EBM Search Process

Bench Research

John, S. C., John, A. V., Moss, A. W., Gustafson, P. A., Fernando-Silva, L., & John, S. P. (2020). Bench testing of a bubble noninvasive ventilation device in an infant lung simulator. Respiratory care, 65(9), 1339-1345. https://doi.org/10.4187/respcare.07346

The study was a comparative assessment of the performance of the nonelectric bubble non-invasive positive pressure ventilation (NIV) against the commercially available ventilators. Ventilation remains a critical component of managing neonatal and infantile respiratory distress due to a wide range of causes. The use of either invasive or non-invasive is informed by the condition at hand, its severity and availability of equipment and expertise.

EBM Search Process

The study employed an infant lung simulator to depict varying degree of respiratory distress by using different degrees of resistance and compliance settings for the lungs, and delivering varying pressure amounts using the NIV device and the 2 comparison ventilators. Similarity of pressure waveforms and tidal volumes delivered were then assessed. The conclusion was that the NIV device and the ventilators had near similar tidal volumes delivered and pressure waveforms, hence the recommendation of the NIV as an adjunct for management of infants with respiratory distress in resource-limited settings since it is simple.

Strengths and Weaknesses of Review Article

Article review represent a more recent entrant into the evidence-based practice arena. It involves re-assessing and compiling the research findings from one or more similar research data for purposes of gaining more insight into the variable under study through establishment of patterns, shortfalls and strength of evidence……………. When used in studies that are randomized controlled, it is termed metaanalysis and forms the highest quality of evidence available and can be used to inform policy decisions. Article reviews are important in critiquing the methodology and study processes of various research work as well.

Strengths

It effectively summarizes the main ideas of a research output, putting them in a clear position more extensive analysis. Also, by providing a platform to critique the research venture’s methodology and findings, article reviews form an important aspect of assessing the effectiveness of a research findings, and its contribution to the field (Aveyard & Bradbury-Jones, 2019).

Article review also forms an assortment of extensive data on the subject of the research being reviewed, since the critique is based on thoughtful deduction as well as methodological reasoning accompanied by existent proven findings form other researches (Aveyard & Bradbury-Jones, 2019; Xiao & Watson, 2019). Importantly, if any weaknesses or flaws are noted during the review process, they are noted and put out to prevent a cascading of mistakes in research.

Weaknesses

In reviewing articles, it is important that the reviewer possesses both the know-how of reviewing and knowledge of the subject matter. When either is unavailable or inadequate, then the review process becomes marred with inefficiencies (Xiao & Watson, 2019). Further, some reviews may present only a single or limited viewpoint of the reviewer if most factors are not considered, especially since much credence is also lent to subjective reasoning.

Where multiple studies are involved, such as in metaanalyses, it is essential to factor in time changes in the analyses since varied outcomes between studies done 20 years ago may just be due to the influence of time, and the accompanying evolution (Xiao & Watson, 2019). Also, reviewing multiple studies, each with a structural and methodological flaw of its on renders it difficult to make a meaningful conclusion off the review process (Aveyard & Bradbury-Jones, 2019). Finally, other than being cumbersome, proper and multiple reviews are expensive and often need more than one hand-on-deck.

Performing a Search in PubMed

“Does Prone Position in severe ARDS decrease length of mechanical ventilation”?

The above is the clinical question, and searching will involve the following steps (Castagnetti et al., 2019).

Opening the browser and searching for the NCBI page.
On the page that appears, one copies the entire PICO question on the search box, and then searches under the PubMed database by choosing PubMed on the left dropdown menu.
The search results will the post every research article associated with the word (s) in the stem of the PICO used for the search.
To navigate that, use of Boolean operators will be used to refine the search (prone position AND ARDS) as well as (prone position AND length of mechanical ventilation).
To then sift the articles based on information needed, one clicks on the filter option, where they can choose to enlist specific articles based on type of study published, whether it has an abstract or full text, the year of publication, the specific author, journal or language of publication. This helps in narrowing down to articles relevant to the PICO question.
After identification of the articles to be used one can initially retrieve them by checking the abstract or access them through a hospital or health institutional library.

Components of a Clinical Study

Clinical studies are research ventures involving human subjects. Often, clinical studies are used to evaluate parameters such as drug treatment, prevention, diagnostic efficacy, natural history of disease and quality of life (Shrivastava et al., 2015). They have their own set guidelines of performance and components to be adhered to, to ensure maximum outcome and minimize subject harm.

Study Protocol- The WHO recommends that all clinical studies must have a study protocol. That is a document or written plan detailing the nature, goals, duration, design, endpoints and participants of a particular study (Shrivastava et al., 2015). Any tests or procedures also have to be included, as well as data analysis and management.
Inclusion and exclusion criteria- All studies have specific participants chosen from the general population based on particular parameters. Parameters to be met for inclusion or exclusion from the study have to be clearly defined early.
Informed consent- One’s participation in a clinical trial is entirely voluntary, and protected by law. Accordingly, before one is involved, they must be made aware of the entire process in terms of duration, tests, drugs and their dosages, expected side effects or complications and how they will be mitigated (Shrivastava et al., 2015). Consent can be altered at any point in the journey.
Compensation- In studies where this is provided for, it must be clearly described in exact amounts.
Stakeholders- They include the participants, investigators, sponsors, oversight organizations and research organizations.

Databases for Peer-reviewed Literature

Scopus
PubMed
ScienceDirect
EBSCO database
Embase
Cochrane library

References

Aveyard, H., & Bradbury-Jones, C. (2019). An analysis of current practices in undertaking literature reviews in nursing: Findings from a focused mapping review and synthesis. BMC medical research methodology, 19(1), 1-9. https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-019-0751-7

Castagnetti, M., Herbst, K. W., Bagli, D., Beckers, G. M. A., Harper, L., Kaefer, M., … & Fossum, M. (2019). EBM II: How to perform a literature search. Journal of pediatric urology, 15(3), 268-269. https://doi.org/10.1016/j.jpurol.2019.03.006

Shrivastava, S. R. B. L., Shrivastava, P. S., & Ramasamy, J. (2015). Protocol of a Clinical Trial: Elements, Concerns and Potential Solutions. Biology and Medicine, 7(2), 1. https://www.longdom.org/open-access/protocol-of-a-clinical-trial-elements-concerns-and-potential-solutions-0974-8369-1000228.pdf

Xiao, Y., & Watson, M. (2019). Guidance on conducting a systematic literature review. Journal of Planning Education and Research, 39(1), 93-112. https://journals.sagepub.com/doi/full/10.1177/0739456X17723971