Becoming a Professional II: Evidence Based Medicine (EBM), Critical Appraisals, and Evaluating Information sources
Evidence Based practices includes using the 5A's:
- Assess -- Define the problem, determine your client's values and your own clinical expertise with this problem.
- Ask -- Using a PICO, PEO, or other question-builder, determine the population, interventions/exposures, and outcomes you'll be exploring (these steps will help you determine keywords to help locate relevant information sources!).
- Acquire -- Where are you going to find your evidence? How are you constructing your search to find information? What type of evidence is available or needed (e.g. clinical trials, case studies, etc.)? How can you access what you find?
- Appraise -- What is the level of the quality of the evidence you've found? Use a Critical Appraisal tool to help determine that level of quality of that information source! (see below for some options)
- Apply -- Using the evidence found, your your clinical expertise, and client's values, apply the treatment option that best relates to addressing the case in front of you (remember the EBM VEN diagram!).
If you are interested in learning more about evidence-based practices, the Evidence Based Veterinary Medicine (EBVM) Network has a free tutorial where you can dive into learning more about the 5A's covered in the Becoming a Veterinary Professional course site for this course. Access the current tutorial: http://www.ebvmlearning.org/ (available through June 30, 2021). A new tutorial has also been released: https://learn.rcvsknowledge.org/course/view.php?id=2
Your assignment for this course blends components of a true EBM methodology, along with applying general evaluation criteria (listed below). While a general critical appraisal template was provided in your Canvas site, if you pursue EBM, it is best to select and apply a critical appraisal tool that is specific to the study design(s) in the evidence you've found. Examples of specific tools are listed below.
Critical Appraisals of Information Sources
When looking at scholarly literature, it is easy to fall into the trap that as it is peer-reviewed, it must be good. However, all sources, including journal articles, should be evaluated for their level of quality before assuming it is a good source of information to use. This can be done by applying a critical appraisal.
In the course this semester, you will apply a critical appraisal to the source you found following the critical appraisal template provided in your Canvas site. However, other critical appraisal tools are available, many are based on the type of study that was conducted (this is where it becomes extremely important to properly identify the type of study that was done!).
The following are a few Critical Appraisal tools available for animal studies:
- Provides a collection (menagerie) of reporting guidelines for research studies that involve animals, some are listed below as well.
- The goal of this critical appraisal tool is to improve the reporting of livestock trials with production, health, and food-safety outcomes.
- This is a modification of the STROBE statement for use in reporting observational studies in animal populations.
- Also includes a tool where you can upload your paper and highlight where each of the responses to the questions of the critical appraisal appear.
- A checklist (and article) about critical appraisal for animal studies
The following are a few Critical Appraisal tools available for broader types of studies:
- Several critical appraisal tools grouped by study design.
- The NIH has a variety of study quality assessment tools grouped by study design.
General Evaluation criteria
Whether purposefully or by habit, you have already been applying general evaluation criteria to any source of information you've come across. There are several types of evaluation criteria that can be implemented when reviewing a source for its credibility, authority, reliability. The basic areas to examine include: