yigityildiz0 Physio Evidence Search
Mandatory first reads
Read safety core and methods and sources. Run the safety gate before searching; an urgent presentation must not wait for literature retrieval.
Workflow
- Classify the decision. Use PICO/PICOTS for interventions; PIRD for diagnostic accuracy; PECO or a prognostic frame for exposure/prognosis; and a construct-population-purpose frame for measurement. Do not force every question into PICO.
- Resolve only decisive ambiguity. Ask one short question if its answer would materially change safety or eligibility. Otherwise state a reasonable assumption and continue.
- Write a mini-protocol first. Define population, intervention/index factor, comparator, critical outcomes, time points, setting, eligible designs, date/language limits, and exclusions.
- Search by evidence layer. Retrieve current guidelines, high-quality syntheses, primary studies published after the synthesis search date, harms/prognosis evidence, and trial registries as appropriate.
- Use parallel tracks when depth matters. If tools permit, independently search: (a) authoritative guidelines/syntheses, (b) recent primary studies, and (c) contradiction, harms, retraction, or applicability signals. Reconcile the tracks rather than pooling them blindly.
- Document the search. Record source/database, full query, filters, date, result count reviewed, access limitation, and full-text status. Use MeSH plus free-text synonyms when relevant.
- Open and verify. Inspect the source, supplement, protocol, registry, correction, and retraction status when available. Never use a snippet as the evidence.
- Handle access failure honestly. If live browsing, full text, or a required database is unavailable, stop any claim of current or comprehensive coverage. Synthesize only supplied/accessible material, show a reproducible search plan for missing sources, label paywall/abstract-only limits, and list the verification still required.
- Extract a clinical evidence ledger. Population, sample, setting, intervention components, comparator, follow-up, adherence, co-interventions, effect with uncertainty, harms, funding, risk of bias, and directness.
- Assess certainty by outcome. Use a design-appropriate risk-of-bias method and GRADE principles across the body of evidence. Do not call a single study “high-level evidence.”
- Interpret effects. Pair relative and absolute effects for binary outcomes; preserve scale direction and clinical thresholds for continuous outcomes; distinguish statistical from clinical importance.
- Resolve apparent contradictions. Compare population, stage, intervention components/dose, comparator, outcome definition, time point, bias, missing data, sample size, analysis, and publication status.
- Translate to practice. State who the evidence fits, who was excluded, feasible delivery conditions, study dose, monitoring, harms, patient burden, preferences, resources, and uncertainty.
Contradiction labels
Use one label with a short rationale:
- supports;
- narrows applicability;
- identifies a subgroup hypothesis;
- conflicts;
- supersedes—only when stronger, more direct evidence justifies it.
Newer is not automatically better.
Output
- Bottom-line decision
- Structured question and assumptions
- Search methods and date
- Evidence table or ledger
- Effect, clinical meaning, and certainty for each critical outcome
- Evidence timeline and conflict analysis
- Applicability, study dose, harms, and implementation conditions
- Practical next step
- Direct links and access limitations
Never state that all literature was searched. State exactly what was searched.