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Evidence-Based Medicine (EBM) Resources
Evidence-based medicine is the "conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients" (Sackett, DL, Rosenberg WM, Gray JA, et al. BMJ. 1996 312(7023):71-2).
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TRIP (Turning Research Into Practice) Database Plus Simultaneously searches evidence-based sources of systematic reviews, practice guidelines, and critically-appraised topics and articles -- including most of those listed above and many more. Also searches MEDLINE’s Clinical Queries, medical image databases, e-textbooks, and patient information leaflets.
Filtered Resources Filtered resources appraise the quality of studies and often make recommendations for practice. Systematic Reviews / Meta-Analyses Authors of a systematic review ask a specific clinical question, perform a comprehensive literature search, eliminate the poorly done studies and attempt to make practice recommendations based on the well-done studies. A meta-analysis is a systematic review that combines all the results of all the studies into a single statistical analysis of results. The Cochrane Database of Systematic Reviews Consists of detailed, structured topic reviews of hundreds of articles. Teams of experts complete comprehensive literature reviews, evaluate the literature, and present summaries of the findings of the best studies. Published by the International Cochrane Collaboration. The Database of Abstracts of Reviews of Effect (DARE) Full-text database containing structured abstracts of systematic reviews from a variety of medical journals. DARE is produced by the National Health Services' Centre for Reviews and Dissemination (NHS CRD) at the University of York. DARE records cover topics such as diagnosis, prevention, rehabilitation, screening, and treatment. Also available via Ovid Systematic Reviews are also searchable in MEDLINE:
- Ovid MEDLINE: Enter your search query. Click on the “Limits” icon; select “Systematic Reviews” under “Subject Subsets.”
- PubMed: Click on “Clinical Queries” on the left side of the screen; select “Find Systematic Reviews” and enter your search query.
Critically-Appraised Topics Authors of critically-appraised topics evaluate and synthesize multiple research studies. Clinical Evidence Summarizes the current state of knowledge about the prevention and treatment of clinical conditions, based on thorough searches and appraisal of the literature. It describes the best available evidence from systematic reviews, RCTs, and observational studies where appropriate, and if there is no good evidence it says so. National Guideline Clearinghouse A comprehensive database of evidence-based clinical practice guidelines and related documents produced by the Agency for Health Care Research and Quality, in partnership with the American Medical Association and the American Association of Health Plans. Updated weekly. Note: Guideline evidence varies from expert opinion to high levels of evidence. InfoPOEMS Clinical awareness system that highlights important new evidence via DailyPOEMs™ ("Patient-Oriented Evidence that Matters"), synopses of new, valid evidence relevant to patient care originating from critical appraisal of studies published in more than 100 journals. There is a PDA version of this product. PIER Evidence-based clinical guidance designed for rapid access to clinical information at the point of care. PIER is peer-reviewed, updated continually and includes recommendations based on all levels of medical evidence. Recommendations also include strength-of-recommendation ratings based on the quality of the underlying evidence. From the American College of Physicians. There is a PDA version of this product.
Critically-Appraised Individual Articles Authors of critically-appraised individual articles evaluate and synopsize individual research studies. The ACP Journal Club The editors of this journal screen the top 100+ clinical journals and identify studies that are methodologically sound and clinically relevant. An enhanced abstract, with conclusions clearly stated, and a commentary are provided for each selected article. Published by the American College of Physicians-American Society of Internal Medicine. Check ejournals list for multiple subscriptions. Bandolier Bandolier is an independent journal about evidence-based healthcare published in the UK. It includes “information about evidence of effectiveness (or lack of it), and put[s] the results forward as simple bullet points of those things that worked and those that did not: a bandolier with bullets. Information comes from systematic reviews, meta-analyses, randomised trials, and from high quality observational studies.” bmjupdates Quality articles from over 110 clinical journals are selected by research staff, and then rated for clinical relevance and interest by an international group of physicians. Includes a searchable database of the best evidence from the medical literature and an email alerting system. From BMJ Publishing Group and McMaster University's Health Information Research Unit. “Evidence-Based…” Journal series (e.g., Evidence-Based Medicine, Evidence-Based Mental Health, Evidence-Based Nursing)
Primary research articles within the discipline are selected for quality and clinical relevance. A structured abstract and expert commentary are provided for each study. Check ejournals list for multiple subscriptions.
Unfiltered Resources Evidence is not always available via filtered resources. Searching the primary literature may be required. It is possible to use specific search strategies in MEDLINE and other databases to achieve the highest possible level of evidence. PubMed To limit your PubMed search to the best evidence-producing studies: Click on "clinical queries" (on the left side of the screen). This specialized search is intended for clinicians and has built-in search "filters." Four study categories--therapy, diagnosis, etiology, prognosis--are provided, and you may indicate whether you wish your search to be more sensitive (i.e., include most relevant articles but probably including some less relevant ones) or more specific (i.e., including mostly relevant articles but probably omit a few). Ovid Medline To limit your Ovid MEDLINE search to the best evidence-producing studies: Clinical Queries (See PubMed) is searchable in Ovid; click on the "Limits" icon. EMBASE Major biomedical and pharmaceutical database covering drug research, pharmacology, pharmaceutics, toxicology, clinical and experimental human medicine, health policy and management, public health, occupational health, environmental health, drug dependence and abuse, psychiatry, forensic medicine, and biomedical engineering/instrumentation. Produced by Excerpta Medica and updated weekly. To limit your EMBASE search to the best evidence-producing studies: Click on the ‘Limits’ icon to use ‘Clinical Queries’. PsycINFO International coverage of the professional and academic literature in psychology, medicine, psychiatry, nursing, sociology, education, pharmacology, physiology, linguistics, and other areas. To limit your PsycINFO search to the best evidence-producing studies: Click on the ‘Limits’ icon to use ‘Clinical Queries’ or limit to ‘methodology’ types. CINAHL Cumulative Index to Nursing and Allied Health Literature To limit your CINAHL search to the best evidence-producing studies: Click on the ‘Limits’ icon to use ‘Clinical Queries’ or limit to ‘Research’ or other ‘publication’ types (i.e., systematic review).
Background Information/Expert Opinion Note: Evidence in these resources may vary from expert opinion to high levels of evidence. UpToDate A clinical information resource, which offers up-to-date, fully referenced expert answers to patient-care, diagnosis, and treatment questions. Topic reviews are written by recognized authorities who review the topic, synthesize the evidence, summarize key findings, and provide specific recommendations. (Access restrictions: UpToDate is licensed for on-site use only at Dartmouth College, Dartmouth Medical School, and the Dartmouth-Hitchcock Medical Center. Remote access is not permitted.) eMedicine Physician authors and editors contribute to the eMedicine Clinical Knowledge Base, which contains articles on 7,000 diseases and disorders. The evidence-based content provides the latest practice guidelines in 62 medical specialties. eMedicine's professional content undergoes multiple levels of physician peer review. eBooks Full-text electronic books. Harrison's Online Searchable and continually updated version of Harrison's Principles of Internal Medicine. ACP Medicine Electronic textbook of general medicine; updated continually.
Evidence-Based Medicine Information Sites Centre for Evidence-Based Medicine (Oxford University) The Centre promotes evidence-based health care and provide support and resources to anyone who wants to make use of them. Includes the EBM Toolbox, an assortment of materials which are very useful for practitioners of EBM, and EBM Teaching Materials, including PowerPoint presentations. Centre for Evidence-Based Medicine (Toronto) Includes many resources for practicing and teaching EBM. Evidence-Based Medicine A selective list of additional EBM websites developed and maintained by Duke University Medical Center Library. Netting the Evidence From the School of Health and Related Research (ScHARR) at the University of Sheffield, UK. Includes a comprehensive list of EBM databases, journals, articles, and other information sources. Users' Guides to Evidence-Based Practice From the University of Alberta's Centre for Health Evidence. Includes the complete set of EBM Users' Guides originally published as a series in the Journal of the American Medical Association (JAMA).
Evidence-Based Medicine Tutorials Introduction to Evidence-Based Medicine From Duke University Medical Center Library and University of North Carolina at Chapel Hill Health Sciences Library. SUNY Health Sciences Evidence-Based Medicine Course
Evidence-Based Medicine Resources for PDA Evidence-Based Medicine Resources for the PDA A list of resources from the Dartmouth Biomedical Libraries.
Local Resources (e.g., Class Handouts, Tip Sheets)
EBM
Courses and Basics
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An Introduction to
Information Mastery - Very good course by Mark Ebell, MD at
Michigan State University
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Centre for Evidence-Based Medicine - At the University of Oxford
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Evidence-Based
Medicine - Presentation from University of South Florida
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Evidence Based Medicine at UVA Family Medicine - Brief,
on-the-mark description
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Evidence Based Medicine Course - Excellent short course from
SUNY Health Sciences Center-Brooklyn
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Evidence-Based Medicine in Primary Care: An Overview - Very good
article by John Geyman, MD
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Evidence-Based
Medicine Toolkit - Good fundamentals from the University of
Alberta
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How do
I Find...? - Brief, practical information from
Bandolier
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How to Read a Paper - BMJ series on finding medical articles
and assessing their value
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MEDLINE - National Library of Medicine medical literature
database
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NHS Centre for Reviews and
Dissemination - Excellent comprehensive site for of systematic
reviews from the University of York
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PubMed
Clinical Queries - Search for articles on etiology, diagnosis,
treatment, prognosis
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PubMed Search for Evidence-Based Medicine Articles - Search
string: "evidence based medicine"
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Users' Guides to
the Medical Literature - The series of JAMA articles, from
McMaster University
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"What
Works?" Evidence-Based Medicine and Real-Life Practice - A
lecture/tutorial by Robert J. Flaherty, MD
- EBM Web Links
- And, if this is all just too much
for you,
Seven Alternatives to Evidence Based Medicine by David Isaacs
and Dominic Fitzgerald
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EBM Pyramid and EBM Page Generator, copyright 2006 Trustees of Dartmouth College and Yale University. All Rights Reserved.
Produced by Jan Glover, David Izzo, Karen Odato and Lei Wang.
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