THE QUALITY ISSUE: THE NEED FOR SYSTEMATIC SEARCH STRATEGIES, CRITICAL APPRAISAL AND HIERARCHY LEVELS OF EVIDENCE

BY NICK DINSDALE, BSc

INTRODUCTION Few of us would argue with the importance of evidence-based practice (EBP) in sports medicine, but to develop such a culture we must have good- quality research literature (1). Research is simply a way of solving problems. Questions are raised, and methods are devised in an attempt to answer them (2). Research enables us to convert theory into practice in order to solve clinical problems. Research in medicine and the sciences has developed within a framework of thinking known as the “scientific method”. This framework has become the predominant model for rigorous research investigation. Unfortunately, owing to the vast quantities of research material now available, searching and locating relevant literature can be difficult and is often very time-consuming. Furthermore, the quality of research evidence cannot always be relied upon for EBP. This article attempts to identify some of the typical pitfalls and discusses the research skills required for EBP.

SYSTEMATIC SEARCH STRATEGIES

The ability to conduct a literature search is an important skill (3) because the underpinning of EBP now relies on new skills – those of searching for research evidence, and those involved in critical appraisal of evidence (4). Efficient search strategies offer the opportunity to source relevant research, of potentially high quality, in the most time-efficient manner. There are several strategies for

conducting a literature search, including searching with the help of a computer, cross-checking references lists, and hand-searching personal files (4). Caution should be exhibited when

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Evidence-based practice is an important aspect of sports medicine, but such practice requires good-quality research literature. The vast quantities of research material available make searching and locating relevant literature difficult and time-consuming. In addition, not all research evidence is of a high quality, and therefore cannot be relied upon for use in evidence-based practice. In this article we identify some of the typical pitfalls of research and discuss the research skills required in order to practise in an evidence-based manner.

using general Internet search engines such as Google or Yahoo!, particularly when gathering evidence on medical care issues. Although these search engines are attractive and easy to use, they often retrieve non-scientific, low- quality information (5). Internet search engines suffer from a lack of overall quality control, and the information continued therein is often incomplete because authors and publishers are reluctant to give away information free of charge. For most topics, computerised searches of medical scholarly databases such as MEDLINE, EMBASE, CINAHL, and SportDiscus offer the greatest potential yield, convenience and effective use of time. For randomised controlled trials and systematic reviews in physiotherapy,

the PEDro database and the Cochrane Library Database of Systematic Reviews and Controlled Trials Register are useful (6).

Databases of primary research

are staggeringly large: in 2005 there were more than 12 million citations in MEDLINE and 7 million in EMBASE. Simply searching using free text can give the impression that searching in the medical literature databases is easy. However, this is wrong; we still have to know how to formulate systematic search strategies in each particular database in order to identify reliable research (7). Identifying keywords forms part of a search strategy (8) but often results in a large number of false hits. Most scholarly databases offer the option of searching

sportEX dynamics 2008;18(Oct):10-13