- Overview
- Ask a Question
- Study Design
- Search the Evidence
- Critically Appraise the Evidence
- Video Tutorials
John Reazer
- Instructional/Reference Services Librarian
- jxr1217@med.miami.edu
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The "Classic Definition"
"EBM is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research ... thoughtful identification and compassionate use of individual patients' predicaments, rights, and preferences in making clinical decisions about their care".
Sackett DL. Rosenberg WM. Gray JA. Haynes RB. Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ. 312(7023):71-2, 1996
Introduction to Evidence-Based Practice (Duke University)
This self-paced tutorial will take you through the complete EBM process, emphasizing the elements of a well-built clinical question and the key issues that help determine the validity of evidence.
Evidence-Based Medicine Toolbox
The goal of this Website is to help develop, disseminate, and evaluate resources to use in practice and in teaching EBM to undergraduate, postgraduate and continuing education health care professionals.
Evidence Based Medicine - Finding the Best Clinical Literature (University of Illinois)
This guide is designed to assist health care professionals and students become effective and efficient users of the medical literature.
The Evolution of Evidence-Based Medicine
This 10 minute video will introduce to the development and key concepts of Evidence-Based Medicine
Suny Downstate Medical Centre Evidence-Based Medicine Tutorial
Work at your own pace through this tutorial.
University of Western Australia Answering Clinical Questions Tutorial
Four modules will help you to answer clinical questions using an EBP approach.
Etiology: how to identify causes for disease (including its iatrogenic forms).
Diagnosis: how to select and interpret diagnostic tests, in order to confirm or exclude a diagnosis, based on considering their precision, accuracy, acceptability, expense, safety, etc.
Prognosis: how to estimate our patientâs likely clinical course over time and anticipate likely complications of the disorder.
Therapy: how to select treatments to offer our patients that do more good than harm and that are worth the efforts and costs of using them.
Prevention: how to reduce the chance of disease by identifying and modifying risk factors and how to diagnose disease early by screening.
FROM: User's Guides to the Medical Literature: essentials of evidence-based clinical practice G. Guyatt et al (eds) New York, 2008.
PICO is a useful tool for asking focused clinical questions.
PICO clarifies the question, determines search concepts and type of study that is most appropriate to answer the question type.
P.I.C.O. Model for Clinical Questions
|
P |
Patient, Population, or Problem |
How would I describe a group of patients? |
|
I |
Intervention, Prognostic Factor, or Exposure |
Which main intervention, prognostic factor, |
|
C |
Comparison or Intervention (if appropriate) |
What is the main alternative to compare |
|
O |
Outcome you would like to measure or achieve |
What can I hope to accomplish, measure, |
|
|
What type of question are you asking? |
Diagnosis, Etiology/Harm, Therapy, Prognosis, |
|
|
Type of study you want to find |
What would be the best study design? |
- Oxford University Study Design
This page gives a brief comparison of the advantages and disadvantages of the different types of studies. - Clinical Epidemiology & Evidence-Based Medicine Glossary
Clinical Study Design and Methods Terminology.
- Understanding Research Study Designs
In order to find the best possible evidence, it helps to understand the basic designs of research studies. The following basic definitions and examples of clinical research designs follow the “hierarchy of evidence.â€
- GRADE Working Group
Grading of Recommendations Assessment, Development and Evaluation (GRADE). The working group has developed a common, sensible and transparent approach to grading quality of evidence and strength of recommendations - Levels of Evidence and Grades of Recommendations
Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence - Strength of Recommendation Taxonomy (SORT)
A patient-centered approach to grading evidence in the medical literature.
Evidence-based practice requires that clinicians search the literature to find answers to their clinical questions. There are literally millions of published reports, journal articles, conference proceedings, and research studies available to clinicians. Choosing the best resource to search is an important decision.
- AccessMedicine
Trusted Content. Instant Answers. Innovative online resource that provides students, residents, clinicians, researchers, and all health professionals with access to more than 50 medical titles from the best minds in medicine, updated content, thousands of images and illustrations, interactive self-assessment, case files, diagnostic tools, a comprehensive search platform, and the ability to download content to a mobile device. - ClinicalKey
Clinical search engine that adapts to any screen size, helping you find fast answers and deep evidence from more than 1,000 full-text reference books, 600 full-text journals, videos, images and more.
- ACP Journal Club
The content is carefully selected from over 100 clinical journals through reliable application of explicit criteria for scientific merit, flowed by assessment of relevance to medical practice. - BMJ Clinical Evidence
Clinical Evidence describes the best available evidence from systematic review, RCTs, and observational studies when appropriate for assessing the benefits and harms of treatment. - DynaMed Plus
DynaMed Plus is the next-generation clinical reference tool physicians can rely on for fast, easy access to point-of-care decision support. Written by a team of specialized physicians and researchers, content is updated several times daily to include information on the latest evidence-based research, providing practice-changing answers to clinical questions with optimized speed. - UpToDate
Clinical decision support tool designed to answer clinical questions that arise in daily practice. Subscription database with access for UM/JMH authorized users.
- Center for Review and Dissemination (DARE)
Assists decision-makers by identifying and describing systematic reviews and economic evaluations, appraising their quality, and highlighting their relative strengths and weaknesses. - Cochrane Library
A collection of databases that contain different types of high-quality, independently-assessed evidence to inform healthcare decision-making. Includes: Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, Database of Abstracts of Reviews of Effects, Cochrane Methodology Register, Health Technology Assessment Database and NHS Economic Evaluation Database. - PubMed Clinical Queries
Allows you to quickly focus your PubMed search on clinical studies and systematic reviews. Find out more in our online tutorial.
- Trip Database
The TRIP Database searches across multiple Internet sites for evidence-based content. It covers key medical journals, Cochrane Systematic reviews, clinical guidelines, and other highly relevant sources. - SUMSearch
SUMSearch is a metasearch engine that provides references to answer clinical questions. Simultaneously searches multiple sources of high quality with emphasis on Evidence-Based Medicine
How to Construct a Well-Built Clinical Question (PICO)
Learn from this live Calder Library Training Session the basics of contructing the PICO question.
