Discuss the difference between external and internal evidence as it relates to your PICOT search strategy. PICOT ; Urinary Tract Infections Address the strengths and weaknesses of searching in a databank versus a web-based search engine. You must use two databanks mentioned in the text. Examples of databases include PubMed, Cochrane literature, and CINAHL
Introduction:
When conducting a research study, it is essential to use different types of evidence to support the research question and findings. In evidence-based practice, two types of evidence commonly used are external evidence and internal evidence. External evidence refers to evidence from external sources, such as published research articles, while internal evidence refers to evidence from clinical experience and expert opinion. In this discussion, we will explore the difference between external and internal evidence in the context of a PICOT search strategy for urinary tract infections (UTIs). Additionally, we will evaluate the strengths and weaknesses of searching in a database compared to a web-based search engine, specifically focusing on two databases: PubMed and Cochrane Library.
External Evidence in PICOT Search Strategy:
External evidence is crucial in a PICOT search strategy as it provides scientific knowledge and research findings that help answer the research question. It includes published research articles, systematic reviews, and meta-analyses that have been critically appraised for their validity and applicability. External evidence is particularly important in evidence-based practice as it supports decisions made in patient care, ensuring that interventions and treatments are backed by reliable research.
In the context of UTIs, a PICOT search strategy might include keywords such as “urinary tract infection,” “treatment,” and “intervention.” Using these keywords, a search can be conducted in databases like PubMed and Cochrane Library, which are highly regarded for their collection of academic and peer-reviewed research articles. The external evidence gathered from these databases is essential in understanding the efficacy of different interventions for UTIs, such as antibiotic therapy, preventive measures, or alternative treatments.
Internal Evidence in PICOT Search Strategy:
Internal evidence, on the other hand, is based on the clinician’s level of expertise, experience, and patient preferences. It involves the clinician’s own clinical knowledge, skills, and judgment, along with considering the patient’s values and circumstances. Internal evidence is often used when external evidence is insufficient or when there is a need for tailoring interventions to meet individual patient needs.
In the case of a PICOT search strategy for UTIs, internal evidence might come from a clinician’s experience in managing UTIs, their knowledge of patient preferences, and the unique characteristics of the patient population. For instance, a clinician may have noticed through practice that certain antibiotics are more effective for treating UTIs in pregnant women, even if the external evidence does not explicitly support this finding. Such internal evidence can be valuable in providing personalized care and making decisions in situations where external evidence is limited or lacking.
Strengths and Weaknesses of Searching in Databases versus Web-based Search Engines:
Databases like PubMed and Cochrane Library are commonly used for conducting systematic reviews, literature searches, and evidence synthesis. These databases have several strengths, such as their extensive coverage of scholarly literature, peer-reviewed articles, and their focus on evidence-based medicine. PubMed, for example, is maintained by the National Library of Medicine and provides access to a comprehensive collection of biomedical literature. Cochrane Library, on the other hand, specializes in systematic reviews, including protocols and clinical trials.
One of the strengths of searching in databases is the ability to apply filters and advanced search techniques to refine the search results. These filters can include publication dates, study types, and study populations, helping researchers quickly identify relevant articles. Additionally, databases like PubMed and Cochrane Library typically have a rigorous peer-review process, ensuring the quality and validity of the included articles. This adds to the credibility and reliability of the evidence gathered.
However, there are also some limitations to using databases for literature searches. One challenge is that databases only include published and indexed articles, which means that some relevant studies may be missed if they are not published or included in the database. Additionally, accessing full-text articles may require subscription fees or institutional access, limiting the availability of certain articles to researchers who do not have access to these resources. Lastly, databases may have a time lag in terms of including the most recent studies, as it takes time for articles to go through the publication process and be added to the database.
In contrast, web-based search engines like Google Scholar offer a broader range of sources, including non-peer-reviewed articles and gray literature. This can be advantageous in finding newer, unpublished studies or reports that may not be indexed in databases. However, a major limitation is the lack of quality control and peer-review process in web-based search engines, which means the reliability and validity of the information found may vary significantly. Researchers need to critically evaluate the sources and information obtained from web-based searches.
Conclusion:
In conclusion, external evidence obtained from databases like PubMed and Cochrane Library plays a crucial role in supporting a PICOT search strategy for urinary tract infections. External evidence provides reliable, published research articles that help answer research questions and support evidence-based decision-making. On the other hand, internal evidence, including clinical expertise and patient preferences, can complement external evidence and guide personalized patient care. When utilizing databases or web-based search engines, it is essential to consider their strengths and weaknesses, such as comprehensiveness, quality control, and access limitations. Researchers should critically evaluate the evidence obtained from these sources to ensure its reliability and applicability in practice.