Evidence Based Medicine

What is evidence-based medicine?

Integrating the finest, latest research evidence available with clinical expertise and patient values. There is a hierarchy of evidence. Some types of evidence are better than others. There are four steps in the EBM process:

1. Formulating the question
2. Information search
3. Review of information and critical appraisal
4. Using the results in clinical practice—integrating the evidence with patient factors
5. Evaluation of the whole process for improvement

In formulating the clinical questions, the “PICO” approach is often used: defining the patient, intervention, comparator and outcome.

Systematic Reviews (meta-analyses)

Cochrane Library
http://www.thecochranelibrary.com

Pubmed
http://www.pubmed.gov (choose clinical query)

Bandolier
http://www.medicine.ox.ac.uk/bandolier/

Centre for Reviews & Dissemination—University of York
http://www.york.ac.uk/inst/crd

DARE
http://www.crd.york.ac.uk/crdweb

Campbell Collaboration
http://www.campbellcollaboration.org/

Health-evidence
http://health-evidence.ca

HTA
http://www.ncchta.org

Essential Evidence Plus (POEMS)
http://www.essentialevidenceplus.com

Meta-search Engines

Trip Database
http://www.tripdatabase.com

Sumsearch
http://sumsearch.uthscsa.edu

Clinical Practice Guidelines

National Guideline Clearinghouse
http://www.guidelines.gov

NICE
http://www.nice.org.uk

CKS-Clinical Knowledge Summaries NHS—Free Registration
http://cks.nhs.uk

Canadian Medical Association
http://www.cma.ca/cpgs

Critically Appraised Topics (CATs)

Best Bests (Emergency Medicine)
http://www.bestbets.org

Centre for EBM Oxford
http://www.cebm.net

Evidence-based on Call
http://www.eboncall.org

Evidence-based Medicine Scottish Intensive Care Society
http://www.sicsebm.org.uk

Occupational CATs
http://www.otcats.com

Primary Information Sources

Pubmed
http://www.pubmed.gov

National Cancer Institute
http://www.cancer.gov

EBSCO full text CINAHL and Medline

MD Consult

University Resources

Evidence based Practice Tutorial University of Minnesota
http://evidence.ahc.umn.edu/ebn.htm

Evidence-based Health Care NYU
http://library.nyu.edu/health/evidence/

University of Toronto
http://www.cebm.utoronto.ca

Duke University
http://www.mclibrary.duke.edu/subject/ebm/

EBM Toolkit
http://www.ebm.med.ualberta.ca/

University of Sydney
http://www.health.usyd.edu.au/current/coursework/ebm.php

North Carolina EBP Education Center of Excellence
http://library.ncahec.net/ebm/pages/index.htm

McMaster University—Health Information Research Unit
http://hiru.mcmaster.ca/hiru/

Other EBM Sources

AHQR
http://www.ahrq.gov/browse/evidmed.htm

SCHARR—Netting the Evidence
http://www.sheffield.ac.uk/scharr/sections/ir/links/index

INAHTA
http://www.inahta.org

Critical Appraisal Tools

Consort Statement
http://www.consort-statement.org

Agree Collaboration
http://www.agreecollaboration.org

Clinical Significance Calculator
http://spph.ubc.ca/sites/healthcare/files/calc/clinsig.html

If you have comments or suggestions, email me at amangino@barnabashealth.org