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I have made some notes which I use in my Cochrane Library demonstration sessions. They contain background material, links and references on evidence-based medicine, and the Cochrane Collaboration.You can Click here to view them.
The Cochrane Library (and Related Resources)
Click here to access the Cochrane Library. There is a useful NICS Guide to the Cochrane Library which explains the purpose of the Cochrane Library, and how to search it.
Abstracts of Cochrane Reviews - Browse by Collaborative Review Group
At this site you can see abstracts of the reviews produced by each group. The full text of these reviews and protocols is available in The Cochrane Library.
The Cochrane Collaboration
This is a brochure outlining the structure of the Collaboration and describing its work.
Cochrane Database of Systematic Reviews is now included in Medline.
Browse contents and abstracts on PubMed.
Database of Abstracts of Reviews of Effects (DARE)
DARE is a database of high quality systematic research reviews of the effectiveness of health care interventions. It is part of the Cochrane Collaboration, and at this site is searchable by author and words from the title.
Cochrane Reviewers' Handbook
From the introduction
"The basic principles of reviewing research are the same, whatever type of evidence is being reviewed. Although we focus mainly on systematic reviews of RCTs we address issues specific to reviewing other types of evidence when this is relevant."
Searching for Evidence-Based Medicine on Medline
When you have performed a search on a clinical topic in Medline you will find that there are several publication types that indicate that an article is useful for evidence based practice. If you limit your search to include each of these publication types you should get references to most articles indexed in Medline that are appropriate for evidence based practice.
CLINICAL TRIAL PHASE III
CLINICAL TRIAL PHASE IV
Both of these experimental designs use a control group, as does
CONTROLLED CLINICAL TRIAL
META ANALYSIS
is a statistical analysis that allows the results of several studies to be pooled to provide more reliable EBP data.
PRACTICE GUIDELINE
Should be a list of evidence based serial statements to assist in diagnosis and treatment of particular conditions.
RANDOMIZED CONTROLLED TRIAL
This is the gold standard for Evidence Based Practice.
PubMed also has a special feature PubMed Clinical Queries a specialised search, intended for clinicians, which has built-in search "filters" for detecting clinically sound studies in Medline. Four study categories--therapy, diagnosis, etiology, prognosis--are provided, and you can choose the emphasis to be either specificity (i.e., mostly relevant articles but probably omiting a few) or sensitivity (i.e., most relevant articles but probably some less relevant ones). For details see the PubMed Clinical Queries Table which explains sensitive (broad) and specific (narrow) searches and approximate equivalents in the PubMed query language as recommended in Developing optimal search strategies for detecting clinically sound studies in MEDLINE. Haynes et al. J Am Med Inform Assoc.1994 November;1 (6): 447–458.
There is also a Systematic Reviews search option.
For step-by-step notes on searching PubMed for evidence based practice click here
Other Resources
ACP Journal Club
This is actually a journal produced by the The American College of Physicians-American Society of Internal Medicine (ACP-ASIM). Its stated aim is to select published articles according to explicit criteria and to abstract those studies and reviews that warrant immediate attention by physicians attempting to keep pace with important advances in the treatment, prevention, diagnosis, cause, prognosis, or economics of the disorders managed by internists. These articles are summarized in "value-added" abstracts and commented on by clinical experts. Journals are reviewed according to a priority list. All issues of the following "core" journals are reviewed: American Journal of Medicine, Annals of Internal Medicine, Archives of Internal Medicine, BMJ, Circulation, Diabetes Care, JAMA, Journal of General Internal Medicine, Journal of Internal Medicine, Lancet, and New England Journal of Medicine. Other journals are reviewed as space permits, as announced in each issue.
ARIF Critical Appraisal Process
From the Aggressive Research Intelligence Facility based at the University of Birmingham, set up to help health care workers access and interpret research evidence in response to particular problems, the ARIF critical appraisal process is described here, and linked to this page are details about the purpose of critically appraising review articles and the checklist ARIF uses formally to do this.
Bandolier
The first issue of Bandolier, an independent journal about evidence-based healthcare, written by Oxford scientists, was printed in February 1994. It has appeared monthly ever since and has become the premier source of evidence based healthcare information in the UK and worldwide for both healthcare professionals and consumers.
BMJ collections of articles by topic.
bmj.com Topic collections : Changing physician behavior
bmj.com Topic collections : Diagnostics tests
bmj.com Topic collections : Guidelines
bmj.com Topic collections : Other evidence based practice
bmj.com Topic collections : Randomized controlled trials: descriptions
bmj.com Topic collections : Randomized controlled trials: examples
bmj.com Topic collections : Systematic reviews (incl meta-analyses): descriptions
bmj.com Topic collections : Systematic reviews (incl meta-analyses): examples
The Campbell Collaboration
The Campbell Collaboration collaborates closely with its sibling organization, the Cochrane Collaboration, which prepares and maintains systematic reviews of the effects of interventions in health care.
The Campbell Collaboration currently consists of two unique databases:
The C2 Register of Interventions and Policy Evaluations (C2-RIPE)
The C2 Social, Psychological, Education, and Criminological Trials Registry (C2-SPECTR)
Canadian Medical Association. Clinical Practice Guidelines Infobase
A searchable database of guidelines produced or endorsed in Canada by a national, provincial or territorial medical or health organization, professional society, government agency or expert panel.
CASP (Critical Appraisal Skills Programme)
The Critical Appraisal Skills Programme is part of the Public Health Resource Unit, working at the Institute of Health Sciences in Oxford, to help bring the principles and practice of evidence-based practice to as wide an audience as possible.
CenterWatch Clinical Trials Listing Service
CenterWatch Inc. is a multimedia publishing company based in Boston, Massachusetts. The web site is designed to be a resource both for patients interested in participating in clinical trials and for research professionals.
Centres for Health Evidence (CHE). Users' Guides to Evidence-Based Practice
A complete set of Users' Guides originally published in the Journal of the American Medical Association (JAMA). The full text is available here in its pre-publication version with permission from the journal.
ClinicalTrials.gov: Linking Patients to Medical Research
The U.S. National Institutes of Health, through its National Library of Medicine, has developed ClinicalTrials.gov to provide patients, family members and members of the public with current information about clinical research studies.
CRISP - A Database of Biomedical Research Funded By the National Institutes of Health (NIH)
CRISP (Computer Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other research institutions in the United States.
eMedicine Clinical Knowledge Base
The evidence-based content, updated regularly, provides the latest practice guidelines in over 50 medical specialties. eMedicine's professional content undergoes 4 levels of physician peer review plus an additional review by a PharmD prior to publication.
eMJA: Clinical Guidelines
Clinical guidelines from the Medical Journal of Australia - listed by topic.
EPC Evidence Reports
Under the Evidence-based Practice Program of the Agency for Healthcare Research and Quality (formerly the Agency for Health Care Policy and Research—AHCPR), 5-year contracts are awarded to institutions in the United States and Canada to serve as Evidence-based Practice Centers (EPCs). The EPCs review all relevant scientific literature on clinical, behavioral, and organization and financing topics to produce evidence reports and technology assessments.
 Evidence-Based Decisionmaking for Community Health Programs
By Catherine A. Jackson, Kathryn Pitkin, and Raynard Kington. A RAND research document, MR-933-MLHS, 1998.
Evidence-Based Medicine Glossary
From the Centre for Evidence-Based Medicine situated at Oxford University.
Evidence-Based Medicine Resource Center
Formed by the New York Academy of Medicine in partnership with the Evidence-based Medicine Committee of the American College of Physicians, New York Chapter.
Evidence Based Medicine Tool Kit
From the University of Alberta.
Evidence Based Medicine Toolbox
From the Centre for Evidence-Based Medicine situated at Oxford University.
Evidence-Based Medicine: What it is and what it isn't
An article by David L Sackett and others, based on an editorial from the BMJ 13th January 1996 (BMJ 1996; 312: 71-2)
Health Evidence Network (HEN)
HEN is a programme of the World Health Organization Regional Office for Europe. Of particular interest are the Evidence Reports, the full text of which is available on line.
Health Report - Facing the evidence - part one
Health Report - Facing the evidence - part two
Transcripts from Radio National's Health Report, with Norman Swan.
Health Technology Assessment (HTA) Database
Health care technology is defined as prevention and rehabilitation, vaccines, pharmaceuticals, and devices, medical and surgical procedures, and the systems within which health is protected and maintained. Technology assessment studies the medical, social, ethical and economic implications of development, diffusion, and the use of health technology and informs policy decisions. Its aim is to improve the quality and cost-effectiveness of healthcare.
HealthLinks: Evidence-Based Practice
A useful selection of links from the University of Washington.
InfoPOEMs Home Page
POEMS (Patient Oriented Evidence that Matters) for the primary care physician. Includes POEMs reviews published in the Journal of Family Practice.
Introduction to Evidence-Based Medicine
This is a helpful tutorial from the Duke University Medical Center Library. I've targeted the section entitled The Well-Built Clinical Question" , but the section on "The Literature Search" is also worth looking at for its PubMed search example.
Locating and Appraising Systematic Reviews
This article from the journal Annals of Internal Medicine (April 1997) looks at the ways of locating systematic reviews, covering their strengths and weaknesses. The methods of finding these reviews include electronic databases such as MEDLINE, Best Evidence and the Cochrane Library. It also present steps used to critically appraise review articles. The article is provided by the American College of Physicians for medical professionals.
Method for Evaluating Research Guideline Evidence (MERGE)
From the Centre for Clinical Policy and Practice of the NSW Health Department The Method for Evaluating Research and Guideline Evidence (MERGE) sets out an explicit standardised approach to reviewing and incorporating scientific evidence into guidelines. MERGE helps guideline developers comply with principles outlined by the NH&MRC Quality of Care and Health Outcomes Committee (QCHOC)
National Guideline Clearinghouse
The National Guideline Clearinghouse™ (NGC) is a comprehensive database of evidence-based clinical practice guidelines and related documents produced by the Agency for Health Care Policy and Research (AHCPR), in partnership with the American Medical Association (AMA) and the American Association of Health Plans (AAHP).
National Health and Medical Research Council - NHMRC - Clinical Practice Guidelines
National Health and Medical Research Council. Handbook series on preparing clinical practice guidelines
This series includes the following titles:-
How to review the evidence: systematic identification and review of the scientific literature.
How to use the evidence: assessment and application of scientific evidence.
How to put the evidence into practice: implementation and dissemination strategies.
How to present the evidence for consumers: preparation of consumer publications.
How to prepare and present evidence-based information for consumers of health services: A Literature review (1999).
National Quality Measures Clearinghouse (NQMC)
NQMC is sponsored by the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services. It is a public repository for evidence-based quality measures and measure sets.
NeLH - Guidelines Finder
The Guidelines Finder provides an index to clinical guidelines and currently holds details of over 1000 UK national guidelines with links to Internet downloadable versions of the guidelines. It is updated on a weekly basis.
Netting the Evidence : A ScHARR Introduction
An evidence-based search site maintained by the School of Health and Related Research at the University of Sheffield. You will find a wealth of material at this site as well as links to further resources.
NHS Centre for Reviews and Dissemination CRD: Information and Enquiry Service
The CRD provides a free enquiry service about systematic reviews and economic evaluations.
NHS Economic Evaluation Database (NHS EED)
The NHS EED is database of economic evaluations of health care interventions. If you search the Cochrane Library, records from NHS EED will be included in the search results automatically. However NHS EED on the WWW is updated monthly so searchers should be aware that the Internet version of NHS EED will always have more information than the version on the Cochrane Library which is published quarterly.
NICE (National Institute for Clinical Excellence)
This site has two entry points - one for professionals, and one for patients. NICE is part of the National Health Service (NHS), and its role is to provide patients, health professionals and the public with authoritative, robust and reliable guidance on current “best practice”.
NICHSR (National Information Center on Health Services Research & Health Care Technology) Introduction to HSR (Health Services Research) Class Manual: Evaluating the Literature
A straightforward training manual on Evaluating the Literature: Quality Filtering and Evidence-Based Medicine and Health, from the National Library of Medicine.
Primary Care Clinical Practice Guidelines
From the University of California at San Francisco School of Medicine. A series of guidelines for primary care providers.
PRODIGY: Clinical Knowledge Summaries
PRODIGY guidance has been developed and maintained for the NHS by the Sowerby Centre for Health Informatics at Newcastle (SCHIN) since 1998. The Clinical Knowledge Summaries (CKS) Service provides an up-to-date source of clinical knowledge that can help healthcare professionals and patients in managing the common conditions generally seen in primary and first-contact care.
PubMed - Evidence-Based Medicine
I've included here a Medline search on evidence-based medicine, its history, methods, and current trends, in relation to public health issues.
The Relation Between Systematic Reviews and Practice Guidelines
This article from the journal Annals of Internal Medicine (August 1997) looks at the distinction between a systematic review and a practice guideline. It covers methods of developing guidelines, the role of evidence in the development of guidelines, how to use systematic reviews to build guidelines and clinical pathways, and the limitations of relying on the reviews. The site is provided by the American College of Physicians.
A Schema for Evaluating Evidence on Public Health Interventions
A paper prepared by Lucie Rychetnik and Michael Frommer for the National Public Health Partnership. Version 4 April 2002.
Scottish Intercollegiate Guidelines Network (SIGN)
The Scottish Intercollegiate Guidelines Network (SIGN) was formed in 1993. Their objective is to improve the quality of health care for patients in Scotland, through the development and dissemination of national clinical guidelines containing recommendations for effective practice based on current evidence.
SUMSearch
SUMSearch is new method of searching the Internet for evidence based medical information. Querying a number of key databases, such as MEDLINE, and the Database of Abstracts of Reviews of Effects (DARE ), SUMSearch aims to select the most appropriate source, format the search query, modify this query if too few or too many hits are found, and return a single document to the clinician.
SUNY Health Sciences Evidence Based Medicine Tutorial
From the State University of New York. (The guides to searching, and the examples are applicable only to the OVID(tm) character-based version of Medline.)
Trawling the Net : A ScHARR Introduction
This site lists free databases of interest to NHS staff on the internet. The sources have been selected according to three criteria: (1) they contain material of interest to staff working in the UK National Health Service, (2) they have some form of search facility, and (3) they do not require individual passwords or payments of any kind.
TRIP Database
The TRIP Database searches across 58 sites of high-quality medical information and gives direct, hyperlinked access to 'evidence-based' material on the web as well as articles from premier on-line journals such as the BMJ, JAMA, NEJM etc.
Undertaking Systematic Reviews of Research on Effectiveness (CRD Report no. 4)
First published on 4 January 1996, this CRD Report contains Guidelines developed and published by the NHS Centre for Reviews and Dissemination, which can be used as a framework for carrying out systematic reviews or used for information by organisations commissioning reviews.
Users' Guides to the Medical Literature
A series of articles on critical appraisal of medical literature, from JAMA. |
