The process of systematically finding, appraising, and using contemporaneous research findings as the basis for clinical decisions. Evidence-based medicine asks questions, finds and appraises the relevant data, and harnesses that information for everyday clinical practice. Evidence-based medicine follows four steps: formulate a clear clinical question from a patient's problem; search the literature for relevant clinical articles; evaluate (critically appraise) the evidence for its validity and usefulness; implement useful findings in clinical practice… (From BMJ 1995;310:1122)
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.
Cochrane Database of Systematic Reviews (CDSR)
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.
Database of Abstracts of Reviews of Effects (DARE)
Structured abstracts of systematic reviews from a variety of medical journals. DARE cover topics such as diagnosis, prevention, rehabilitation, screening, and treatment. It complements CDSR by offering a selection of quality assessed reviews in subjects with no current Cochrane review.
Systematic Reviews are also searchable in 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.
MetaSearch Engines
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 requires a free registration allows a limited number of free searches.
SUMSearch 2
Simultaneously searches for studies (original studies and systematic reviews) and practice guidelines from PubMed, National Guideline Clearinghouse, and DARE and merged into one list sorted by year of publication.
Critically Appraised Topics
ACP PIER from Stat!RefEvidence-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.
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. Evidence varies from expert opinion to high levels of evidence.
Provides high quality, evidence-based information on dietary supplements (including herbs, vitamins, and minerals), functional foods, diets, complementary practices (modalities), exercises, and medical conditions
Critically Appraised Individual Articles
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.”
Unfiltered Journal Information: Randomized Controlled Trials, Cohort Studies, Case Series/ Reports
PubMed (limit by Type of Article, such as Randomized Controlled Trial, Clinical Trial, Meta- Analysis or Practice Guidelines)
Family Practice Inquiry Network's evidence answers to questions posed by primary care physicians, published in Journal of Family Practice and American Family Physician.
CINAHL (Limit by Publication Type, such as Clinical Trial, Practice Guideline or Research; or use the Clinical Queries limit; or the Evdence-Based Practice limit)
Expert Opinion/ Background Information
A clinical information resource, which offers up-to-date, fully referenced expert answers to patient-care, diagnosis, and treatment questions. (for on-site use only on the LGH network.)
Presents a collection of monographs that cover 65 professional specialties and three consumer areas, complete with full streaming video, audio, and color images suitable for clinical and teaching purposes. It contains a section of Tools, interactive algorithms, calculators, decision rules, diagrams, scores, and tables. For users who want information via their PDA, eMedicine has downloadable content for PalmOS, Windows CE, PocketPC, Psion, and Franklin eBookMan.
Evidence-Based Practice 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