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Evidence-Based Medicine Resources
Evidence-Based Medicine: think of it as a pyramid. At the very top sit systematic reviews, which 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. Next come critically-appraised topics, which evaluate and synthesize multiple research studies. Next are critically-appraised individual articles, which evaluate and synopsize individual research studies. These three top segments are the filtered information forming the upper pyramid. Three areas of unfiltered information form the middle of the pyramid. These consist of randomized controlled trials, cohort studies, and case-controlled studies and reports. All can be found by searching the National Library of Medicine’s Medline database. At the base of the pyramid sit the background information & expert opinion upon which everything is built. Evidence in these resources may vary from expert opinion to high levels of evidence.
Here, organized from the point of the pyramid to its base, are the Select PBMC EBM Resources: TRIP (Turning Research Into Practice) Database Plus 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. Systematic Reviews are searchable in MEDLINE: PubMed: 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. 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, 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 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. Search PIER via STAT!Ref ~ click Advanced Search ~ select ACP PIER ~ type your terms into the search box. Please contact the PBMC Library for password information: 207-596-8456 / pkahn@penbayhealthcare.org
Critically-Appraised Individual Articles Authors of critically-appraised individual articles evaluate and synopsize individual research studies. The ACP Journal Club 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. ACP Journal Club [print edition] is available in the PBMC Library ~ vol. 114 (1999) to the present. OR Search ACP Journal Club via STAT!Ref ~ click Advanced Search ~ select ACP Journal Club ~ type your terms into the search box. Please contact the PBMC Library for password information: 207-596-8456 / pkahn@penbayhealthcare.org “Evidence-Based…” Journal series (e.g., Evidence-Based Medicine, Evidence-Based Mental Health, Evidence-Based Nursing) Primary research articles within the discipline are selected for quality and clinical relevance. A structured abstract and expert commentary are provided for each study. The following titles are available through the library: Evidence-Based Medicine [print] 1995-1999 Evidence-Based Cardiovascular Medicine 1997-2006 Evidence-Based Health Policy & Mgmt 1997-1998 Evidence-Based Healthcare 1999-2004 Evidence-Based Obstetrics & Gynecology 1999-2006 Evidence-Based Oncology 2000-2002 To access MD Consult: log on from within the PBH system and create your own userid & password.
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. PubMed PubMed is the U.S. National Library of Medicine's premiere search system for health information, available FREE on the Internet. 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).
Background Information/Expert Opinion Note: Evidence in these resources may vary from expert opinion to high levels of evidence. eMedicine Physician authors and editors contribute to the eMedicine Clinical Knowledge Base, which contains articles on 7,000 diseases and disorders. The evidence-based content provides the latest practice guidelines in 62 medical specialties. eMedicine's professional content undergoes multiple levels of physician peer review. Topics are presented in a consisten, disease-oriented format: DDX, workup, diagnosis, treatment, medication, follow-up, and bibliography. Extensive patient information is also included. Please contact the PBMC Library for password information: 207-596-8456 / pkahn@penbayhealthcare.org MD Consult MD Consult brings the leading medical resources together into one integrated online service to help practitioners find answers to clinical questions, make better treatment decisions, and stay abreast of recent developments. Includes eBooks, journals, guidelines, patient handouts, much more. To access MD Consult: log on from within the PBH system and create your own userid & password. ACP Medicine Textbook of general medicine, updated continually. Hard copy is available in the PBMC Library. STAT!Ref An electronic resource for healthcare professionals, with textbooks and reference materials in many medical and nursing subject areas. Please contact the PBMC Library for password information: 207-596-8456 / pkahn@penbayhealthcare.org Lippincott Nursing Collection Available through Books @ Ovid, this is a full-text bookshelf of practical, day-to-day nursing reference. Please contact the PBMC Library for password information: 207-596-8456 / pkahn@penbayhealthcare.org
Evidence-Based Medicine Information Sites Centre for Evidence-Based Medicine (Oxford University) 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. Centre for Evidence-Based Medicine (Toronto) Includes many resources for practicing and teaching EBM. Evidence-Based Medicine A selective list of additional EBM websites developed and maintained by Duke University Medical Center Library. Netting the Evidence 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. Users' Guides to Evidence-Based Practice 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 Introduction to Evidence-Based Medicine From Duke University Medical Center Library and University of North Carolina at Chapel Hill Health Sciences Library. SUNY Health Sciences Evidence-Based Medicine Course From the State University of New York
Evidence-Based Medicine Resources for PDA Evidence-Based Medicine Resources for the PDA A list of resources from the Dartmouth Biomedical Libraries.
EBM Pyramid & Page Generator, copyright 2006 Trustees of Dartmouth College & Yale University. All rights reserved. Produced by Jan Glover, David Izzo, Karen Odato, & Lei Wang
Other library information: Updated 5/19/2009
This service is offered by the following organizations:
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