Evidence Based Medicine/Practice Pyramid & USD Databases
Evidence-Based Medicine (EBM) Resources
Evidence-Based Medicine is the integration of best research evidence with clinical expertise and patient values. (Sackett DL, Straus SE, Richardson WS, et al. Evidence-based medicine: how to practice and teach EBM. 2nd ed. Edinburgh: Churchill Livingstone, 2000.)
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 appraise the quality of studies and often make recommendations for practice.
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.
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.
Authors of critically-appraised topics evaluate and synthesize multiple research studies.
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.
Evidence-based clinical guidance designed for rapid access to clinical information at the point of care. Smart Medicine 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.
Provides the most useful information at the point of care. Usefulness requires a balance of validity, relevance, convenience and affordability. Where available, links are provided to full-text electronic electronic resources via a PubMed reference.
Authors of critically-appraised individual articles evaluate and synopsize individual research studies.
The ACP Journal Club (Currently unavailable)
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 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.
To limit your PubMed search to the best evidence-producing studies: Click on "Clinical Queries" (under PubMed Tools). This specialized search is intended for clinicians and has built-in search "filters." Five clinical study categories--therapy, diagnosis, etiology, prognosis, clinical prediction guidelines--are provided, and you may indicate whether you wish your search to be more broad (i.e., include most relevant articles but probably including some less relevant ones) or more narrow (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.
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 this resource may vary from expert opinion to high levels of evidence.
Searchable and continually updated version of Harrison's Principles of Internal Medicine.
Full Text Available via AccessMedicine -- 17th ed. 2008
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.
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.
Sacket, D.L. et al. (2000). Evidence-Based Medicine. How to practice and teach EBM. Churchill Livingstone: London.
vi. Use the following guidelines in choosing references:
•Avoid citing other clinical review articles—you should emphasize original research articles, systematic reviews, Cochrane Library reviews, and citations from BMJ’s Clinical Evidence, validated clinical decision rules, randomized trials, and evidence-based practice guidelines where possible. Clinical review articles may be cited as sources for tables, figures, or general background information.
•Emphasize recent references (past 10 years); in general, avoid letters to the editor, editorials, and references that are older than 10 years or of historic interest only.
•Avoid references from obscure or non–English-language journals.
•Do not cite abstracts, unpublished observations, manuscripts in preparation or submitted for publication, or personal communications.
•To avoid plagiarism, be sure not to use the language, content, or concepts of another source without an appropriate reference. Do not use extensive verbatim or near-verbatim portions of text from another source, even with appropriate citation.
USD & Wegner Librarians