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Step 2. Identify Appropriate Sources of Evidence

Once you have a question, you'll need to decide where to start your search. Your question topic and the type of evidence required will guide your selection. To find the best evidence, you need to know about the breadth of sources are available to you, the relative quality of these sources, and how to match questions to a source to search.

 

In this section, you'll:
  • Recognize that evidence varies in quality (e.g. merit, relevance, validity)
  • Understand that different types of literature are acquired from a range of sources
  • Identify sources of evidence that are appropriate to your question topic

Matching your question to appropriate evidence sources 

Now that you know more about the quality of evidence and the different study types or publications, it's time to identify which sources to search based on your question and information need. 

Below are examples featuring different kinds of clinical questions and recommendations for evidence sources that best fit the question type, along with suggestions on where to start searching. 

Matching Question Types to Evidence Sources

Questions about: Treatments or interventions to achieve a particular outcome.

Recommended publication types: Meta-analysis, systematic review, randomized control trials

Example question:

How effective is sheepskin at reducing the risk of pressure ulcers in patients with spinal cord injuries?

PICO

P: Patients with spinal cord injuries

I:  Sheepskin

C: ---

O: Reduce the risk of pressure ulcers

Where you could start your search:

Questions about: The accuracy of diagnostic assessments.

Recommended publication types: Meta-analysis, systematic review, cross-sectional studies with random or consecutive sample

Example question:  

For pregnant women over 35 years of age, is the Non-Invasive Prenatal Test (NIPT) done at 11 weeks as effective as an amniocentesis done at 18 weeks at diagnosing Down syndrome?  

PICO

P: Pregnant women

I:  Non-Invasive Prenatal Test (NIPT)

C: Amniocentesis

O: Diagnosis Down syndrome

Where you could start your search:

Questions about: Progression or likelihood of an outcome for a population with certain characteristics

Recommended publication types: Meta-analysis, systematic review, cohort or survival studies

Example question:

In women with triple-negative breast cancer in remission, what is the likelihood of recurrence within 5 years?

PICO: Prognosis questions are often framed as P and O components only

P: Women with TNBC in remission  

I:  ---

C: ---

O: Recurrence in 5 years

Where you could start your search:

Questions about: Causes of disease or condition; impact, usually negative, from an intervention or some exposure

Recommended publication types: Meta-analysis, systematic review, randomized control trials, cohort studies, case-control studies

Example question:  

For otherwise healthy adults, at what point does alcohol consumption switch from reducing to increasing the risk of a stroke?

PICO

P: Adults

I:  Alcohol consumption reduces risk

C: Alcohol consumption increases risk

O: Stroke

Where you could start your search:

Questions about: Fact or situation that is observed with an unknown cause; may relate to any aspect of a service or clinical practice; usually involve a population and outcome. We often include health system and qualitative questions in the phenomena category.

Recommended publication types: Qualitative studies

Example question:

For patients with time-sensitive medications, what reminder prompts are most effective?

PICO

P: Patients with time-sensitive medications

I:  ---

C: ---

O: Reminders/prompts to take medication

Where you could start your search:

Questions about: Best practices in diagnosing, managing, and treating diseases and clinical conditions to optimize patient care.

Recommended publication types: Clinical practice guidelines (CPGs), position statements, published protocols (from reputable health-care organizations and recognized professional bodies)

Example question:

What are the standards for managing dysphagia in adults following a stroke?

PICO

P:  Adults suffering dysphagia after stroke

I:  ---

C: ---

O: Make effective evidence-based care decisions

Where you could start your search:

Additional

Based on your question, what types of materials or publications do you need?        
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Where could you potentially start your search?