Internet Resources

Evidence-Based Practice
a resource guide for students
Compiled by Choo Meng Hwee

Definition of the concept of 'Evidence-Based Medicine' in Medical Subject Headings of the US National Library of Medicine

"The process of systematically finding, appraising, and using contemporaneous research findings as the basis for clinical decisions. Evidence-based medicine asks questions, finds and appraises the relevant data, and harnesses that information for everyday clinical practice. Evidence-based medicine follows four steps: formulate a clear clinical question from a patient's problem; search the literature for relevant clinical articles; evaluate (critically appraise) the evidence for its validity and usefulness; implement useful findings in clinical practice."

Users' guides to evidence-based practice (Centre for Health Evidence)

Is all evidence created equal? (Library of the Health Sciences Peoria, University of Illinois at Chicago)

Critically appraise the Medical Literature

User's Guide to Medical Literature
A series from the Evidence-Based Medicine Informatics Project at McMaster University, and provided by The Canadian Centres for Health Evidence.

• Available in print and CD-ROM: Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice

How to read a paper : the basics of evidence based medicine
A series in the British Medical Journal on database searching and article appraisal.

Flaherty RJ. A simple method for evaluating the clinical literature. Fam Pract Manag. May 2004:47-52. (Restricted to NUS Staff and Students)

Pyramid of Evidence

Adapted from: Medical Research Library of Brooklyn
- http://library.downstate.edu/ebm/2100.htm

"As you move up the pyramid the amount of available literature decreases, but increases in its relevance to the clinical setting."
From: Types of Questions and Studies in Introduction to Evidence-Based Medicine (Duke University Medical Center Library and Health Sciences Library, UNC-Chapel Hill )

Answering Background questions: "who, what, when, why, where or how" about a disease, drug, intervention or concept.

	BOOKS
	The best place to look for answers to background questions are in current, regularly updated electronic or print texts.
	ACP Medicine (in print, loose-leaf)
	Published by the American College of Physicians. A comprehensive, continually updated reference of internal medicine for the practitioner.
	Bookshelf (National Center for Biotechnology Information, National Library of Medicine & National Institutes of Health, US)
	Harrison's principles of internal medicine
	Griffith's 5 minute clinical consult
	MDConsult Books (To register here for first time user)
	Diagnostic strategies for common medical problems (in print)
	Help clinicians with critical appraisal of diagnostic tests and quantitative decision-making on diagnostic strategies.
	REVIEW ARTICLES
	UpToDate (For NUS Yong Loo Lin School of Medicine teaching/research staff and students)
	An evidence-based clinical information resource which gives physicians the concise and practical answers they need at the point of care.
	MDConsult (To register here for first time user)
	MEDLINE via PubMed (National Library of Medicine, US)
	Search tips: use Limits Feature Tab: Under Publication Types, select Review.
	DRUG REFERENCE
	MICROMEDEX Healthcare Series (Restricted to NUS Staff and Students)

 

Answering Foreground questions: using resource that synthesizes a wide range of knowledge.

	SYSTEMATIC REVIEWS
	Reviewers use explicit and rigorous methods to identify, critically appraise, and synthesize relevant studies from the published medical research
	The Cochrane Library (via NUS Library Portal; Restricted)
	Consists the regularly updated collection of evidence-based medicine databases. Including:
	Cochrane Database of Systematic Reviews ~Complete reviews which are updated and maintained by collaborative review groups ~Protocols for reviews currently bring prepared. Protocols include background, objectives and methods of reviews in progress. ~Alphabetical list of titles of Cochrane Reviews (abstract: 2005 issue 2) Database of Abstracts of Reviews of Effects (DARE) ~Contains critical assessments of systematic reviews from a variety of medical journals. Cochrane Central Register of Controlled Trials (CENTRAL) ~International collection of controlled trials from a variety of sources.
	Search tips for abstracts:  in The Cochrane Library,                                or via Wiley InterScience                                or via PubMed
	MEDLINE via PubMed (National Library of Medicine, US)
	Search tips: Find Systematic Reviews in the Clinical Queries Feature: Consists of stored search strategies for retrieving Systematic Reviews.
	NICHD Cochrane Neonatal Home Page
	Alphabetical listings of systemic reviews provided by the Cochrane Neonatal Review Group, and sponsored, by the National Institute of Child Health and Human Development (NICHD).
	META-ANALYSES
	A type of systematic overview, which uses specific methodologic and statistical technique for combining quantitative data.
	The Cochrane Library (via NUS Library Portal; Restricted)
	MEDLINE via PubMed (National Library of Medicine, US)
	Search tips: use Limits Feature Tab: Under Publication Types, select Meta-Analysis.
	RANDOMIZED CONTROLLED STUDIES
	MEDLINE via PubMed (National Library of Medicine, US)
	Search tips: use Limits Feature Tab: Under Publication Types, select Randomized Controlled Trials.
	CRITICALLY APPRAISED TOPICS
	Publishes critiques of research topics.
	ACP Journal Club (via NUS Library Portal; Restricted)
	Editors of this Journal screen top clinical journals on a regular basis and identify studies that are both methodologically sound and clinically relevant. They write an enhanced abstract of the chosen articles and provide a commentary on the value of the article for clinical practice.
	Search tips:  in ACP Journal Club Search page,                       or via PubMed (no abstracts)
	Clinical Evidence (in print)
	Referenced summaries of preventive and therapeutic interventions covering common, primary or important clinical conditions.
	Search tips:  in PubMed (no abstracts)
	Bandolier
	Use when searching for freely-available, distilled information.
	InfoPOEMs
	Lookup evidence from journal articles, practice guidelines, Cochrane database abstracts, clinical tools and so on.
	PsycINFO (via NUS Library Portal)
	Includes summaries of peer-reviewed journal articles. Search by setting Limits under Publication Type of 'Journal-Peer-Review'.
	TOXNET (National Library of Medicine, US)
	Consists of a cluster of databases on toxicology, hazardous chemicals, and related areas. Including:
	Hazardous Substances Data Bank ~Broad scope in human and animal toxicity, safety and handling, environmental fate, and more. Scientifically peer-reviewed. GENE-TOX ~Peer-reviewed mutagenicity test data from the Environmental Protection Agency (EPA).
	Search in LINC (NUS Libraries Catalogue) for a list of journals on Evidence Based Practice
	The CATmaker software, developed by Douglas Badenoch from the Centre for Evidence-Based Medicine, is a tool to guide you in Critically Appraised Topics.
	PRACTICE GUIDELINES
	Quality guidelines are produced or endorsed by national, health or medical organization, professional society or expert panel.
	Clincal Practice Guidelines  by Canadian Medical Association
	Clinical Practice Guidelines by Ministry of Health, Singapore. Available in print at the Medical Library, NUS.
	Evidence Reports by the Agency for Healthcare Research and Quality.
	National Guideline Clearinghouse evidence-based guideline collection from the Agency for Health Care Policy and Research (AHCPR), in partnership with the American Association of Health Plans (AAHP) and the American Medical Association (AMA).
	Primary Care Clinical Practice Guidelines. Introduction to using guidelines, and extensive listing by clinical content based on Internet resources.
	National Institute for Clinical Excellence (NICE) Based on the best available evidence, NICE published these clinical guidelines on the appropriate treatment and care of people with specific diseases and conditions within the NHS.
	Primary Care Clinical Practice Guidelines on the web, compiled by Peter Sam, from University of California San Francisco.
	CLINICAL STUDIES
	Search for case studies in:
	MEDLINE via PubMed (National Library of Medicine, US)
	Search tips: use Clinical Study Category in the Clinical Queries Feature: Consists of stored search strategies for retrieving clinically relevant literature. Select from the four categories and same specify the emphasis of high sensitivity or high specificity on articles.
	CLINICAL TRIALS
	Cancer Research Portfolio (National Cancer Institute)
	CenterWatch (Industry sponsored trials)
	ClinicalTrials.gov (NIH funded trials)
	MetaRegister of Controlled Trials (current trials)

EBM WEBSITES

Centre for Evidence-Based Dentistry (Institute of Health Services, Oxford)

Centre for Evidence-Based Medicine (University of Toronto Libraries)

Centre for Evidence-Based Medicine (Oxford University) -- Includes teaching materials, analytical tools.

Centre for Evidence Based Mental Health (Department of Psychiatry, University of Oxford)

Centre for Evidence-Based Nursing -- A site focusing on evidence-based nursing

Evidence-Based Practice (Northern Ontario Virtual Library) -- EBM resource list, database information, EBM tutorials and tools.

Evidence-Based Medicine (McMaster University) -- Coverage of EBM concepts and practice.

Evidence-Based Medicine (University of Hertfordshire) -- Annotated EBM resource list, EBM journal links, database information, and information on electronic mailing lists related to EBM.

Evidence Based Medicine Resource Center (New York Academy of Medicine)

Netting the Evidence : A ScHARR Introduction to Evidence Based Practice on the Internet (School of Health and Related Research (ScHARR), University of Sheffield) -- An annotated list of EBM related sites on the Web.

Search Engines

Tutorials