The massive explosion of information has made us all a little batty.
*Mr. Ketterman's Case
I know that there is a lot of information that could help me with Mr. Ketterman's care, but it's really hard for me to read and analyze each article, one at a time. Isn't there something that can help me understand if and how I should apply an article to my patients? (See Appendix for Mr. Ketterman's health history.)
There are several sources of information that we can use to help us find and organize evidence for use in daily practice. In Chapter 12 we discussed how to differentiate among individual studies and in Chapter 13 how to assess individual studies. But looking at one study at a time can be time-consuming. The amount of information that is now available is staggering. One analysis of the quantity of material available electronically shows that in 2010 there were over 988 exabytes (1 exabyte equals 1 quintillion bytes) of information available on the Internet. This is equivalent to over 18 million times the number of books ever printed.1 There are now many examples of abstractions of individual studies that help bring some meaning out of this amazing mass of information for clinical practice. In this chapter we will discuss synopses of individual studies (Fig. 14-1).2 As DiCenso et al tell us, "The advantages of a synopsis of a single study over a single study are 3-fold: first, the assurance that the study is of sufficiently high quality and clinical relevance to merit abstraction; second, the brevity of the summary; and third, the added value of the commentary."3
Sources of Information About Evidence. (From DiCenso A, Bayley L, Haynes RB. Accessing pre-appraised evidence: Fine-tuning the 5S model into a 6S model. Evid Based Nurs. 2009;12:99–101.)
Synopses are designed to provide clinicians with direct, quick advice about specific clinical action by providing a brief, focused abstract of a study. A synopsis can be as brief as a single sentence, such as the title of many of the review articles in some evidence based journals. A review of the titles in Box 14.1 shows that while single sentences might provide some general guidance, they usually do not give clinicians sufficient information about the specificity of an intervention to be useful in treatment planning. However, the single sentence can tell clinicians if reading the review, and perhaps the article, would be worthwhile.
Box 14.1 Examples of Single-Sentence Synopses
Review: Oral vitamin D prevents nonvertebral and hip fractures in a dose dependent manner in patients >65years of age (Denman M. EBM. October 2009;14(5):148-149)
Review: Back exercise interventions prevent self-reported episodes of back problems in adults but ergonomic education does not (Margo K. EBM. August ...