Defining EBM | Finding the Best Evidence | Learning EBM Online

Defining EBM

• "Evidence-based medicine is the integration of best research evidence with clinical expertise and patient values."
  
  Sackett, D. L. (2000). Evidence-based medicine: How to practice and teach EBM (2nd ed.). Edinburgh; New York: Churchill Livingstone.

• "Evidence-based medicine (EBM) involves caring for patients by explicitly integrating clinical research evidence with pathophysiologic reasoning, caregiver experience, and patient preferences."
  
  Cook, D. J., and Levy, M. M. (1998). Evidence-based medicine. A tool for enhancing critical care practice. Critical Care Clinics, 14(3), 353-358.

• "Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research."
  
  Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., and Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn't: It's about integrating individual clinical expertise and the best external evidence. BMJ, 312(7023), 71-72. http://www.bmj.com/cgi/content/full/312/7023/71
  

Finding the Best Evidence

Point-of-Care Databases

• DynaMed -  an evidence-based, clinical decision support tool containing more than 2000 up-to-date clinical topic summaries with information on etiology, directed history and physical findings, differential diagnoses and diagnostic testing, prognosis, treatment, prevention, links to patient education resources, and the most common ICD-9 Codes.

• PIER (From ACP) - an evidence-based, clinical decision support tool containing more than 330 disease modules, 11 videos, 14,000 pages of medical condition and diagnostic text, and 2500 graphs and tables. Integrated with STAT!Ref. Accessible from local and remote locations.

• UpToDate -  an expert opinion and evidence-based, clinical decision support tool containing more than 60,000 pages of original text covering 7,000 topics in primary care and internal medicine from 3000 expert contributors, 250 patient education sheets, 15,000 graphics, and 160,000 MEDLINE abstracts. Accessible only from the OSU CHS Campus on West 17th Street and the Health Care Center at 2345 Southwest Blvd.

• FIRSTConsult -  an evidence-based, clinical decision support tool containing more than 600 medical conditions, 1500 diagnoses, 300 signs and symptoms, 300 patient education sheets in English and Spanish, 1400 of the most common ICD-9 Codes, and 30 Surgical/Diagnostic procedures. Accessible from local and remote locations.

• Cochrane Database of Systematic Reviews -  contains full text articles, as well as protocols focusing on the effects of healthcare. Data is evidence-based medicine and is often combined statistically (with meta-analysis) to increase the power of the findings of numerous studies, each too small to produce reliable results individually.  
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• Database of Abstracts of Reviews of Effects (DARE) -  includes comprehensive abstracts of published systematic reviews on the effects of health care from around the world, which have been critically analyzed according to a high standard of criteria. This database provides access to quality reviews in subjects for which a Cochrane review may not yet exist.  
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Indexes to Published Research Reports

• Cochrane Central Register of Controlled Trials -  a bibliography of controlled trials identified by contributors to the Cochrane Collaboration and others, as part of an international effort to hand search the world's journals and create an unbiased source of data for systematic reviews.  
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Learning EBM Online

Introduction to Evidence-Based Medicine

This self-paced tutorial guides the health care professional through the complete EBM process, emphasizing the elements of a well built clinical question and the key issues that help determine the validity
of evidence. This tutorial was developed by the Medical Center Library, Duke University and Health Sciences Library, University of North Carolina at Chapel Hill.

Filtering the Wisdom: Searching and Delivering the Evidence for Clinical Care Questions

This 5-week online course will provide librarians with the tools necessary to enhance their evidence-based search skills and to deliver filtered search results to health care professionals. Librarians will gain a basic understanding of the types of evidence-based resources and levels of evidence for clinical questions, and they will be able to design search strategies to retrieve focused, evidence-based information. This course will begin January 2008 and is sponsored by the Medical Library Association.

Evidence-Based Medicine and the Medical Librarian

This eight-week course is designed as an introduction for medical librarians to the practice of evidence-based medicine (EBM).  Practicing EBM means combining clinical expertise, the preferences and values of the patient and the best available evidence to make good patient care decisions.

Evidence-Based Knowledge Portal

This Evidence-Based Knowledge Portal, developed by the Eskind Biomedical Library with NLM grant funding, includes tutorials addressing facets of statistical analysis and critiquing the medical literature. Virtual practice cases allow users to explore principles of EBM in the context of a clinical scenario. Must request a password for access.


Searching the Medical Literature for the Best Evidence
Health Sciences Library, University of North Carolina at Chapel Hill, NC

This tutorial is designed to teach the user how to select and search key resources in locating evidence-based information for clinical decision-making. The emphasis of this tutorial is on understanding how and when to use core EBM resources and techniques for productive searching. Resources covered inthis tutorial are: UpToDate, Cochrane Database of Systematic Reviews, ACP Journal Club, and PubMed Clinical Queries

Evidence Based Medicine (UMass)

Lamar Soutter Library at the University of Massachusetts Medical School has developed a simple yet in depth online tutorial for Evidence Based Medicine. This resource looks and feels more like an online course than a tutorial. It is easy to navigate and includes a number of internal links allowing users to decide their own pace.

An Introduction to Information Mastery

This is a Web-based course that introduces the basic concepts of Information Mastery, Evidence-Based Medicine (EBP), and critical appraisal of the medical literature. The course was developed by Dr. Mark Ebell at Michigan State University.

SUNY Downstate Medical Center Evidence Based Medicine Tutorial
Medical Research Library of Brooklyn, SUNY Downstate Medical Center

The tutorial introduces EBM principles and strategies used in  searching and evaluating the literature.