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Evidence-based Medicine to Evidence-based Public Health

Two integrated frameworks demonstrating how to translate evidence-based practice (a clinical approach) to evidence-based public health.

Public Health Scholarship

What does scholarship mean to you?  What does it mean to your mentors?  

To me, the scholarly process is not quick and easy, it is a beautiful process that allows one to grow with the knowledge they hope to impart in a meaningful and unbiased way.  It takes rigor.  I love the definition provided below.

The scholarly method or scholarship is the body of principles and practices used by scholars to make their claims about the world as valid and trustworthy as possible, and to make them known to the scholarly public. It is the methods that systemically advance the teachingresearch, and practice of a given scholarly or academic field of study through rigorous inquiry. Scholarship is noted by its significance to its particular profession, and is creative, can be documented, can be replicated or elaborated, and can be and is peer-reviewed through various methods. (http://www.aacn.nche.edu/publications/position/defining-scholarship)

DLV

A Checklist

What is your research question or hypothesis, and what outcome are you trying to achieve?

Scenario:  I have heard teenagers and young adults state that electronic cigarettes are not harmful.  Many feel they are much safer than tradittional cigarettes.

Electronic cigarettes can be harmful, and and young adults and teenagers should be discouraged from smoking e-cigarettes.

Is this an adequate hypothesis?  Is there a great deal of scholarly information on this topic or too little?  How strong is the evidence to support the hypothesis?

First of all, there are two components to the above statement.  It would be best to concentrate on one.  

What type of review should you do?

A literature review is a detailed process that collect data from the published literature, is synthesized or summarized  focusing a great deal of information in a meaningful way.  Review the Grant & Booth (2009) article to learn about the various types of reviews.  This table will focus on three reviews, the Systematic Review, the Scoping Review and the Narative Review.


 

 Systematic Reviews   

 Scoping Reviews

 Narrative Reviews

---Evidence based in nature 
---Often addresses the effectiveness of a specific intervention

Helps with answering a clinical or research question

---Evidence based in nature
---Help provide direction in addressing a specific 
---Not evidence based in nature
--Summarizes a topic but does not provied 

Helps with understanding the many facets of a clinical or research topic

The Cochrane guidelines state that three databases should be searched, minimally:  The Cochrane Library, PubMed/Medline and Embase.  It is important to note that there are significant additional databases that must be searched in order to present an unbiased review!

Useful Examples

This article is an excellent example that will help in understanding the structure of a systematic review/meta-analysis:

Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis, BMJ 2011;343:d4488

  • Read the last paragraph in the Introduction. Can you determine the question/hypothesis?
  • Review the databases searched in the Methods section, first paragraph.  This is a great example of a comprehensive search.
  • Review the search strategy in the Methods section, second paragraph. Could you reasonably reconstruct this search if you need to update it since its publication in 2011?  It cannot be pasted in to other databases than PubMed/Medline.  You have to decide if it is better to do a search that can be pasted across all databases OR several searches that are appropriate for each individual database.  You have to find the right balance between too much information that is not relevant or too little information that may miss important articles.

Types of Reviews