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Center for Health Sciences
Medical Physiology - Evidence-Based Medicine
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Introduction

What is EBM?

Patient Care Model
Life-long Learning
Why is EBM Important?
Available Evidence?
EBM Issues

The Well-built Question

The EBM Process
Anatomy of a Question

Finding Evidence

Selecting a Resource
Searching the Resource
Reviewing Search Results
Returning to the Patient

Evaluating Evidence

Evaluating the Validity
Validity Questions

 

Knowledge Test

Multiple Sclerosis
Case #2
Case #3
Case #4

 

Reference/
Glossary
Feedback

 

Reference

What is EBM? | Well-Built Clinical Question | Literature Search | Evaluating the Evidence

What is EBM?

Bordley DR. Evidence-based medicine: a powerful educational tool for clerkship education. American Journal of Medicine. 102(5):427-32, 1997 May.

Covell, DG. Uman, CG. Manning, PR. Information needs in office practice: are they being met? Annals of Internal Medicine 103(4):596-599, Oct 1995.

Crowley SD, Owens TA, Schardt CM, Wardell SI, Peterson J, Garrison S, Keitz SA. A Web-based compendium of clinical questions and medical evidence to educate internal medicine residents. Acad Med 78(3):270-4, 2003 Mar.

Michaud G. McGowan JL. van der Jagt R. Wells G. Tugwell P. Are therapeutic decisions supported by evidence from health care research? Archives of Internal Medicine158(15):1665-8, 1998 Aug 10-24.

Osheroff JA. Forsythe DE. Buchanan BG. Bankowitz RA. Blumenfeld BH. Miller RA. Physicians' information needs: analysis of questions posed during clinical teaching. Annals of Internal Medicine 114(7):576-81, 1991 Apr 1.

Sackett, D. Evidence-based Medicine: How to Practice and Teach EBM. 2nd edition. Churchill Livingtone, 2000.

Sackett, D. Evidence-based Medicine - What it is and what it isn't. http://www.cebm.net/ebm_is_isnt.asp 1996.

Sackett DL, Straus SE. Finding and applying evidence during clinical rounds: the "evidence cart". JAMA 280(15):1336-8, 1998 Oct 21.

Tonelli, M.R. The philosophical Limits of Evidence-based Medicine. Academic Medicine 73(12):1234-1240, Dec 1998.

Well-Built Clinical Question

Richardson WS, Wilson MC, Nishikawa J, Hayward RSA. The well-built clinical question: a key to evidence-based decisions. ACP Journal Club. Nov-Dec 1995;123;A12.

The Literature Search 

Duke University, Medical Center, Ovid tutorial. http://www.mclibrary.duke.edu/training/ovid

PDQ Evidence-Based Principles and Practice, 1999, by Ann McKibbon, is not only an excellent introduction to EBM but also provides search strategies for doing a literature search using MEDLINE, CINAHL Database of Nursing and Allied Health Literature, PsycINFO, and EMBASE/Excerpta MEDICA. Order information from B.C. Decker, Inc. at http://www.bcdecker.com

UNC-Chapel Hill, HSL, Database Searching learning module: http://www.hsl.unc.edu/services/tutorials/srchdbs/splash.htm

Evaluating the Evidence

Users' Guides to the Medical Literature from JAMA: Note: The full text of the Users' Guide series is available from the Centre for Health Evidence.

Guyatt GH ; Rennie D. Users' guides to the medical literature [editorial]. JAMA 1993 Nov 3; 270(17):2096-7.

Oxman AD ; Sackett DL ; Guyatt GH. Users' guides to the medical literature. I. How to get started. The Evidence-Based Medicine Working Group. JAMA 1993 Nov 3; 270(17):2093-5.

Therapy

Guyatt GH ; Sackett DL ; Cook DJ. Users' guides to the medical literature. II. How to use an article about therapy or prevention. A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA 1993 Dec 1;270(21):2598-601.

Guytt GH ; Sackett DL ; Cook DJ. Users' guides to the medical literature. II. How to use an article about therapy or prevention. B. What were the results and will they help me in caring for my patients? Evidence-Based Medicine Working Group. JAMA 1994 Jan 5; 271(1):59-63.

Diagnosis

Jaeschke R ; Guyatt G ; Sackett DL. Users' guides to the medical literature. III. How to use an article about a diagnostic test. A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA 1994 Feb 2;271(5):389-91.

Jaeschke R ; Guyatt GH ; Sackett DL. Users' guides to the medical literature. III. How to use an article about a diagnostic test. B. What are the results and will they help me in caring for my patients? The Evidence-Based Medicine Working Group. JAMA 1994 Mar 2; 271(9):703-7.

Etiology/Harm

Levine M ; Walter S ; Lee H ; Haines T ; Holbrook A ; Moyer V. Users' guides to the medical literature. IV. How to use an article about harm. Evidence-Based Medicine Working Group. JAMA 1994 May 25; 271(20):1615-9.

Prognosis

Laupacis A ; Wells G ; Richardson WS ; Tugwell P. Users' guides to the medical literature. V. How to use an article about prognosis. Evidence-Based Medicine Working Group. JAMA 1994 Jul 20; 272(3):234-7.