Physician Assistant

last modified 2018-08-14T15:23:35-04:00
Capstone Resources

Searching

You must get Institutional Review Board approval for all human subject research.

  • Plan your search first. You can use the PICO Search Strategy Worksheet below to guide the process.
  • Choose databases appropriate to the subject and type of information that you are looking for.
  • Focus on using primary sources that are original research. Refer to the Evidence Pyramid.
  • Take advantage of the Advanced Search Techniques available in many databases.
  • Remember that searching is an iterative process. You will usually need to refine your strategy several times.
  • Pay attention to the indexing terms or assigned subject headings, referenced sources and related citations.

Selecting a Journal

  • Identify potential journals by searching by subject in the National Library of Medicine catalog or WorldCat. Use filters to limit your search to journals currently idexed in Medline. You may want to limit your search to English language journals.
  • Review the Aims and Scopes  and  Author Instructions to ensure that your topic is appropriate and read about the peer review process for the journal.
  • Read the instructions to reviewers as well, and keep these pints in mind as you write your article.
  • Review recent issues to make sure that the journal has not published a similar article recently.
  • Consider the impact factor or relative importance of the journal. You can usually find the impact factor on the publisher's Web site. To compare different journals in a particular subject, use Journal Citation Reports.
  • Other factors to consider include the acceptance/rejection rate, the length of the review process, any author or processing fees, and author rights.

Finding Full Text Articles

  • Be sure you have the correct citation. You can verify many citation using the Single Citation Matcher tool from the National Library of Medicine (PubMed).
  • If there is no link to full text in the searched database, start by looking up the journal name in the E-journals list and look for a resource that provides access to the desired date range.
  • If you do not find the title or date range desired, check the journal name in the library catalog.
  • If you still cannot find the journal, place an article request using the interlibrary loan article request form or ask your librarian for assistance.

Select Capstone Databases

Citing

Citation Managers

  • Citation managers, also known as bibliographic managers or reference management tools, are software applications that assist researchers in all stages of the research process.
  • You have two good choices: EndNote Web is more end-user friendly, but Zotero is more flexible and powerful.

Citation Style

  • The PA Program at Mercer University uses AMA Style. 
  • Different academic disciplines use different citation styles because they cite different types of materials and because they place a higher value on certain criteria.
  • See the References and Style Guides tab for extensive information on using the AMA style.

Core Resources & Selected Textbooks

Selected Textbooks

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  Individual Titles

eBook Collections

References & Style Guides

Online Resources

  • APA Style From the Purdue University writing lab.
  • Citing Medicine The NLM Style Guide for authors, editors, and publishers.
  • Instructions for Authors - Biomedical Publications These pages provide links to Web sites which provide instructions to authors for over 6,000 journals in the health and life sciences. All links are to "primary sources".
    From the Mulford Health Science Library University of Toledo.
  • International Committee of Medical Journal Editors (ICMJE) Uniform Requirements for Manuscripts Submitted to Biomedical Journals (also known as Vancouver style) from the International Committee of Medical Journal Editors. These manuscript guidelines were first developed by a group of medical journal editors in 1978. They have been revised frequently and are currently followed by more than 500 biomedical journals, which include many of the requirements in their instructions to authors.
  • List of Journals Indexed for MEDLINE Journals and their abbreviations from the PubMed Journal Database. Search by topic, title or ISSN, or browse by subject terms.
  • Purdue OWL: Medical Writing Basic suggestions on medical writing
  • Vancouver Style: Sample References From the National Library of Medicine. The International Committee of Medical Journal Editors Uniform Requirements for Manuscripts Submitted to Biomedical Journals - aka Vancouver Style.

Reference Requirements

References serve three distinct purposes:

1) documentation

2) acknowledgement

3) directing readers to additional resources

Authors are solely responsible for the accuracy of references within their work, therefore it is imperative that primary sources are always consulted.

Do not cite a source that you have not examined.

References must include certain data to ensure that the data can be identified and retrieved. Please refer to section 3.4 (p. 42) of the AMA Manual of Style to view the minimum acceptable data for references.

The AMA style divides references into bibliographic groups using a period. Each period separates bibliographic groups, ie. author information, title, publisher information, etc., and sets a sequence of bibligraphic elements. Bibliographic elements refers to the different items within each bibliographic group. Bibliographic elements are differentiated with three different punctuation marks.

Example: Author(s). Article title. Journal name. Year; vol (issue no.):pages.doi.

Use a comma  if items are subelements or closely related elements. For example, up to six author names are separated by comma within the author bibliographic group.

Use a semicolon to separate different types of elements within a bibliographic group. For example, within the publisher bibliographic group, a semicolon is used between the publisher's name and the copyright year. A semicolon is also used to differentiate between logically related elements within a bibliographic group. A semicolon is used before volume identification data.

Use a colon before the publisher's name, between the title and subtitle and after a connecting or explanatory phrase such as Presented at: or Quoted by: or Cited by:.

For additional information, please Section 3.1 (p. 40-41) of the AMA Manual of Style (2007). 

How to cite an e-book in AMA style

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Follow the format for a regular› book, and then add the URL and “Accessed” date at the end.

Example:

Riordan-Eva P, Cunningham ET.  Vaughan & Asbury's General Ophthalmology.  18th ed.  New York, NY: McGraw-Hill; 2012. http://accessmedicine.mhmedical.com/book.aspx?bookid=387.  Accessed January 4, 2016.

Evidence-Based Practice

What is Evidence-Based Practice?

The practice of health care in which the practitioner systematically finds, appraises, and uses the most current and valid research findings as the basis for clinical decisions.  The term is sometimes used to denote evidence-based medicine specifically but can also include other specialities, such as evidence-based nursing, pharmacy, and dentistry.

Source  -  Moby's Medical Dictionary, 8th ed., 2009.


Highly Recommended Databases for Evidence-Based Practice

  • DynaMed
    Medical information database for Point-of-Care reference.
  • PubMed

Evidence-Based Practice Sites

PICO

Pyramid of Evidence

There is a range in quality of evidence available in the literature, with systematic reviews being the very highest quality.  As you move up the pyramid, the amount of literature decreases but its clinical relevance increases.

ebm_pyramid.gif

EBM Pyramid: (c) Copyright 2006 - 2011. Trustees of Dartmouth College and Yale University. All Rights Reserved. Produced by Jan Glover, Dave Izzo, Karen Odato, and Lei Wang.

Sources of research may be either pre-appraised summaries ie. filtered information or unfiltered primary literature.

systematic reviews or meta-analyses Cochrane Library or PubMed
critically-appraised topics Dynamed Plus
randomized controlled trials PubMed
cohort studies PubMed
case-controlled studies etc. PubMed
background info/expert opinion Books, National Guideline Clearinghouse

Study Designs

What type of question are you asking and which would be best to support the evidence? Choose the study design that supports the highest level of evidence.

Type of Question Suggested Type of Study or Methodology 
therapy randomized controlled trial (RCT)
diagnosis prospective, blind comparison to a gold standard
etiology/harm RCT> cohort > case control > case series
prognosis cohort study > case control > case series
quality improvement randomized controlled trial
quality of life qualitative study
cost analysis economic evaluation
clinical exam prospective, blind comparison to gold standard

Adapted from Duke University Medical Center Library's Evidence Based Medicine Resources http://www.mclibrary.duke.edu/subject/ebm/searching/ebmresources.pdf and  Introduction to Evidence Based Practice 5th ed c.2010 http://www.hsl.unc.edu/services/tutorials/ebm/index.htm

 

Types of Study Designs

Case series
A report on a series of patients with an outcome of interest. No control group is involved.

Case-Control Study
Case-control studies begin with the outcomes and do not follow people over time. Researchers choose people with a particular result (the cases) and interview the groups or check their records to ascertain what different experiences they had. They compare the odds of having an experience with the outcome to the odds of having an experience without the outcome.

Cross-sectional study
The observation of a defined population at a single point in time or time interval. Exposure and outcome are determined simultaneously.

Cohort Study
A clinical research study in which people who presently have a certain condition or receive a particular treatment are followed over time and compared with another group of people who are not affected by the condition.

Controlled Clinical Trial
A type of clinical trial comparing the effectiveness of one medication or treatment with the effectiveness of another medication or treatment. In many controlled trials, the other treatment is a placebo (inactive substance) and is considered the "control."

Randomized Controlled Trial
A controlled clinical trial that randomly (by chance) assigns participants to two or more groups. There are various methods to randomize study participants to their groups.

Systematic Review
A summary of the clinical literature. A systematic review is a critical assessment and evaluation of all research studies that address a particular clinical issue. The researchers use an organized method of locating, assembling, and evaluating a body of literature on a particular topic using a set of specific criteria. A systematic review typically includes a description of the findings of the collection of research studies. The systematic review may also include a quantitative pooling of data, called a meta-analysis.

Meta-Analysis
A way of combining data from many different research studies. A meta-analysis is a statistical process that combines the findings from individual studies.

Adapted from Study Designs. In NICHSR Introduction to Health Services Research: a Self-Study Course.  http://www.nlm.nih.gov/nichsr/ihcm/06studies/studies03.html and Glossary of EBM Terms. http://www.cebm.utoronto.ca/glossary/index.htm#top

EBM Tutorials

Evidence-Based Medicine Databases

  • AHRQ's Evidence-based Practice Reports Agency for Healthcare Research and Quality's Evidence-based Practice Centers
  • CINAHL Plus with Full Text Search 800 nursing and allied health journals, nursing dissertations, and selected other biomedical journals. Many fulltext articles available. Limited coverage of psychology and management literature is also included.
  • DynaMed Medical information database for Point-of-Care reference.

Evidence-Based Medicine Internet Resources

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  • Centre for Reviews and Dissemination The CRD databases are updated daily and provide decision-makers with access to: over 9,000 quality assessed systematic reviews, over 11,000 economic evaluations, over 10,000 summaries of completed and ongoing health technology assessments, and summaries of all Cochrane reviews and protocols.
  • Clinical Epidemiology Glossary From the Evidence-Based Medicine Toolkit published by the University of Alberta Faculty of Medicine.
  • Dr. Chris Cates' EBM Web Site The Web site of an EBM practitioner and reviewer for the Cochrane Group. It includes explanations of EBM concepts and links to useful sources.
  • PEDro (Physiotherapy Evidence Database) PEDro is a free database of over 15,000 randomized trials, systematic reviews and clinical practice guidelines in physiotherapy. PEDro is produced by the Centre for Evidence-Based Physiotherapy at The George Institute for International Health.
  • SUMSearch2 From the University of Kansas Medical Center, SUMSearch simultaneously searches for original studies, systematic reviews, and practice guidelines from multiple sources. Searches for studies are revised up to 6 times as needed, while guidelines and systematic reviews may be revised once each.
  • The NNT The NNT (Number Needed to Treat) offers a measurement of the impact of a medicine or therapy by estimating the number of patients that need to be treated in order to have an impact on one person.

Evidence-Based Medicine Tutorials