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.)
Evidence-Based Medicine Pyramid
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 a limited number of free searches.
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.
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.
Systematic Reviews are also searchable in MEDLINE:
Enter your search query.
Click on the “Limits” icon; select “Systematic Reviews” under “Subject Subsets.”
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.
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.
PIER (available via Stat!Ref)
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.
Note: There is a PDA version of this product.
Critically-Appraised Individual Articles
Authors of critically-appraised individual articles evaluate and synopsize individual research studies.
Note: Enter “ACP” in electronic journal to access journal
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.
(e.g., Evidence-Based Medicine, Evidence-Based Oncology, evidence-based healthcare) 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 the
electronic journals list for multiple subscriptions by entering keyword “evidence-based.”
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. )
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).
To limit your MEDLINE search to the best evidence-producing studies: click on the "Limits" icon.
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 these resources may vary from expert opinion to high levels of evidence.
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.)
Full-text electronic books available via Stat!Ref, MDConsult, PsychiatryOnline, Access Medicine.
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.
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
From Duke University Medical Center Library and University of North Carolina at Chapel Hill Health Sciences Library.
From SUNY Health Sciences Evidence-Based Medicine Course.
Evidence-Based Medicine Resources for PDA
A list of resources from the Dartmouth Biomedical Libraries.
10/24/08. This form was adapted to include resources available at the Health Sciences Library. The original content and format was adapted from "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."
Updated 01/08/10