Search for reliable information on current issues of children outpatient management (based on evidence medicine) Prepared by Muratova Feruza (541 GM) Checked by Ospanova AS

Evidence based medicine (EBM) is the conscientious, explicit, judicious and reasonable use of modern, best evidence in making decisions about the care of individual patients. EBM integrates clinical experience and patient values with the best available research information. It is a movement which aims to increase the use of high quality clinical research in clinical decision making. EBM requires new skills of the clinician, including efficient literature-searching, and the application of formal rules of evidence in evaluating the clinical literature. The practice of evidence-based medicine is a process of lifelong, self-directed, problem-based learning in which caring for ones own patients creates the need for clinically important information about diagnosis, prognosis, therapy and other clinical and health care issues.

Cohort studies Cohort methodology is one of the main tools of analytical epidemiological research. The word cohort is derived from the Latin word cohors meaning unit. The word was adopted in epidemiology to refer a set of people monitored for a period of time. In modern epidemiology, the word is now defined as group of people with defined characteristics who are followed up to determine incidence of, or mortality from, some specific disease, all causes of death, or some other outcome (Morabia, 2004). In cohort studies, individuals are identified who initially do not have the outcome of interest and followed for a period of time. The group can be classified in sub sets on the basis of the exposure. For example, a group of people can be identified consisting of both smoker and non-smoker and followed them for the incidence of lung cancer. At the beginning of the study none of the individuals have lung-cancer and the individuals are grouped into two sub sets as smoker and non- smoker and then followed for a period of time for different characteristics of exposure such as smoking, BMI, eating habits, exercise habits, family history of lung cancer or cardiovascular diseases, etc. Over the time, some individuals develop the outcome of interest. From the data collected over time, it is convenient to evaluate the hypothesis whether smoking is related with the incidence of lung cancer. The following schematic shows the basic design of a cohort study. There are two types of cohort studies: prospective and retrospective. A prospective study is conducted at present but followed up to future i.e., waiting for the disease to develop. On the other hand, a retrospective study is carried out at present on the data collected in the past. This is also called as historic cohort study. In the next blog, I will discuss these in detail.

Randomised controlled trials (RCTs) are a type of clinical trial. RCTs aim to make a fair comparison between a new treatment and the existing treatment, or between two (or more) existing treatments, to see which one works best. A controlled trial compares two or more groups of people: one or more experimental group(s) who receive a new treatment, and a control group, who receive the current standard treatment (which might be the best existing treatment, no treatment or a placebo). Information from the follow-up of the control group allows the researchers to see whether the new treatment(s) they are testing are any more or less effective than the existing treatment. The decision about which treatment each participant in a randomised controlled trial receives is made at random – based on chance, rather than decided by the doctor or participant. This process is called randomisation. Randomisation ensures that the two (or more) groups of people in a trial are as similar as possible, except for the treatment they receive. This is important because it means that researchers can be sure that any differences in outcomes between the groups are therefore only due to the treatment received. Randomized controlled trials (RCTs) are accepted as the gold standard for providing the best evidence for research

7 reliable search engines for your health writing 1. PubMed PubMed is probably the first online search engine that comes to mind for health writers. It is a free online archive of medical journal articles maintained by the United States National Institutes of Healths National Library of Medicine (NLM). It contains over 25 million records and searches several databases – including interfacing with MEDLINE and other publications by the NLM, such as MedlinePlus. You can easily refine your search per topic in PubMed by typing search terms to the MeSH (Medical subject text heading) to filter results and find specific journal articles. Having two or three go-to medical journal search engines can help you consistently source quality evidence.CLIC 2. Ovid If you have a login access from your institution, there are other search engines that search MEDLINE, such as Ovid, Ebscohost and ProQuest. Ovid is a comparable search engine to PubMed. Its advantage over PubMed is it searches more databases in addition to MEDLINE, including EMBASE and the Cochrane Database of Systematic Reviews (CDSR). This means that your search will expand to include more results giving you more evidence to use for your writing.

3. Web of Science Web of Science uses a large database of 8,700 international scientific journals from Thomson Reuters. The database includes a large number of international publications from Asia and requires a subscription to access the articles. Web of Science has a useful database to search for scholarly research data on emerging trends if youre writing protocols or guidelines. It covers over 250 disciplines in science, social science, arts and humanities. 4. Science Direct You may already be familiar with ScienceDirect. It is a full text scientific database, which can really help your writing when you need to read more than the abstract. The search engine allows you to find articles in over 3,800 science, technology and medicine journals owned by academic publisher Elsevier. Another similar portal is SpringerLink that has access to over five million articles in journals operated by publisher Springer.

5. Scopus In 2006, an American researcher authored a review suggesting that, if you regularly use Web of Science to search for articles, Scopus can be a great complement – as neither resource includes everything published. Scopus is a large database of over 60 million peer-reviewed literature also owned by Elsevier. Scopus interfaces with the EMBASE and MEDLINE databases to search records for journal articles. You can access the full-text articles from more than 4,200 full-text journals, however login may be required via a subscription for some full- text journal articles. 6. Cochrane Library If youre looking for systematic reviews or meta-analyses, you should search the Cochrane Library. In addition to results obtained from the Cochrane Database of Systematic Reviews (CDSR), Cochrane library search results can also include control trials in MEDLINE and EMBASE, Cochrane protocols and editorials. Cochrane library is a subscription-based search platform. However, some open-access articles may be retrieved, depending on when the article is published.

7. Google Scholar Google Scholar is a free medical journal search engine indexing journal articles from a variety of databases. If you regularly use Google to search online, using Google Scholar will come quite naturally and you can easily navigate and filter the results to suit your search. Google Scholar Google Scholar is a great secondary search engine to use after your initial search. If youre having trouble finding an article, often a search in Google Scholar can help you find the article.

In this presentation I tried to summarize the most important points of searching reliable modern data on children outpatient management. All these resources can help you in case if you are fully capable to understand scientific articles. International and national guidelines are also a good resource of evidence based data.

References 1. Evidence Based Medicine – New Approaches and Challenges Izet Masic, Milan Miokovic, and Belma Muhamedagic Izet MasicMilan MiokovicBelma Muhamedagic 2. journal-search-engines/ 3. als/what_is_a_randomised_controlled_trial/