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This page collects some resources for finding information on evidence-based medicine (EBM). 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). Some research sources will have higher levels of evidence than others due to their design and the work that goes into them. The picture below shows some common medical information sources from highest to lowest levels of evidence:
(EBM Pyramid and EBM Page Generator, copyright 2006 Trustees of Dartmouth College and Yale University. All Rights Reserved.
Produced by Jan Glover, David Izzo, Karen Odato and Lei Wang.)
Filtered resources appraise the quality of studies and often make recommendations for practice.
TRIP database search - The TRIP (Turning Research Into Practice) Database provides access to a wide range of evidence-based specialist sources by allowing users to cross-search a number of publications including the Cochrane database, Bandolier, Clinical Evidence, Evidence-Based Nursing and Evidence-Based Mental Health via a single interface. (Get@SFU cannot be enabled for this database. If you find a source you want, please check the library catalogue for availability.)
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.
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.
Systematic reviews and meta-analyses are also searchable in key health databases:
- Ovid Medline: Before entering your search, select 'Systematic Reviews' in the 'Limits' box.
- PubMed: After entering your search, select 'Systematic Reviews' or 'Meta-Analyses' under 'Article Types' to the left of your search results.
Critically-appraised systematic reviews and meta-analyses
Systematic reviews and meta-analyses are summarized and evaluated.
Screens, summarizes, evaluates and rates systematic reviews and meta-analyses of relevance to public health decision-making. Funded by the Canadian Institutes of Health Research.
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.
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 is not always available via filtered resources, so searching the primary literature may also be required. It is possible to use specific search strategies in MEDLINE and other databases to achieve the highest possible level of evidence.
- PubMed: To limit your PubMed search to the best evidence-producing studies: After entering a search, check boxes under 'Article Types' to the left of the search results to limit by type of article.
- Ovid Medline: To limit your Ovid Medline search to the best evidence-producing studies: Check boxes under the search box to limit by type of article. You can also click on the 'Additional Limits' button to choose specific types of clinical queries.
- PsycINFO: To limit your PsycINFO search to the best evidence-producing studies: Click on the ‘Limits’ icon to use ‘Clinical Queries’ or limit to ‘methodology’ types.
- CINAHL Complete: To limit your CINAHL search to the best evidence-producing studies: Click on the ‘Limits’ icon to use ‘Clinical Queries’ or limit to ‘Research’ or other ‘publication’ types (e.g., systematic review).
In all of these databases, you may wish to search for specific kinds of studies with high levels 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.
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.
Evidence-based medicine tutorials
Introduction to Evidence-Based Practice
From Duke University Medical Center Library and University of North Carolina at Chapel Hill Health Sciences Library.
National Collaborating Centre for Methods and Tools Modules on Evidence-Informed Practice
Requires the creation of a free account.