Searching for evidence to inform clinical practice

Literature search and retrieval are essential steps in evidence-based practice. However, locating the relevant research to answer a specific clinical question can be daunting due to the volume and scattering of published literature. For clinicians, this necessitates the acquisition of basic skills to make literature searching effective and efficient. The first step is to take a hierarchic approach to searching: begin by looking for well-developed guidelines and evidence summaries; these may be found on the websites of various professional bodies. If guidelines and evidence summaries do not exist, searches for well-conducted systematic reviews are likely to give more precise and accurate answers than single studies. Such reviews may be found within databases such as the Cochrane Library or the Reproductive Health Library. If systematic reviews do not exist, a carefully planned search, with appropriate input from a clinical librarian, will need to be carried out in primary bibliographic databases such as MEDLINE and EMBASE. If all else fails, the final port of call will be contacting experts, Internet discussion forums or manufacturers. Once evidence has been obtained, following assessment of its quality, importance and relevance, it may be adopted in practice.