LibGuides: Evidence Based Medicine: Home

Evidence Based Medicine: A short background and brief literature review

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Evidence-Based Practice...

"A way of providing health care that is guided by a thoughtful integration of the best available scientific knowledge with clinical expertise. This approach allows the practitioner to critically assess research data, clinical guidelines, and other information resources in order to correctly identify the clinical problem, apply the most high-quality intervention, and re-evaluate the outcome for future improvement." (2009 Medical Subject Headings (MeSH)).

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If…

"Twenty years ago, you could read all the literature in your field," said reference librarian Kathy Robbins, PhD, MLIS, scanning shelf after shelf of medical journals at the University of Minnesota Bio-Medical Library in Minneapolis. "Now, 6000 journal articles are published each day."1

(That would be thirty five years ago today.)

And…

Historically there “were a number of physicians who seem to have courted the sort of deference more likely to be associated with landed gentility.”2

Then…

“Evidence based medicine quickly became an energetic intellectual community committed to making clinical practice more scientific and empirically grounded and thereby achieving safer, more consistent, and more cost effective care.3 Achievements included establishing the Cochrane Collaboration to collate and summarize evidence from clinical trials;4 setting methodological and publication standards for primary and secondary research;5 building national and international infrastructures for developing and updating clinical practice guidelines;6 developing resources and courses for teaching critical appraisal;7 and building the knowledge base for implementation and knowledge translation.8^”9

1. Levin, A. (2001). The Cochrane Collaboration. Annals Of Internal Medicine, 135(4), 309-312.

2. Lawrence, C. (1985). Incommunicable knowledge: Science, technology and the clinical art in britain 1850-1914. Journal of Contemporary History, 20(4), 503-520. Retrieved from www.scopus.com

3. Pope C. Resisting evidence: the study of evidence-based medicine as a contemporary social movement. Health 2003;7:267-82. http://www.scopus.com/record/display.url?eid=2-s2.0-0041418150&origin=resultslist&sort=plf-f&src=s&st1=%22Resisting+evidence%22&st2=&sid=764E09B216E0A680D0EBBDCF3A1AEA6F.WlW7NKKC52nnQNxjqAQrlA%3a10&sot=b&sdt=b&sl=35&s=TITLE-ABS-KEY%28%22Resisting+evidence%22%29&relpos=2&relpos=2&citeCnt=84&searchTerm=TITLE-ABS-KEY%28%5C%26quot%3BResisting+evidence%5C%26quot%3B%29

4. Levin A. The Cochrane Collaboration. Ann Intern Med 2001;135:309-12. [PubMed]

5. Simera I, Moher D, Hirst A, Hoey J, Schulz KF, Altman D. Transparent and accurate reporting increases reliability, utility, and impact of your research: reporting guidelines and the EQUATOR Network. BMC Med 2010;8:24. [PMC free article] [PubMed]

6. Hill J, Bullock I, Alderson P. A summary of the methods that the National Clinical Guideline Centre uses to produce clinical guidelines for the National Institute for Health and Clinical Excellence. Ann Intern Med 2011;154:752-7. [PubMed]

7. Horsley T, Hyde C, Santesso N, Parkes J, Milne R, Stewart R. Teaching critical appraisal skills in healthcare settings. Cochrane Database Syst Rev 2011;11: CD001270. [PubMed]

8. McCormack L, Sheridan S, Lewis M, Boudewyns V, Melvin CL, Kistler C. Communication and dissemination strategies to facilitate the use of health-related evidence. Evidence Reports/Technology Assessments No 213. US Agency for Healthcare Research and Quality, 2013. http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=1756

9.Greenhalgh, T., Howick, J., & Maskrey, N. (2014). Evidence based medicine: a movement in crisis?. BMJ (Clinical Research Ed.), 348g3725. doi:10.1136/bmj.g3725

Introduction to Evidence-Based Practice tutorial/Duke University Medical Center
This tutorial is intended for any health care practitioner or student who needs a basic introduction to the principles of Evidence-Based Practice. Upon completion of this self-paced tutorial, you will be able to:

define Evidence-Based Practice (EBP)
identify the parts of a well-built clinical question
identify searching strategies that could improve PubMed searching
identify key critical appraisal issues that help determine the validity of a study

Sources-filtered

Cochrane Library
The Cochrane Library (ISSN 1465-1858) is a collection of six databases that contain different types of high-quality, independent evidence to inform healthcare decision-making, and a seventh database that provides information about Cochrane groups.
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We are a global independent network of researchers, professionals, patients, carers, and people interested in health.

Cochrane contributors from more than 120 countries work together to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest. Many of our contributors are world leaders in their fields - medicine, health policy, research methodology, or consumer advocacy - and our groups are situated in some of the world's most respected academic and medical institutions.

Our work is recognized as representing an international gold standard for high quality, trusted information.
PubMed Clinical Queries
Systematic Reviews... displays citations for systematic reviews, meta-analyses, reviews of clinical trials, evidence-based medicine, consensus development conferences, and guidelines. See filter information or additional related sources.
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Clinical Study Categories... displays citations filtered to a specific clinical study category and scope. These search filters were developed by Haynes RB et al. See more filter information.
UpToDate
For more than 20 years, clinicians around the world have relied on UpToDate as their primary resource for medical knowledge at the point of care. The knowledge contained in UpToDate is evidence-based and continuously updated, but it is not merely an aggregation and report of the latest research; UpToDate presents a comprehensive synthesis of the evidence, followed by recommendations that can be acted on at the point of care. It combines an advanced publishing platform with the rigor of a sophisticated editorial process managed by a faculty of accomplished physician authors and editors, renowned leaders in their specialties.
ACP Journal Club
This links to an EBSCO Medline Complete search for phrase "ACP Journal Club" in the JN "Annals of internal medicine"
ACP Journal Club summarizes the best new evidence for internal medicine from over 130 clinical journals. Once a bimonthly stand-alone journal, ACP Journal Club is now a monthly feature of Annals of Internal Medicine. Research staff and clinical editors rigorously assess the scientific merit of the medical literature as it is published and a worldwide panel of over 5000 physicians assesses the clinical relevance and newsworthiness of rigorous studies.

Sources-unfiltered

PubMed Advanced Search Builder
PubMed comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
AccessMedicine
AccessMedicine from McGraw-Hill Medical is a comprehensive online medical resource that provides a complete spectrum of knowledge from the best minds in medicine, with essential information accessible anywhere.

Authoritative, trusted, and continuously updated with optimized content for any mobile device, AccessMedicine is guided by a preeminent Advisory Board that includes three of the medical field’s top academic experts, Mark A. Graber, MD; Diane Levine, MD; and Anderson Spickard, III, MD.

AccessMedicine provides medical students with a variety of resources needed to excel in basic science studies and clerkships; helps residents, nurse practitioners, and physician assistants with instant access to videos, self-assessment, and leading medical textbooks that facilitate decision-making at the point-of-care; enables faculty to create, track, and report their students’ progress through a curriculum tool that eases workflow; and allows practicing physicians to brush up on their medical knowledge to ensure the best patient outcome.
Scopus
Scopus is the largest abstract and citation database of peer-reviewed literature: scientific journals, books and conference proceedings. Delivering a comprehensive overview of the world's research output in the fields of science, technology, medicine, social sciences, and arts and humanities, Scopus features smart tools to track, analyze and visualize research.
Google Scholar
Google Scholar provides a simple way to broadly search for scholarly literature. From one place, you can search across many disciplines and sources: articles, theses, books, abstracts and court opinions, from academic publishers, professional societies, online repositories, universities and other web sites. Google Scholar helps you find relevant work across the world of scholarly research.

MeSH headings for types of evidence...see below

Medical Subject Headings
Controlled vocabulary thesaurus produced by the NATIONAL LIBRARY OF MEDICINE. It consists of sets of terms naming descriptors in a hierarchical structure that permits searching at various levels of specificity.

Year introduced: 2005
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One can use these headings for searching PubMed, Medline Complete (Ebsco), the York College Catalog (Books and More) and other databases.

Evidence Hierarchy

Meta-Analysis [Publication Type]
Works consisting of studies using a quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc. It is often an overview of clinical trials. It is usually called a meta-analysis by the author or sponsoring body and should be differentiated from reviews of literature.

Year introduced: 2008(1993)
Review [Publication Type]
An article or book published after examination of published material on a subject. It may be comprehensive to various degrees and the time range of material scrutinized may be broad or narrow, but the reviews most often desired are reviews of the current literature. The textual material examined may be equally broad and can encompass, in medicine specifically, clinical material as well as experimental research or case reports. State-of-the-art reviews tend to address more current matters. A review of the literature must be differentiated from HISTORICAL ARTICLE on the same subject, but a review of historical literature is also within the scope of this publication type.

Year introduced: 2008(1966)
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All MeSH Categories
Publication Type Category
Publication Formats
Review
Consensus Development Conference
Consensus Development Conference, NIH
Randomized Controlled Trial [Publication Type]
Work consisting of a clinical trial that involves at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.

Year introduced: 2008(1991)
Cohort Studies
Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.

Year introduced: 1989
Case-Control Studies
Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.

Year introduced: 1990
Case Reports [Publication Type]
Clinical presentations that may be followed by evaluative studies that eventually lead to a diagnosis.

Year introduced: 2008(1966)
Investigative Techniques
Investigative techniques used in pre-clinical and clinical research, epidemiology, chemistry, immunology, genetics, etc. They do not include techniques specifically applied to DIAGNOSIS; THERAPEUTICS; anesthesia and analgesia; SURGICAL PROCEDURES, OPERATIVE;
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All MeSH Categories

Analytical, Diagnostic and Therapeutic Techniques and Equipment Category

Investigative Techniques

Animal Experimentation

Animal Use Alternatives

Science Librarian

Stefka Tzanova

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Tools and other Sources

EBM l Calculators
CINAHL Complete: Cumulative Index to Nursing & Allied Health Literature (EBSCO)
This is the definitive research tool for nursing and allied health professionals.
CINAHL Complete provides broad content coverage including over 50 nursing specialties, speech and language pathology, nutrition, general health and medicine and more.
Cinahl Information Systems is accredited with distinction by the American Nurses Credentialing Center’s Accreditation Program.
CINAHL Complete -- Evidence-Based Care Sheets
Each evidence-based care sheet incorporates the latest evidence, statistics, research and references on a given topic. The references are ranked, using a coding matrix, according to the type of literature they represent (systematic reviews, meta-analysis, etc).
Asking Focused Questions... (PICO)
Asking of well-built clinical questions using the concepts patient, intervention, comparisons and outcomes
The basic principles of evidence-based medicine
EBM Glossary
Includes commonly used terms and abbreviations, and information about EMB study types.