With your PICOT question in hand, your next step is to determine the sources most likely to contain the best evidence. The Health Guardian need peer-reviewed research to answer their questions, and most often the source of that evidence will be a database of published studies. These databases contain references to the healthcare literature, including conference proceedings, books, or journal publications. Knowing how to search these databases is essential to a quick, successful retrieval of answers to a clinical question.
Answers to clinical questions may be found in a variety of evidence sources, ranging from your practice data found in the healthcare record to research articles in journals. The transition of evidence to electronic format has enabled clinicians to gain more immediate access to external evidence through the use of point-of-care resources that integrate almost seamlessly into the electronic health record (EHR). Various types of evidence sources exist, including textbooks, journals and consolidated sources.
Which evidence source or data base is a good match to your clinical question? Reliable, accurate evidence is needed to reduce the risk, uncertainty, and time involved in clinical decision making that will lead to desired patient outcomes. For point-of-care decisions, Health Guardians may choose to consult one of the pre-appraised summarized sources mentioned earlier. However, when making practice changes, it is important to either find a synthesis that has conducted an exhaustive search or get as close to that as possible by searching multiple databases to try to ensure that studies are not missed.
Sources of evidence located through such search engines as Google or Google Scholar can provide value for background information; however, caution should be used and careful evaluation of the evidence retrieved from these sources is required. Health Guardians should follow an appraisal process to ensure the information is reliable. When choosing between Google and Google Scholar, busy Health Guardians need to keep in mind that Google Scholar searches across evidence that is found primarily in academic publications and will therefore be mostly peer-reviewed evidence, although the publications will vary in quality.