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Listed below are a few tutorials to help you use the PC Library databases to find evidence.
Evidence-based practice is the process by which health care providers incorporate the best research or evidence into clinical practice, and combine that with clinical expertise and within the context of patient values.
Franz, J. F., & Mertz, L. (2020). Evidence-Based Practice. In J. L. Longe (Ed.), The Gale Encyclopedia of Medicine (6th ed., Vol. 3, pp. 1920-1923). Gale.
The American Dental Association (ADA) defines Evidence-based Dentistry (EBD) as “an approach to oral healthcare that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient’s oral and medical condition and history, with the dentist’s clinical expertise and the patient’s treatment needs and preferences.” - ADA Center for Evidence-Based Dentistry
Image from ebd.ada.org
Evidence-based practice involves 5 steps:
1. Ask a focused question to satisfy the health needs of a specific patient using the PICO model.
2. Find the best evidence by searching the literature.
3. Critically appraise the literature, testing for validity, clinical relevance, and applicability.
4. Apply the results in clinical practice based on clinical expertise and patient concerns.
5. Evaluate the outcomes in your patient.
Adapted from Rio Salado Community College Library's Dental Hygiene (DHE) Research Guide, which is adapted from Introduction to Evidence-Based Practice.
To find research efficiently, you must ask a well-designed question that will lead to finding relevant sources. It is important to know the difference between a background or foreground question. From there, you can then decide which type of question you have and find the best research literature to answer your question.
Background questions:
Foreground questions:
The PICO model is designed to help you define and answer your patient-centered question. A well-formulated question will help in building your search and finding information.
Here is an example from the University of Michigan Library of how to use PICO components to break your research question down into parts (keywords or phrases). Click through the tabs in this box to review the steps in the process.
Mark McGee – a 70-year-old male – is concerned about his bad breath. You tell him that he wouldn’t have much to be concerned about if he only brushed his teeth. He doesn’t believe you and says, “show me the evidence!”
Based on the clinical scenario above:
Not all of these terms will be used directly in the search, but it's good to be aware of all potential search terms.
Here is the question that you will base your search on.
For adult patients, will the use of toothbrushing, compared with doing nothing [i.e., what the patient is currently doing], result in reduction of bad breath?
The keywords that were created using PICO can then be used to search for evidence-based research in databases. Synonyms, words that mean the same thing or are closely related to each other, can help expand your search appropriately.
For this search, the synonyms are:
| Keyword | Synonym |
| bad breath | halitosis |
| toothbrushing | oral hygiene |
You could also use terms such as mouth rinses or toothpaste.
Here are the terms (also known as a "search string") that will be used to search the database:
("bad breath" OR halitosis) AND (toothbrushing OR "oral hygiene")
Bad breath & halitosis are synonyms for one concept, so they're connected by the Boolean operator OR & placed within parentheses.
Toothbrushing & oral hygiene are synonyms for the second concept. They're connected to the first concept with the Boolean operator AND.
To learn more about using Boolean operators, visit the Search for Resources section of this guide.
An evidence pyramid is a visual representation of the hierarchy of evidence that helps you to recognize both the quality of evidence and the amount of evidence available at each level. As an example, systematic reviews are at the top of the pyramid, meaning they are at the highest level of evidence, but they offer the least amount of resources. As you go down the pyramid, the amount of evidence will increase as the quality of the evidence decreases. Here is one example of an evidence pyramid:
