to locate tools to assist you with each step of EBM. The Critical Appraisal section includes worksheets with guided questions to help you appraise articles, explanations and examples for calculating NNT, and calculators to assist with calculating other measures.
- Evidence-Based Medicine ToolboxThe critical appraisal worksheets provide guided questions to help you appraise articles; the EBM calculators provide assistance with calculating measures of risk and NNT.
- JAMAEvidence This link opens in a new windowThis exhaustive guide to EBM covers all steps of the process. "Learning tools" includes worksheet for critical appraisal, "education guides" provides narrative discussion of the importance of appraisal and the measures used, and "calculators" provides calculators to aid you in calculating measures of risk, NNT, and NNH.
Evidence-Based Pharmacotherapy: Optimal Patient Care = Best Knowledge + Competent PractitionerCall Number: Norris Medical Library, Upper Level, QV 704 C541e 2007This textbook provides an exhaustive overview of EBP. Most valuable for appraisal are chapter 4, a narrative discussion of statistical measures used in EBP; and chapter 5, which covers how to calculate statistical measures (including NNT and NNH) and use these in clinical decision making.
The Pharmacist's Guide to Evidence-Based Medicine for Clinical Decision MakingCall Number: Norris Medical Library, Upper Level, WB 330 B915p 2008Publication Date: 2008This textbook is brief and aimed at the practicing clinician. It includes less mathematically-focused measures of appraisal. Chapters 6 and 8 focus on developing a clinical decision based on evidence and applying this clinical decision to individual patients.
Apply, Assess
Application of your evidence-based decision to your patient requires factoring in patient preferences, abilities, and resources-- pharmacy's focus on interacting with patients provides you with great help here-- and clinician experience and resources.
Assessment involves evaluation of the patient after application of your evidence-based decision.
Assessment also includes evaluation of your EBP process and abilities in order to improve over time.
Practicing EBP also gives you a chance to identify gaps in research literature-- a great way to discover new research you could conduct.