Evidence Based Practice in Athletic Training - 2

The first of these databases is CINAHL (Proquest). This database covers literature from English nursing journals and primary journals from thirteen allied health disciplines including Athletic Training and Physical Therapy. There is also selective coverage of journals in biomedicine, behavioral sciences, management, and education.(2,3) This database is particularly useful because it provide abstracts as well as full text articles.

The second database of choice is MEDLINE/Pub-Med. This database comes from the National Library of Medicine (NLM) that provides the most comprehensive listing of biomedical and health related journal citations and abstracts. MEDLINE covers nearly 4,500 journals published in the United States and more than 70 other countries, which date back to 1966.(4) The majority of publications in MEDLINE are scholarly journals with a handful of magazines and newspapers. MEDLINE is a comprehensive database but has limited access to full text articles.4 MEDLINE searches are routed through PubMed, which is part of the NLM and offers expanded options for searching.

The third database of choice is the Cochrane Library. This database consists of a regularly updated collection of evidence-based medicine literature, which features comprehensive reviews and analysis. The reviews are highly structured and systematic, providing the reader with a comprehensive summary of the literature pertaining to the effects of healthcare interventions.(5)

All three databases do provide help sections that explain the process of searching in a systematic format. Another great source of information is the librarian at the university, college, or public library. They may have access to tutorials or classes that teach strategies for online database searching.

Plan Search Strategy
Once the databases are selected, establishing a systematic search strategy is necessary to optimize time and effort. Establishing a list of key words and phrases that are relevant to the topic would help speed up the process. The focus of the clinical question is to find evidence that supports the use of ankle bracing to prevent sprains. The following key words and phrase will be used in the search.

1. Key Words- Ankle Bracing, Ankle Supports, Ankle Prophylaxes
2. Key Phrases- Prevention of Ankle Sprains, Treating and preventing ankle

Now that the key words and phrases are intact, let the search begin!
With searching all three databases the use of the key words were more effective than the key phrases. The key words of Ankle Bracing and Ankle Supports yielded the most articles or “hits”. The key phrases only produced articles that were relevant to the mechanisms of ankle sprains not to clinical question. With each of the databases, the focus was to find literature from peer-reviewed journals. Most databases have options for peer review searches. Peer reviewed journals typically have an expert editorial panel that evaluate the literature to ensure accuracy and quality of work. A good example would be the Journal of Athletic Training or the Journal of the American Medical Association. All three databases produced literature that was peer reviewed and relevant to the topic. The results are as follows:

1. MEDLINE/PubMed- 201 hits
2. CINAHL- 52 hits
3. Cochrane Library-4

As one can see, there is a large amount of available literature. The search needed to be narrowed to literature that would directly answer the clinical question. Review or secondary articles would be the literature of choice for the clinical example. Review articles are literature that interpret and analyze the original work from other authors. If one would look at the bibliography of the article, you would notice that the author’s research was based on other primary and secondary recourses. In the clinical example, review articles will provide the most relevant research in a consolidated format. Review articles are nice because the author gathers original work, analyses the results, presents different sides of the argument, and establishes an opinion or recommendation on the subject.

If time is not a factor, reading original research can be very helpful and educational. Primary research gives the practitioner original findings, new ideas, and presents recommendations for future research.

Evaluation of Literature
The results of searching all three databases yielded three review articles that analyze the most relevant literature from peer-reviewed journals. The next task is to evaluate the articles to see if the evidence supports the intervention. Next is a listing of the article citations with a summary of the authors’ findings.

Thacker SB, Stroup DF, Branche CM, Gilchrist J. The prevention of ankle sprains in sports: A systematic review of the literature. The Am J of Sports Med., Nov/Dec 1999;Vol. 27, Iss. 6; pg. 753, 8 pgs