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Sladen Library Evidence-Based Medicine (EBM) Resources

Evidence-based medicine is the "conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients" (Sackett, DL. BMJ. 1996 Jan 13;312(7023):71-2).

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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 recently started offering free access. You can create your own account or use the generic login: Username=nphs and Password=wales.

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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.

The Cochrane Database of Systematic Reviews

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. Available through the Ovid interface.

The Database of Abstracts of Reviews of Effect (DARE)

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. Available through the Ovid interface.

Systematic Reviews are also searchable in MEDLINE:

• Ovid MEDLINE: Enter your search query. Click on the “More 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.

Critically-Appraised Topics

Authors of critically-appraised topics evaluate and synthesize multiple research studies.

National Guideline Clearinghouse

A free 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.

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. Available through the Stat!Ref interface.

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. Available through the Ovid interface.

Bandolier

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.” Access to the web site is free, but there is a delay in loading new articles.

bmjupdates

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-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 link above will take you to Sladen's Journal List from which you can select the specific journal you need. Available through the Ovid interface.

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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. A randomized controlled trial (RCT) is a research study in which participants are randomly allocated into an experimental group or a control group and followed over time for the variables/outcomes of interest. A cohort study is a research study that compares two groups (cohorts) of patients, one that received the exposure of interest and one that did not, and follows these cohorts forward for the outcome of interest. A case-controlled study is a research study which identifies patients with the outcome of interest (cases) and patients without the same outcome (controls), and looks back to see if they had the exposure of interest. A case series is a report on a series of patients with an outcome of interest. No control group is involved. A case report is a report of a patient with an exposure or an outcome of interest. [Adapted from Centre for Evidence Based Medicine, Toronto]

PubMed

Free Medline interface from the National Library of Medicine. 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).

Ovid Medline

To limit your Ovid MEDLINE search to the best evidence-producing studies: Click on the "More Limits" icon, then select the study category you need from the "Clinical Queries" menu. Nine study categories are available -- including therapy, diagnosis and prognosis -- and you can indicate whether you wish your search to be more sensitive or more specific.

PsycINFO

International coverage of the professional and academic literature in psychology, medicine, psychiatry, nursing, sociology, education, pharmacology, physiology, linguistics, and other areas. Available through the Ovid interface.

To limit your PsycINFO search to the best evidence-producing studies: Click on the ‘More Limits’ icon to use ‘Clinical Queries’ or limit to ‘methodology’ types.

CINAHL

Cumulative Index to Nursing and Allied Health Literature. Available through the Ovid interface.

To limit your CINAHL search to the best evidence-producing studies: Click on the ‘More Limits’ icon to use ‘Clinical Queries’ or limit to ‘Research’ or other ‘publication’ types (i.e., systematic review).

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Background Information/Expert Opinion

UpToDate

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. UpToDate started indicating the level of evidence for its Treatment Recommendations in 2006.

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. Free internet resource.

Sladen Electronic Books

Complete list of full-text electronic books available through Sladen Library.

Harrison's Online

Available through the Stat!Ref interface.

ACP Medicine

Available through the Stat!Ref interface.

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Evidence-Based Medicine Information Sites

Centre for Evidence-Based Medicine (Oxford University)

The Centre promotes evidence-based health care and provides 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).

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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

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Evidence-Based Medicine Resources for PDA

Evidence-Based Medicine Resources for the PDA

A list of resources from the Dartmouth Biomedical Libraries.

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Local Resources

Sladen Evidence-Based Practice Resources

Sladen Literature Search Services

Sladen librarians can access hundreds of databases on your behalf -- including BIOSIS, EMBASE and Science Citation index - to find the information you need.

PEDro

PEDro (Physiotherapy Evidence Database) provides access to abstracts of randomized controlled trials, systematic reviews, and clinical practice guidelines on physiotherapy.

OT Seeker

OTSeeker provides access to abstracts of randomized controlled trials and systematic reviews regarding occupational therapy.