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Evidence-Based Practice PubMed Tutorial

PubMed will provide evidence-based articles if you program PubMed correctly. Many "systematic reviews" and some "reviews" will provide evidence-based practice information. "Meta-analysis" is another possible option. The KEY is to program PubMed to find systematic reviews, but that takes some practice. The first graphic in this tutorial is a screen-capture of what the finished selection of options on the left side of the screen should look like. Please scroll down this long web page, starting with step one, in order to see what you need to do to select the correct options within PubMed in order to find evidence-based articles.

In the end, the finished selection of options should look something like this:





The first screen is the search screen. You need to type the topic that you want to search. For this example, we are going to find evidence-based information for MRSA (methicillin-resistant Staphylococcus aureas).

Click on the "Search" button for PubMed to start the search.



STEP TWO: Article Types


The "Results" show that PubMed found 21,424 articles that have something to do with MRSA. A LONG list of citations is presented. NOW, is the time to select options (filters) to narrow the search to evidence-based information. Many (but not all) systematic reviews provide evidence-based information, so the first option is to select systematic reviews under "Article types" on the left side of the screen. Often, PubMed will have a specific default option such as "Clinical Trial" chosen. You can click on the "clear" link OR deselect any option other than systematic reviews. 

Click on "More..."  


STEP THREE: Select Systematic Reviews


After clicking on "More," you will be presented with a drop-down window of MORE options. Scroll down the window in order to click within the box next to "Systematic Reviews."  The checkmark within the box indicates that you have selected systematic reviews. Remember to DESELECT any other options listed in this menu.

Click on the "Show" button.


STEP FOUR: Click on Systematic Reviews


Still, you need to click on "Systematic Reviews" so that the link is highlighted and the checkmark appears next to "Systematic Reviews."



After selecting "Systematic Reviews," PubMed automatically applies the selection (option). Quickly, the list of citations is reduced from 21,425 articles about MRSA to 342 articles that are "systematic reviews" of MRSA. It gives you another good idea on how difficult it is to find evidence-based information on a variety of topics.

Most students want the free full-text (article) as well as other features, so please scroll down this long web page for information about more options to select, as well as how to view the entire article. There ARE quite a few steps in this process.



STEP SIX: Select "Free full text available"

For "Text availability," click on "Free full text available" in order to access  entire articles that are FREE. The "Full text available" option will provide you access to websites that ask you to pay a fee.  You need to click on the middle option, "Free full text available" in order to have the opportunity to access the entire article FOR FREE. Please notice in this graphic how after selecting "Free full text available" that the "Results" are down to 85.


STEP SEVEN: Publication Dates

You can choose whatever your teacher will allow. Many teachers want articles within FIVE years. However, IF you are allowed to access older articles then you will have more to choose from.


STEP EIGHT: Humans as Species

There are A LOT of research studies using animals as part of the study rather than humans. You need to select "Humans" if you want the information to be about humans.


STEP NINE: Choosing the language of ENGLISH

PubMed is a LARGE international database full of medical citations and articles. Many of the articles listed are published in languages other than English. It is helpful to ask PubMed to present articles in ENGLISH. PubMed does not always present the language options on the screen. SO, below "Species, " you will need to click on "Show additional filters."  You will need to select "Languages" as an option. After that, you can select English.



STEP TEN: Choose Languages

Click within the box next to "Languages" and then click on the "Show" button towards the bottom of the menu.


STEP ELEVEN: Click on English

After clicking on "Show" in the previous step, "English" will appear as an option on the main screen.

Click on "English."  A checkmark will appear next to "English" and "English" will become highlighted.



After all of that, we end up with a list of 39 citations that are systematic reviews (hopefully all evidence-based) that have something to do with MRSA.

The next step is to choose one or more of these citations to see what the entire article will provide.



STEP THIRTEEN: Click on Title of Citation

Number 30 might be something that can be used. The title of the article is "Systematic review and meta-analysis of the effectiveness and safety of tigecycline for treatment of infectious disease." The authors are Cai, Y, Wang R, Liang B, Bai N, and Liu Y. This article is in the scholarly journal of Antimicrobial Agents and Chemotherapy, March 2011 volume 55, issue 3. The article can be found on pages 1162-1172.

Click on the title in order to access the entire article.


STEP FOURTEEN: Abstract and Choose FULL-TEXT Icon/Button

PubMed presents the citation and abstract (summary of the article).

Because we asked PubMed to provide "Free full text available", you should see one OR two buttons (options) in the upper right corner of the screen. One of the buttons will lead you to the full-text / PDF entire article. If there are two buttons, usually the one will lead you to a web page that asks you to pay money. Select the button that offers the FREE entire article.




Often, there is a link to the PDF (scanned image) of the entire article. You can view the full-text or the PDF file.






According to the article, the authors performed  "a systematic search of the literature in PubMed (up to November 2010), the Cochrane Central Register of Controlled Trials (Cochrane Library, issue 3, 2010), and Embase (1980 to November 2010) was conducted to identify relevant RCTs for our meta-analysis. The terms used for the search strategy were “tigecycline,” “glycylcycline,” “infection,” “skin and soft tissue infection,” “intra-abdominal infection,” “pneumonia,” “bacteremia,” “sepsis,” and “urinary tract infection.” Searches were limited to RCTs only. In addition, the references of the initially identified articles, including relevant review papers, were hand searched and reviewed. Abstracts presented in scientific conferences were not searched for."

The authors REVIEWED the literature and RCTS (randomly controlled trials). They "performed a meta-analysis of RCTs to clarify whether the use of tigecycline could be associated with improved outcomes in comparison with those achieved with other antibiotics for the treatment of infections, including cSSSIs, cIAIs, CAP, and infections caused by MDR pathogens."

The authors provided information based on the evidence from MULTIPLE studies.



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