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Abstract
Background: evidence-based healthcare decisions has been an established method of how to practice medicine since the first years of 1990, and accepted as a new paradigm, but in many low- and low-to-middle-income countries, the teaching of the necessary skills to find and comprehend and appraise the evidence has not yet been introduced in the pre-graduate nor the postgraduate curricula. Isolated groups of healthcare professionals with the necessary competencies and knowledge promote workshops that are difficult to access due to a schedule conflict with work and time dedicated to continuous medical education. Internationally there are many other books, but they are written in English and at a more elevated level of performance. The lack of using evidence for decision making in health care has shown medical practice variations, which produce inequity, injustice in healthcare delivery and a waste of resources for healthcare systems.
Objectives: share insights for writing a book about how to develop the necessary skills for critically reading biomedical literature in a low-to-middle income country, and in Spanish.
Methods: after a systematic search of books on critically reading medical evidence, accessible in my country, I decided to write a book with the aim of reaching those who have never read or heard about 'evidence-based healthcare'. I decided on four essential elements or components of the book, which will be equally distributed between the four known phases: how to identify and structure the PICO (population, intervention, comparison, outcome) question, how to navigate in our electronic databases in order to find the necessary information efficiently, to critically appraise the found documents, and a minimum understanding of statistics. There was a systematic strategy to look for and find the theoretical basis for the book.
Results: I wrote the book with the following sequence: an introduction that explained the origins of the change of paradigm in decision making in health care, the definition of evidence-based medicine and especially of critically reading. Then there is an exposure to the methodology for critically reading. How to construct answerable clinical questions and the PICO format with the different types of questions (etiology, diagnosis, therapeutic and prognosis); about databases of literature, search engines, filters (clinical queries), thesaurus and Booleans; about bias and precision, internal and external validity, some elemental notions about methodological designs and critical appraisal of literature; about P value, relative and absolute risks.
Conclusions: the book fulfils the need for textbooks in the area of critically reading in the context of countries with difficulties introducing the teaching of necessary skills for critically reading the literature.
Patient or healthcare consumer involvement: in promotion and dissemination of the book as a useful tool for every interested person in need of medical information and not only for healthcare providers.
Objectives: share insights for writing a book about how to develop the necessary skills for critically reading biomedical literature in a low-to-middle income country, and in Spanish.
Methods: after a systematic search of books on critically reading medical evidence, accessible in my country, I decided to write a book with the aim of reaching those who have never read or heard about 'evidence-based healthcare'. I decided on four essential elements or components of the book, which will be equally distributed between the four known phases: how to identify and structure the PICO (population, intervention, comparison, outcome) question, how to navigate in our electronic databases in order to find the necessary information efficiently, to critically appraise the found documents, and a minimum understanding of statistics. There was a systematic strategy to look for and find the theoretical basis for the book.
Results: I wrote the book with the following sequence: an introduction that explained the origins of the change of paradigm in decision making in health care, the definition of evidence-based medicine and especially of critically reading. Then there is an exposure to the methodology for critically reading. How to construct answerable clinical questions and the PICO format with the different types of questions (etiology, diagnosis, therapeutic and prognosis); about databases of literature, search engines, filters (clinical queries), thesaurus and Booleans; about bias and precision, internal and external validity, some elemental notions about methodological designs and critical appraisal of literature; about P value, relative and absolute risks.
Conclusions: the book fulfils the need for textbooks in the area of critically reading in the context of countries with difficulties introducing the teaching of necessary skills for critically reading the literature.
Patient or healthcare consumer involvement: in promotion and dissemination of the book as a useful tool for every interested person in need of medical information and not only for healthcare providers.
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