Evidence Analysis Library

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EvidenceAnalysisLibrary
Part I

• EAL Part I presentation includes
• List of Current EAL Projects
• Steps in Evidence Analysis Process
• Navigating the EAL

Updated September 2006
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www.adaevidencelibrary.com

Online Resource with the best available
research on important dietetics topics in
a practitioner-friendly format
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Key messages

• Definition
• Why evidence-based practice?
• Current Projects/Topics
• Steps in Evidence Analysis Process
• Example from EAL

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Definition/Description

• Evidence-Based Dietetics Practice
• is the use of systematically reviewed
  scientific evidence in making food and nutrition
  practice decisions
• by integrating best available evidence with
  professional expertise and client values to
  improve outcomes.

Revised by EBP Committee and approved by HOD
Leadership January 2006
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Why Evidence-based Practice?

• To improve patient outcomes
• To improve patient safety the quality
  efficiency of practice
• To take advantage of the exploding body of
  biomedical knowledge
• Thousands of new research studies appear every
  month

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Diseases Conditions
Current EAL Projects

• Chronic Kidney Disease (revision)
• Diabetes 1 2 (revision)
• Disorders of Lipid Metabolism (Hyperlipidemia
  revision)
• Gestational Diabetes (revision)
• revision of 2001 Guidelines (CD format)

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Diseases Conditions
Current EAL Projects (continued)

• Adult weight management
• Determinants of Pediatric Overweight (FNPA)
• Chronic Obstructive Pulmonary Disease (COPD)
• Critical Illness
• Gluten Intolerance/ Celiac
• Heart Failure
• HIV/AIDS

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Diseases Conditions
Current EAL Projects (continued)

• Hydration
• Hypertension
• Nutrition in Athletic Performance
• Nutrition Care in Bariatric Surgery
• Oncology
• Pediatric Weight Management
• Spinal Cord Injury Nutrition
• Unintended weight loss

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Nutrition Care Process
Current EAL Projects (continued)

• Assessment
• Estimating Energy Expenditure/ Indirect
  Calorimetry
• Intervention
• Nutrition Counseling

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Foods
Current EAL Projects (continued)

• Non-nutritive sweeteners

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Nutrients
Current EAL Projects (continued)

• Fiber

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Did you see your project?

• To suggest a new project for possible analysis in
  the future when resources become available, send
  an email to
• topics_at_adaevidencelibrary.com

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Evidence Analysis Process

• Steps in ADAs
• Evidence Analysis Process

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Steps in ADAs Evidence Analysis Process

• Formulate Questions.
• Expert Workgroup defines questions and the
  analytical framework lists keywords for search
  terms, and determines Inclusion / Exclusion
  Criteria for Literature Review.
• Gather and Classify Evidence Reports
• Lead Analyst conducts Literature Review for each
  question records information online in Search
  Plan Results. Work group approves list of
  included articles for analysis.

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Steps in ADAs Evidence Analysis Process

• Critically Appraise Each Report
• Analysts critically review articles and create
  article Worksheets that are reviewed by Lead
  Analysts and expert workgroup.
• Write the Evidence Summary
• Analysts and Lead Analysts complete Evidence
  Summaries and Overview Tables that are reviewed
  and approved by expert workgroup.

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Steps in ADAs Evidence Analysis Process

• Grade the Conclusion Statement
• Workgroup members reach consensus on a brief
  conclusion statement (the answer to the evidence
  analysis question) and assign a grade based on
  the strength and quality of the evidence.

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Next Steps

• Publish online to the EAL
• Question, Conclusion, Grade, Search Plan
  Results, Evidence Summary, Overview Table,
  Article Worksheets, and Quality Checklists are
  published online.
• Position Papers and Guidelines
• Published Evidence Analysis Questions are used
  in ADA position papers and to support guideline
  recommendations.

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Example from EAL
Drill down to the level of detail desired.

• Question
• Conclusion Statement Grade
• Search Plan Results
• Evidence Summary
• Bibliography
• Worksheets Quality Checklists

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Example www.adaevidencelibrary.com
Select Diseases and Conditions tab.
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1. Select a project from list of Diseases
Conditions.
2. Choose a topic
Disorders of Lipid Metabolism (select project)
Macronutrients (choose topic)
3. Choose a sub-topic - if needed
Trans-fatty acids (sub-topic)
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Question
What is the relationship between diets high in
trans fatty acids and serum cholesterol levels?
Bibliography for Topic
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Conclusion Statement/Grade
Mouse over or click on Question to see
Conclusion Grade
Trans-fatty acids raise total cholesterol and
LDL-C. Unlike saturated fatty acids, trans-fatty
acids do not increase and may decrease HDL-C.
Trans-fatty acids increase the TC/HDL-C ratio in
a dose dependent manner. GRADE I
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Search Plan and Results

• Date Searched
• Inclusion Criteria
• Exclusion Criteria
• Search Terms
• Databases searched
• Articles identified from handsearch
• Included Articles
• Excluded Articles with reason for exclusion

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Grades
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Conclusion Grading Table
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Link to Evidence Summary
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Evidence Summary

• Narrative
• Summary
• Of the
• research
• available
• to answer
• question

Evidence Summary
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Page Down Evidence Summary to Bibliography
Bibliography for Question is listed at end of
Evidence Summary (and linked to worksheets)
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Worksheet

• Citation / PubMed ID
• Date
• Study Design
• Class
• Rating (/0/-)
• Research Purpose
• Inclusion Criteria
• Exclusion Criteria
• Description of Study Protocol
• Data Collection Summary
• Description of Actual Data Sample
• Summary of Results
• Author Conclusion
• Reviewer Comments

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Page Down Worksheet toQuality Criteria Checklist
Answers to questions determine the Quality Rating
of Article Positive () Negative (-) Neutral (?)
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Search on EAL
Enter topic and click on Search.
Example low carbohydrate Results Questions,
Evidence Summaries, Worksheets, and Topics that
use the term, low carbohydrate are displayed in
a table. Each is linked to information on EAL.
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Questions ?
Help
Frequently Asked Questions (FAQs)
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Resources

• Check Resources on EAL for additional PowerPoint
  presentations.

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Contact ADA Staff
eal_at_adaevidencelibrary.com
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send feedback to ADA Staff.