Evidence Based Practice

Evidence-Based Practice Resources

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, Rosenberg WM, Gray JA, et al. BMJ. 1996 312(7023):71-2).

Download This Image

TRIP (Turning Research Into Practice) Database Plus

Simultaneously searches evidence-based sources of systematic reviews, practice guidelines, and critically-appraised topics and articles -- including most of those listed above and many more. Also searches MEDLINEs Clinical Queries, medical image databases, e-textbooks, and patient information leaflets.

Filtered Resources

Filtered resources appraise the quality of studies and often make recommendations for practice.

Systematic Reviews / Meta-Analyses
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 are also searchable in MEDLINE:
Medicine, nursing, dentistry, veterinary medicine, the health care system, pre-clinical sciences. The librarys full text journal collection is accessible from PubMed
Cochrane Central Register of Controlled Trials (CCTR)
Bibliographic database of definitive controlled trials
Critically-Appraised Topics
Authors of critically-appraised topics evaluate and synthesize multiple research studies.
National Guideline Clearinghouse
A comprehensive database of evidence-based clinical practice guidelines and related documents produced by the Agency for Health Care Research and Quality, in partnership with the American Medical Association and the American Association of Health Plans. Updated weekly.
Note: Guideline evidence varies from expert opinion to high levels of evidence.
ACP's PIER The Physicians Information and Education Resource
Evidence-based clinical guidance designed for rapid access to clinical information at the point of care. PIER is peer-reviewed, updated continually and includes recommendations based on all levels of medical evidence. Recommendations also include strength-of-recommendation ratings based on the quality of the underlying evidence. From the American College of Physicians.
DynaMed
Clinical reference tool for use primarily at the 'point-of-care'. Evidence-based summaries of nearly 2,000 topics.
Agency for Healthcare Research and Quality
In 1997 the Agency for Health Care Policy and Research (AHCPR), now known as the Agency for Healthcare Research and Quality (AHRQ), launched its initiative to promote evidence-based practice in everyday care through establishment of 12 Evidence-based Practice Centers (EPCs). The EPCs develop evidence reports and technology assessments on topics relevant to clinical, social science/behavioral, economic, and other health care organization and delivery issuesspecifically those that are common, expensive, and/or significant for the Medicare and Medicaid populations.
Current Practice Guidelines in Primary Care
Practice Guidelines from MDConsult
Critically-Appraised Individual Articles
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.
Evidence-Based Journal series
(e.g., Evidence-Based Medicine, Evidence-Based Mental Health, Evidence-Based Nursing) Primary research articles within the discipline are selected for quality and clinical relevance. A structured abstract and expert commentary are provided for each study.

Unfiltered Resources

Evidence is not always available via filtered resources. Searching the primary literature may be required. It is possible to use specific search strategies in MEDLINE and other databases to achieve the highest possible level of evidence.

PubMed
Medicine, nursing, dentistry, veterinary medicine, the health care system, pre-clinical sciences. The librarys full text journal collection is accessible from PubMed
To limit your PubMed search to the best evidence-producing studies: Click on "clinical queries" (on the left side of the screen). This specialized search is intended for clinicians and has built-in search "filters." Four study categories--therapy, diagnosis, etiology, prognosis--are provided, and you may indicate whether you wish your search to be more sensitive (i.e., include most relevant articles but probably including some less relevant ones) or more specific (i.e., including mostly relevant articles but probably omit a few).
CINAHL
Cumulative Index to Nursing and Allied Health Literature
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 (i.e., systematic review).
OSTMED
Osteopathic literature is not indexed in MEDLINE. The OSTMED project was initiated to make osteopathic literature more readily available
SportsDiscus
sports medicine, physical medicine, physical therapy articles and some full text
ToxNet
Databases on toxicology, environmental health, and hazardous chemicals
Health Source: Nursing/Academic Edition
Provides nearly 580 scholarly full text journals focusing on many medical disciplines

Background Information/Expert Opinion

Note: Evidence in these resources may vary from expert opinion to high levels of evidence.

UpToDate (Available only in library)
A clinical information resource, which offers up-to-date, fully referenced expert answers to patient-care, diagnosis, and treatment questions. Topic reviews are written by recognized authorities who review the topic, synthesize the evidence, summarize key findings, and provide specific recommendations.
UpToDate is licensed for in-library use only at OSUMC. Remote access is not available.
eMedicine
Physician authors and editors contribute to the eMedicine Clinical Knowledge Base, which contains articles on 7,000 diseases and disorders. The evidence-based content provides the latest practice guidelines in 62 medical specialties. eMedicine's professional content undergoes multiple levels of physician peer review.
eBooks
Full-text electronic books.
Harrison's Online
Searchable and continually updated version of Harrison's Principles of Internal Medicine.
ACP Medicine
Electronic textbook of general medicine; updated continually.
Access Medicine
Lange Educational Library, Texts, Differential Diagnosis, Diagnostic Tests, Patient Handouts, News, Drug Information, Guidelines, Images, more
MDConsult
Books, Clinics, Journals Drug Information, News, Patient Handouts, CME, PracticeGuidelines
Stat!Ref
Online library of full text medical, nursing, and allied health books

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.
Centre for Evidence-Based Medicine (Toronto)
Includes many resources for practicing and teaching EBM.
Evidence-Based Medicine
A selective list of additional EBM websites developed and maintained by Duke University Medical Center Library.
Netting the Evidence
From the School of Health and Related Research (ScHARR) at the University of Sheffield, UK. Includes a comprehensive list of EBM databases, journals, articles, and other information sources.
Users' Guides to Evidence-Based Practice
From the University of Alberta's Centre for Health Evidence. Includes the complete set of EBM Users' Guides originally published as a series in the Journal of the American Medical Association (JAMA).

Evidence-Based Medicine Tutorials

Introduction to Evidence-Based Medicine
From Duke University Medical Center Library and University of North Carolina at Chapel Hill Health Sciences Library.
SUNY Health Sciences Evidence-Based Medicine Course