Evidence-Based Decision-Making worksheet ausing your PICO question/topic”
PICO Question: A 45-year-old female presents with a moderate gingival bleeding, will flossing with regular dental floss compared to flossing with water flosser be more effective and result decrease in gingival bleeding?
P: Patient presents with a moderate gingival bleeding
I: Using regular dental floss
C: Using a Water flosser
O: Result in decreased gingival bleeding
Locate clinical research article that pertain (support, or related) to PICO question and evaluate with the EBDM worksheet . There is a Word document for the EBDM worksheet, if you type, please use a different color font. Make sure to complete all parts (A through G)
Name ___________________ Topic _______________________
EBDM Worksheet
PART A. Skill 1 – Convert Information Needs/Problems into Clinical Questions So That They Can Be Answered
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Your questions should be used to help establish your search strategy.
Patient/Problem ________________________________________
Intervention ___________________________________________
Comparison ___________________________________________
Outcome ______________________________________________
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Therapy/Prevention Diagnosis Etiology, Causation, or Harm Prognosis
PART B. Understanding the Publication Type So That Appropriate Studies Can Be Identified
PART C. Skill 2. Conducting a Computerized Search with Maximum Efficiency for Finding the Best External Evidence with which to Answer the Question
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WEBSITE ADDRESS
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List irrelevant terms that you may want to exclude in your search.
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INFORMATION FOUND
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Search History | Results | |
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PART D. Skill 3. Critically Appraising the Evidence for Its Validity and Usefulness.
Article Reference #1 | |||
Type of Study: | Level of Evidence: | Does this answer my question? YES NO | Will I use this for my patient? YES NO |
Are the results of the trial valid? | |||
What are the results? | |||
Will the results help my patients? |
Article Reference #2 | |||
Type of Study: | Level of Evidence: | Does this answer my question? YES NO | Will I use this for my patient? YES NO |
Are the results of the trial valid? | |||
What are the results? | |||
Will the results help my patients? |
Article Reference #3 | |||
Type of Study: | Level of Evidence: | Does this answer my question? YES NO | Will I use this for my patient? YES NO |
Are the results of the trial valid? | |||
What are the results? | |||
Will the results help my patients? |
Article Reference #4 | |||
Type of Study: | Level of Evidence: | Does this answer my question? YES NO | Will I use this for my patient? YES NO |
Are the results of the trial valid? | |||
What are the results? | |||
Will the results help my patients? |
Article Reference #5 | |||
Type of Study: | Level of Evidence: | Does this answer my question? YES NO | Will I use this for my patient? YES NO |
Are the results of the trial valid? | |||
What are the results? | |||
Will the results help my patients? |
PART E. Evaluating the Websites Where Information Pertinent to the Patient is Found
Skill 3. Critically Appraising the Evidence for its Validity and Usefulness
URL of page evaluated: http:// | URL of page evaluated: http:// | |||
Information about the Site | ||||
Domain | .com, .org, .net.edu.mil/ .gov/other: _______________ | .com, .org, .net.edu.mil/ .gov/other: _______________ | ||
Is the domain appropriate for the content? | YesNo | YesNo | ||
Is the purpose and mission of the website appropriate for the information posted? | YesNo | YesNo | ||
Ownership | Private: _______________Public: _______________ | Private: _______________Public: _______________ | ||
Webmaster contact info | Name: Address: Email: | Name: Address: Email: | ||
Date information was posted | mm/dd/yr | mm/dd/yr | ||
Date site was last updated | mm/dd/yr | mm/dd/yr | ||
Credibility of information | ||||
Is the information current? | YesNo | YesNo | ||
Is it clear who wrote the page/information? | Name: Email: Credentials: | Name: Email: Credentials: | ||
Is the writer qualified to discuss the topic? | YesNo | YesNo | ||
Is there bias, opinions? | YesNo | YesNo | ||
Is the information referenced, reliable, and accurate from print/published research? | YesNo Describe your answer: | YesNo Describe your answer: | ||
Are the sources current and well-documented? | YesNo | YesNo | ||
Are there links to more resources? | YesNo | YesNo | ||
What is the purpose of the information? Check all that apply. | InformPersuadeSell | ExplainDiscloseAdvertise | InformPersuadeSell | ExplainDiscloseAdvertise |
Sponsorship | ||||
Is the sponsor clearly identified? | YesNo | YesNo | ||
Is there an advisory board or are there consultants? | YesNo | YesNo | ||
Are the partnerships or advertisements clear? | YesNo | YesNo | ||
Is the information usable based on the above? | YesNo | YesNo | ||
PART F. Skill 4. Applying the Results of the Appraisal, or Evidence, in Clinical Practice
1a. Outcome Measures for Article #1
CER | EER | ARR | RR | RRR | OR | NNT | Sensitivity | Sensitivity | NPV | PPV |
2a. Questions to ask prior to applying evidence to practice for Article #1 Rationale
Are the study groups similar enough to apply to the patient? | Yes | No | |
Is this available, affordable, and appropriate for the patient in this setting? | Yes | No | |
Will this help the patient meet his/her goals/address his/her chief complaint? | Yes | No | |
Is the difference large enough to warrant the treatment? | Yes | No | |
Are there adverse events that influence a potential recommendation? | Yes | No |
1b. Outcome Measures for Article #2
CER | EER | ARR | RR | RRR | OR | NNT | Sensitivity | Sensitivity | NPV | PPV |
2b. Questions to ask prior to applying evidence to practice for Article #2 Rationale
Are the study groups similar enough to apply to the patient? | Yes | No | |
Is this available, affordable, and appropriate for the patient in this setting? | Yes | No | |
Will this help the patient meet his/her goals/address his/her chief complaint? | Yes | No | |
Is the difference large enough to warrant the treatment? | Yes | No | |
Are there adverse events that influence a potential recommendation? | Yes | No |
1c. Outcome Measures for Article #3
CER | EER | ARR | RR | RRR | OR | NNT | Sensitivity | Sensitivity | NPV | PPV |
2c. Questions to ask prior to applying evidence to practice for Article #3 Rationale
Are the study groups similar enough to apply to the patient? | Yes | No | |
Is this available, affordable, and appropriate for the patient in this setting? | Yes | No | |
Will this help the patient meet his/her goals/address his/her chief complaint? | Yes | No | |
Is the difference large enough to warrant the treatment? | Yes | No | |
Are there adverse events that influence a potential recommendation? | Yes | No |
1d. Outcome Measures for Article #4
CER | EER | ARR | RR | RRR | OR | NNT | Sensitivity | Sensitivity | NPV | PPV |
2d. Questions to ask prior to applying evidence to practice for Article #4 Rationale
Are the study groups similar enough to apply to the patient? | Yes | No | |
Is this available, affordable, and appropriate for the patient in this setting? | Yes | No | |
Will this help the patient meet his/her goals/address his/her chief complaint? | Yes | No | |
Is the difference large enough to warrant the treatment? | Yes | No | |
Are there adverse events that influence a potential recommendation? | Yes | No |
1e. Outcome Measures for Article #5
CER | EER | ARR | RR | RRR | OR | NNT | Sensitivity | Sensitivity | NPV | PPV |
2e. Questions to ask prior to applying evidence to practice for Article #5 Rationale
Are the study groups similar enough to apply to the patient? | Yes | No | |
Is this available, affordable, and appropriate for the patient in this setting? | Yes | No | |
Will this help the patient meet his/her goals/address his/her chief complaint? | Yes | No | |
Is the difference large enough to warrant the treatment? | Yes | No | |
Are there adverse events that influence a potential recommendation? | Yes | No |
3. Using evidence-based decision-making, scientific evidence is only one component to the decision-making process. Please synthesize all four of the components to decide on a course of action for your patient.
Summary of Scientific Evidence: | Summary of your Experience/Judgment: | Summary of Patient Preferences/Values: | Summary of Clinical/Patient Circumstances: |
Overall Recommendations to the Patient based on the EBDM Process: |
PART G. Skill 5. Evaluating the Process and Your Performance
Rate your performance of each aspect of EBDM by identifying where you are on the competence continuum. Outline how you plan to strengthen your weaknesses in the comments section.
Novice | Beginner | Competent | Proficient | Expert |
Lacks full understanding, requires frequent guidance, and need to learn theory and rules | Understands the theory but cannot always connect it to practice | Integrates theory and practice and demonstrates the basic abilities of EBDM | Makes analytical thinking with intuitive experience with greater depth and breadth of understanding in a wide range of cases | Effortlessly completes tasks as normal, blending the highest level of judgment and skill |
Skill 1. Converting information Needs/Problems into Clinical Questions So That They Can Be Answered
Rate your level of ability to: | Novice | Beginner | Competent | Proficient | Expert |
Define the specific PICO components | |||||
Formulate a well-built question derived from a patient case using the PICO format | |||||
Identify additional keywords based on PICO | |||||
Identify inclusion criteria | |||||
Use the PICO process for your own questions | |||||
Use the PICO process with staff, students, colleagues | |||||
Comments: |
Rate your level of ability to: | Novice | Beginner | Competent | Proficient | Expert |
Distinguish between publication types | |||||
Identify and select appropriate study designs according to the type of question being asked | |||||
Define the levels of evidence | |||||
Comments: |
Skill 2. Conducting a Computerized Search with Maximum Efficiency for Finding the Best External Evidence with which to Answer the Question
Rate your level of ability to: | Novice | Beginner | Competent | Proficient | Expert |
Identify inclusion criteria | |||||
Use PubMed to search the literature | |||||
Identify MeSH with the PubMed MeSH database | |||||
Use MeSH terms when searching | |||||
Combine search terms with Boolean Operators | |||||
Limit the search based on inclusion criteria | |||||
Track the process with the Search History | |||||
Search different/multiple databases | |||||
Comments: |
Skill 3. Critically Appraising the Evidence for Its Validity and Usefulness
Rate your level of ability to: | Novice | Beginner | Competent | Proficient | Expert |
Identify where the selected study is in the hierarchy of levels of evidence | |||||
Screen and select appropriate abstracts | |||||
Critically appraise the validity of research studies | |||||
Use evidence to answer a PICO question | |||||
Comments: |
Skill 4. Applying the Results of the Appraisal, or Evidence, in Clinical Practice
Rate your level of ability to: | Novice | Beginner | Competent | Proficient | Expert |
Incorporate EBDM into practice | |||||
Present Research findings to patient | |||||
Use the scientific evidence as a resource in clinical decision-making | |||||
Comments: |
Skill 5. Evaluating the Process and Your Performance
Rate your level of ability to: | Novice | Beginner | Competent | Proficient | Expert |
Conduct a self-evaluation | |||||
Make improvements based on past experience | |||||
Identify additional learning needs | |||||
Comments: |