Finding the evidence

When the Cochrane Collaboration fulfils its quest to organize the available evidence in a registry of trials and systematic reviews, it will mean that our task to find the best evidence will be much less daunting than it may at present seem. Meanwhile, to be evidence-based practitioners, we must learn the techniques that will make our search both comprehensive and efficient. To find this evidence requires: 1. the construction of a specific question based on the clinical problem; 2. the design of a search strategy that is inclusive but practical; 3. the search of the appropriate database(s); 4. the scan of the retrieved abstracts for the most useful papers for critical appraisal. Efficient searching for evidence does mean getting to grips with the manifold advantages that computerization can offer us. The use of a computer for this purpose needs, like any other new technique we take on, practice to gain competence and confidence. Within the UK, the National Health Service Research and Development Department has made the collation and dissemination of clinical evidence to practitioners a priority. Hence at present, there is an enormous effort within the UK to make sure that the evidence is in the clinical areas of need, in a format we can use it and available in a place where and when we want it, whether that is the ward or the general practitioner's surgery. The aim is to remove at least some of the barriers that prevent us from becoming individual evidence-based practitioners.