Evidence Based Practice Resources

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Introduction

• Evidence-Based Medicine: What it is and what it isn't
• Evidence-based Medicine: A New Approach to Teaching the Practice of Medicine

Evidence-Based Practice is a five-step process: Construct a relevant, answerable question from a clinical case. Plan and carry out a search of the literature for the best external evidence. Critically appraise the literature for validity and applicability. Apply the evidence to your clinical practice. Evaluate your performance.

Constructing a relevant, answerable question

• Flemming K. EBN notebook. Asking answerable questions. Evidence-Based Nursing 1998;1:36-37.
• Formulating Answerable Clinical Questions (Centre for Evidence-Based Medicine, Mount Sinai Hospital) Including: Educational prescription
• The Well-Built Clinical Question (Duke University Medical Center Library and Health Sciences Library, UNC-Chapel Hill)
• Formulating Patient Centered Questions (University Library, University of Illinois at Chicago)
• Focusing Clinical Questions (Centre for Evidence-Based Medicine, Oxford)

Hierarchy of pre-processed evidence

[Adapted from Haynes R.B. (2006). Of studies, summaries, synopses, and systems: the "5S" evolution of information services for evidence-based healthcare decisions. ACP Journal Club, 145(3), A8-9] and Haynes RB. (2001). Of studies, syntheses, synopses, and systems: the "4S" evolution of services for finding current best evidence. ACP Journal Club, 134(2):A11-3.

EXAMPLES: SYSTEMS: Computerized decision support SUMMARIES:: Evidence-Based Guidelines ~ Evidence-Based Texts   SYNOPSES OF SYNTHESES: DARE ~ Evidence-Based Abstract Journals   SYNTHESES (Systematic Reviews): Cochrane Database of Systematic Reviews   SYNOPSES OF SINGLE STUDIES: Evidence-Based Abstract Journals   SINGLE STUDIES: Clinical Queries

Systems

“Decision support services that match information from individual patients with the best evidence from research that applies.”   (Haynes, 2007)

Summaries

"Summaries integrate best available evidence from the lower layers (drawing on syntheses [ie systematic reviews] as much as possible, to provide a full range of evidence concening management options for a given health problem."  (Haynes, 2007)

Syntheses: Systematic Reviews

"These summaries are based on a rigorous search for evidence, explicit scientific review of the studies uncovered in the search, and systematic assembly of the evidence to provide as clear a signal about the effects of a healthcare intervention as the evidence will allow." (Haynes, 2001)

Synopses

“Synopses of individual studies or systematic reviews encapsulate the key methodologic details and results required to apply the evidence to individual patient care.”   (Haynes, 2001)

 

Tips for Searching for the Evidence

 

Databases

Medline	PubMed PubMed Clinical Queries PubMed Health Services Research (HSR) Queries PubMed Health Services Research Queries Ovid MEDLINE (Use the "Limit" feature to add Clinical Queries) MeSH (Medical Subject Headings) Browser
Cochrane Database	Cochrane Library Abstracts of Cochrane Reviews Search the abstracts of Cochrane Reviews Cochrane Review Topics [plain language abstracts and summaries by topic] Informed Health Online (includes consumer summaries of Cochrane reviews) Cochrane Neonatal Reviews from the National Institute of Child Health & Human Development
Other databases	EvidenceUpdates OVID (Access to the Library's Ovid databases, including Medline and Embase) NHS Centre for Reviews and Dissemination (CRD) Databases, including: Database of Abstracts of Reviews of Effectiveness (DARE) NHS Economic Evaluation Database (NHS EED) Health Technology Assessment (HTA) Database Web of Science (including Science Citation Index) PEDro : Physiotherapy Evidence Database health-evidence.ca (Public Health) Essential Evidence Plus (formerly InfoPOEMS): The Clinical Awareness System TRIP Database (Turning Research Into Practice) Campbell Collaboration (social, behavioral and educational arenas) Public Health +

Evidence-Based Abstract Journals

• E-Resources Database (Access to all of McMaster's electronic resources)
• Evidence-Based Nursing
• ACP Journal Club
• Evidence-Based Healthcare and Public Health
• Evidence-Based Medicine
• Evidence-Based Mental Health
• Evidence-Based Obstetrics & Gynecology
• Current Cancer Treatment Reviews (Incorporating Evidence-Based Oncology)

Evidence-Based Texts

• BMJ Clinical Evidence
• FirstCONSULT
• PIER: the Physicians' Information and Education Resource
• UpToDate (On-campus access only)

Evidence-Based Clinical Practice Guidelines

• Best Practice Guidelines (Registered Nurses Association of Ontario)
• AGREE (Appraisal of Guidelines Research & Evaluation)
• Recommended Clinical Practice Guidelines (Guideline Advisory Committee (GAC))
• CMA Infobase: clinical practice guidelines -- Canadian Medical Association
• Clinical Practice Guidelines -- Alberta Medical Association
• National Guideline Clearinghouse (United States)
• Practice Guidelines (Program in Evidence-Based Care) (Cancer Care Ontario)

Critically Appraised Topics

• The CATbank (Centre for Evidence-Based Medicine, Oxford University)
• CATwalk: a guided walk through the process of doing a CAT (University of Alberta Libraries)

Meta-Searches

• TRIP (Turning Research Into Practice) Database (Clinical Effectiveness Initiative for Wales)
• Essential Evidence Plus
• Primary Care Electronic Library
• SUM Search

Consumer Resources

• MEDLINEplus
• Informed Health Online

Tools

• Users' Guides to Evidence-Based Practice
• EBM Toolbox
• Glossaries and other resources for understanding health care statistics terminology
• Clinical Epidemiology & Evidence-Based Medicine Glossary

Other Resources

• ClinicalTrials.gov
• Bandolier Evidence-Based Health Care
• Cancer Care Ontario Program in Evidence-Based Care (PEBC)
• Evidence-based Pediatrics Web Site (University of Michigan Health System)
• Therapeutics Initiative: Evidence-Based Drug Therapy
• Tutorials:
  • Evidence Based Clinical Practice Tutorial (Edward G, Miner Library, University of Rochester Medical Center)
  • Introduction to Evidence-Based Medicine (Duke University Medical Center Library and Health Sciences Library, University of North Carolina at Chapel Hill)
• Directories
  • Netting the Evidence: : A ScHARR Introduction to Evidence Based Practice on the Internet
  • Evidence Based Medicine (EBM) Toolkit (New York University School of Medicine. The Frederick L. Ehrman Medical Library)
  • Nesbit guide to evidence based resources (University of Rochester, Edward G. Miner Library)
  • Resource Guide for Evidence-Based Practice (University of Alberta Libraries)
  • Evidence-Based Health Care Practitioners Links -- created and maintained by Tom Flemming as part of: Health Care Information Resources
• Clinical Skills
  • Clinical Examination Research Interest Group including the JAMA Rational Clinical Examination series
  • Evidence-Based On-Call database

Resources for Surgery

• Evidence-based Surgery (SOURCE: Surgical Outcomes Research Centre):
  • Incudes the Evidence-Based Surgery articles from the Canadian Journal of Surgery

Evidence-Based Practice Organizations

• The Canadian Cochrane Network and Centre / Réseau et Centre de Cochrane Canadien
• Centre for Evidence-based Medicine (Mount Sinai Hospital, University of Toronto)
• Centre for Evidence-Based Medicine (Oxford, England)
• Cochrane Collaboration
• Agency for Healthcare Research and Quality

 

Need some help? Contact: Liz Bayley
Health Sciences Library, HSC-2B23
Tel: (905)525-9140, ext. 22545
Email: bayleyl@mcmaster.ca