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. BMJ. 1996 Jan 13;312(7023):71-2).
"the intergration of best research evidence with clinical expertise and patient values." (Sackett David L., et al, Evidence-based medicine : how to practice and teach EBM . New York : Churchill Livingstone, 2000. p. 1)
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.
TRIP Database allows free searches.
Filtered resources appraise the quality of studies and often make recommendations for practice.
The only database system of filtered, synopsized, evidence-based information, this integrated search engine allows you to simultaneously search, via keyword, multiple databases:
* EBM Guidelines
* Daily POEMs
* Cochrane Abstracts
* Selected Practice Guidelines
* Decision Support Calculators
* H&P Calculators
* Diagnostic Test Calculators
* Derm Expert
* E/M Coding
* ICD-9 Lookup Tool
Available via workstation or downladable to PDA.
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.
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.
Part of the Cochrane Library
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.
Part of the Cochrane Library
Systematic Reviews are also searchable in MEDLINE:
- PubMed: You may limit your retrieval in PubMed/MEDLINE by using the Limits feature setting the retrieval to the subset SYSTEMATIC REVIEWS
Authors of critically-appraised topics evaluate and synthesize multiple research studies.
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.
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.
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.
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.
Authors of critically-appraised individual articles evaluate and synopsize individual research studies.
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.
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.”
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 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. A randomized controlled trial (RCT) is a research study in which participants are randomly allocated into an experimental group or a control group and followed over time for the variables/outcomes of interest. A cohort study is a research study that compares two groups (cohorts) of patients, one that received the exposure of interest and one that did not, and follows these cohorts forward for the outcome of interest. A case-controlled study is a research study which identifies patients with the outcome of interest (cases) and patients without the same outcome (controls), and looks back to see if they had the exposure of interest. A case series is a report on a series of patients with an outcome of interest. No control group is involved. A case report is a report of a patient with an exposure or an outcome of interest. [Adapted from Centre for Evidence Based Medicine, Toronto]
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).
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.
Background Information/Expert Opinion
Over 200 full-text electronic books available from the MSU Libraries.
Here are two exceptional general medicine resources:
Evidence-Based Medicine Information Sites
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.
Includes many resources for practicing and teaching EBM.
A selective list of additional EBM websites developed and maintained by Duke University Medical Center Library.
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.
The definitive tome for those who want more, A Manual for Evidence-Based Clinical Practice presents the sophisticated concepts of evidence-based medicine (EBM) in unique ways that can be used to determine diagnosis, decide optimal therapy, and predict prognosis. It also offers in-depth expansion of methodology, statistics, and cost issues that emerge in medical research.
Evidence-Based Medicine Tutorials
From Duke University Medical Center Library and University of North Carolina at Chapel Hill Health Sciences Library.
* 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. Links to Michigan State University Libraries accessible resources by John Coffey