Evidence-Based Medicine (EBM) Resources

Evidence-Based Medicine is the integration of best research evidence with clinical expertise and patient values. (Sackett DL, Straus SE, Richardson WS, et al. Evidence-based medicine: how to practice and teach EBM. 2nd ed. Edinburgh: Churchill Livingstone, 2000.)

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.

Systematic Reviews are also searchable in MEDLINE:

• Ovid MEDLINE: Enter your search query. Click on the “Limits” icon; select “Systematic Reviews” under “Subject Subsets.”
• PubMed: Click on “Clinical Queries” on the homepage; under "Find Systematic Reviews".

Critically-Appraised Topics & Articles

Authors of critically-appraised topics & articles evaluate and synthesize multiple research studies.

DynaMed

Dynamed is a clinical reference tool created by physicians for physicians and other health care professionals for use primarily at the 'point-of-care'. With clinically organized summaries for nearly 3,000 topics Dynamed is the only evidence-based reference shown to answer most clinical questions during practice. Dynamed is updated daily and monitory the content of over 500 medical journals and systematic evidence review databases directly and indirectly by using many journal review services. Each publication is reviewed cover-to-cover, and each article is evaluated for clinical relevance and scientific validity. The new evidence is then integrated with existing content, and overall conclusions are changed as appropriate representing a synthesis of the best available evidence. Through this process of systematic literature surveillance, the best available evidence determines the content of Dynamed.

PIER

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.

There is a PDA version of this product.

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

Primary Literature

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

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).

Ovid Medline

To limit your Ovid MEDLINE search to the best evidence-producing studies: Clinical Queries (See PubMed) is searchable in Ovid; click on the "Limits" icon.

EMBASE

Major biomedical and pharmaceutical database covering drug research, pharmacology, pharmaceutics, toxicology, clinical and experimental human medicine, health policy and management, public health, occupational health, environmental health, drug dependence and abuse, psychiatry, forensic medicine, and biomedical engineering/instrumentation. Produced by Excerpta Medica and updated weekly.

To limit your EMBASE search to the best evidence-producing studies: Click on the ‘Limits’ icon to use ‘Clinical Queries’.

PsycINFO

International coverage of the professional and academic literature in psychology, medicine, psychiatry, nursing, sociology, education, pharmacology, physiology, linguistics, and other areas.

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

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).

Background Information/Expert Opinion

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

UpToDate

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.

(Access restrictions: UpToDate is licensed for on-site use only at Dartmouth College, Dartmouth Medical School, and the Dartmouth-Hitchcock Medical Center. Remote access is not permitted.)

Online Books:

• Holland Frei Cancer Medicine
• Harrison's Principles of Internal Medicine
• Devita's Cancer: Principles & Practice of Oncology
• Basic & Clinical Pharmacology
• ACS Surgery Principles and Practice