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Evidence Based Practice
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Course Instructors:
Librarian: Jim Beattie jbeattie@umn.edu
 

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Databases/Electronic Resources
  • Databases
    • MEDLINE (OVID) Authentication Required
      MEDLINE includes citations from the fields of medicine, public health, nursing, dentistry, veterinary medicine, and the basic biomedical sciences.

      The Libraries’ subscription to this resource allows for 40 users at any one time. If you get a busy signal, please wait a few minutes and try accessing the site again.

      MEDLINE is the National Library of Medicine’s bibliographic database/article index that contains over 17 million references to journal articles. Coverage is from 1949 to the present. Over 5200 journals worldwide in over 37 languages are indexed. Covered are basic biomedical research and the clinical sciences, including nursing, dentistry, veterinary medicine, pharmacy, allied health and pre-clinical sciences as well as life sciences that are important to practitioners and researchers â€" biology, environmental science, biophysics, chemistry and plant & animal science. Ovid, a software company specializing in text retrieval applications and search interfaces, provides an easy to use interface for searching MEDLINE.
    • PubMed - U of M Students, Staff & Faculty Authentication Required
      Primary source of journal article access for the health sciences - the campus version provides full text access to all Medline e-journals subscribed to by the University of Minnesota TC Libraries. Includes Medline and Pre-Medline (articles more recent than found in Medline).
    • ACP's PIER: The Physician's Information & Education Resource Authentication Required
      PIER is a product of ACP, The American College of Physicians and is a web-based authoritative, evidence-based guidance tool. PIER’s disease modules include sections on diagnosis, prevention, screening, drug therapy, patient education and case scenarios. On the PDA application, topics are supported with tables, and references to Web sites for supporting articles in Annals of Internal Medicine and PubMed. PIER adds and revises information as new disease findings become available.
    • Essential Evidence Plus (InfoPOEMS) Authentication Required
      Essential Evidence Plus formerly InfoPOEMs, consists of two products -- InfoRetriever and the Daily InfoPOEMs. InfoRetriever provides filtered, graded, summarized evidence and clinical tools for use in the office or at the bedside. Daily InfoPOEMs provides a complete clinical awareness system for knowledge management.
    • MICROMEDEX Authentication Required
      Provides access to drug information resources, including DRUGDEX; POISINDEX; Martindale, the Extra Pharmacopoeia; Index Nominum; and Physician’s Desk Reference. In addition there is a drug interaction utlity, dosing calculators, and differential diagnostic lists. PDA downloads are available for U of MN students, faculty, and staff.
      • Using MICROMEDEX
        Handout on how to search the various databases that make up MICROMEDEX.
    • SumSearch
      SUMSearch is a unique method of searching for medical evidence by using the Internet. SUMSearch combines meta-searching and contingency searching in order to automate searching for medical evidence.
  • E-Texts
    • Harrison's Online Authentication Required
      Consists of the latest edition of the basic text of Harrison’s principles of internal medicine, sections on clinical trials, updates (and their related references, including abstracts) related to the text and an online pretests section. Also included is an online forum where interested participants can post messages, read, or join any discussion threads.

      The Libraries’ subscription to this resource allows for 5 users at any one time. If you get a busy signal, please wait a few minutes and try accessing the site again.
    • MD Consult Authentication Required
      Full text access to selected medical texts, medical journals, practice guidelines, drug information, patient handouts, and CME materials.
      Remote access available for University of Minnesota -- Twin Cities students, staff and faculty.

    • The Merck Manual of Diagnosis and Therapy, 17th ed.
      Presents treatment options for a broad spectrum of medical disorders. Discussions include etiology, epidemiology, and pathogenesis, symptoms and signs, laboratory findings, diagnosis, prognosis, and treatment.
    • STAT!Ref Authentication Required
      Provides keyword searchable access to the full text to more than a ozen major medical and drug textbooks. Titles include: ACP Medicine, Current Diagnosis & Treatment in Cardiology, Current Obstetric & Gynecologic Diagnosis & Treatment, Current Pediatric Diagnosis & Treatment, DeGowin’s Diagnostic Examination, Goodman & Gilman’s The Pharmacologic Basis of Therapeutics, Griffith’s 5-Minute Clinical Consult, and more...

  • Internet Resources/Comprehensive Websites
    • Evidence-based Practice Tutorial
      This is an interactive, interprofessional tutorial developed by Health Sciences Libraries’ librarians and AHC Learning Commons instructional and Web designers.
    • Evidence-Based Medicine Resource Center
      The New York Academy of Medicine in partnership with the Evidence-based Medicine Committee of the American College of Physicians, New York Chapter has developed an Evidence-based Medicine Resource Center. The web site contains references, bibliographies, tutorials, glossaries, and on-line databases to guide those embarking on teaching and practicing evidence-based medicine. It offers practice tools to support critical analysis of the literature and MEDLINE searching, as well as links to other sites that help enable evidence-based medical care.
    • Nesbit Guide to Evidence Based Resources
      Produced by library staff at the University of Rochester Medical Center, this webpage provides links to numerous guides, tutorials, tools, search filters, and other EBM-related resources.
    • ScHARR's Netting the Evidence
      -- An extensive list of evidence- based practice resources on the Internet from the School for Health And Related Research (ScHARR), University of Sheffield, UK.
    • TRIP Database
      The trip database contained Evidence Based Healthcare reources. Each abstract denotes the source and description of information along with complete citations.
  • Associations/Organizations/Societies
    • Agency for Healthcare Research and Quality
      -- AHRQ (formerly AHCPR) is an agency of the US federal government that funds research to enhance the quality, appropriateness, and effectiveness of health care services. The "Clinical Information" section on their homepage links to full text reports of the results of evidence-based healthcare research.
      • AHRQ: Evidence Based Practice
        In 1997 the Agency for Healthcare Research and Quality (AHRQ), launched an 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 issues. This webpage contains links to Evidence-Based Practice Centers (EPCs), Evidence Reports and Evidence Technical Reviews
    • Centre for Health Evidence
      The Centre for Health Evidence promotes evidence-based health care by presenting knowledge-based resources to health professionals in ways that facilitate their optimum use. Located at the University of Alberta, Canada
  • Methodologic Filters for MEDLINE

    When combined with a subject search, methodologic filters retrieve articles that use the best research design, and therefore report the best evidence on the subject. You may either use the filters built into Clinical Queries in either Ovid MEDLINE or PubMed, or you may copy filters into your search, and save using the "Save Searches" function in Ovid or in the Cubby for PubMed.
    • Evidence Based Medicine: Filters/Strategies for Ovid Medline
      [Duke University Medical Center Library] The following filters were developed by Dr. Brian Haynes and Ann McKibbon from McMaster University. They are designed to retrieve high quality evidence from published studies appropriate to decision-making (e.g. clinical trials for diagnosis, cohort studies for prognosis, etc.) from the Medline databases.
    • Finding the Evidence on PubMed
      [Harvey Cushing/John Hay Whitney Medical Library, Yale U] Using simple "limits" to clinical queries and examples of search strings to cut and paste. Also how to save search strings in PubMed
  • Tools, Guides & Other Resources

    EBM calculators, handouts and other "tools" for practicing evidence based health care
    • CAT "Banks"
      A CAT is a document created in response to a clinical question. It summarises individual items of evidence and presents the results in an easily digestible format. CAT stands for "Critically Appraised Topic"
      • BestBETs : Best Evidence Topics
        BETs were developed in the Emergency Department of Manchester Royal Infirmary, UK, to provide rapid evidence-based answers to real-life clinical questions, using a systematic approach to reviewing the literature.
    • CATmaker
      CATmaker is a software tool which helps you create Critically Appraised Topics, or CATs, for the key articles you encounter about Therapy, Diagnosis, Prognosis, Aetiology/Harm and Systematic Reviews of Therapy. From the CEBM - Centre for Evidence Based Medicine
    • EBM Toolbox
      Assortment of useful tools collected by the Centre for Evidence Based Medicine (CEBM)
    • Evidence-Based Medicine Toolkit
      From the University of Alberta. "This is a collection of tools for identifying, assessing and applying relevant evidence for better health care decision-making. The appraisal tools are adapted from the Users’ Guides series prepared by the Evidence Based Medicine Working Group and originally published in JAMA"
    • Handouts & Guides
      • Understanding Research Designs
        Explains the different types of research methodology -- case studies, case control studies, cohort studies, randomized controlled studies, double-blind, meta-analysis and systematic reviews
    • How to Read a Paper
      A series of articles in the British Medical Journal by Trisha Greenhalgh that concisely cover how to assess health research articles.

Cochrane Collaboration

Based on the ideas of Archie Cochrane, MD (see Effectiveness and Efficiency: Random Reflections on Health Services, 1972), Cochrane Collaboration members locate, evaluate, and synthesize randomized controlled trials (RTCs) to make current evidence in treatment and diagnosis available to health care professionals. Members are organized into 50 subject groups, and produce "protocols" of their proposed methodology for finding and analyzing RTCs. Subsequently, they write detailed systematic reviews, and keep them updated with evidence from newly completed RCTs.
  • Cochrane Library Authentication Required
    The Cochrane Library consists of a collection of regularly updated evidence-based health care databases. The Cochrane collection is designed to provide information and evidence to support health care decision-making. The available databases are: The Cochrane Database of Systematic Reviews (regularly updated reviews of the effects of health care interventions); Database of Abstracts of Reviews of Effectiveness: DARE (critical assessments and structured abstracts of good systematic reviews published elsewhere); The Cochrane Controlled Trials Register: CENTRAL (bibliographic information on controlled trials); The Cochrance Database of Methodology Reviews: CDMR (systematic reviews of methodological studies); Health Technology Assessment Database: HTA (information about health technology assessments); NHS Economic Evaluation Database: NHS EED (National Health Service (UK), structured abstracts of articles describing evaluations of health care interventions); browse by Cochrane Collaborative Review Group; and the Cochrane Reviewer’s Handbook.
  • NHS Centre for Reviews and Dissemination (CRD)
    -- Similar to Cochrane, the CRD databases provide provide the NHS (National Health Service -Great Britain) with important information on the effectiveness of treatments and the delivery and organisation of health care

Practice Guidelines
  • Information Resources/Databases
    • Clinical Practice Guidelines Online (AHRQ)
      Between 1992 and 1996, the Agency for Health Care Policy and Research (now the Agency for Healthcare Research and Quality) sponsored development of a series of 19 clinical practice guidelines
    • CMA Infobase: Clinical Practice Guidelines
      These guidelines are produced or endorsed in Canada by a national, provincial/territorial or regional medical or health organization, professional society, government agency or expert panel.
    • Institute for Clinical Systems Improvement (ICSI)
      An independent, non-profit organization, ICSI provides health care quality improvement services to 43 medical organizations. The Knowledge Resources component includes: healthcare guidelines, guideline impact studies, technology assessment reports and other resources
    • National Institute for Clinical Excellance (NICE)
      The National Institute for Clinical Excellence (NICE) is part of the National Health Service (NHS). It is the independent organisation responsible for providing national guidance on treatments and care for people using the NHS in England and Wales. Guidance is intended for healthcare professionals, patients and their carers to help them make decisions about treatment and healthcare.
    • NIH Consensus Development Program
      The NIH Office of Medical Applications of Research (OMAR) manages the NIH Consensus Development Program, the focal point for evidence-based assessments of medical practice and state-of-the-science on behalf of the medical community and the public.
  • Internet Resources
    • Clinical Practice Guidelines
      -- Clinical Practice Guidelines are "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances." Institute of Medicine, 1992
  • Books
    • Clinician's Handbook of Preventive Services, 2nd Edition
      This handbook is the cornerstone of the Put Prevention Into Practice (PPIP) campaign. Since its introduction in 1994, PPIP has provided clinicians with helpful information and practical tools for adopting a non-categorical, systematic approach to the delivery of clinical preventive services.

Tutorials
  • Evidence Based Medicine: Finding the Best Clinical Literature
    (University of Illinois Chicago Library of the Health Sciences-Peoria. Please send comments to Jo Dorsch jod@uic.edu. ) This guide is designed to assist health care professionals and students become effective and efficient users of the medical literature.
  • Evidence-Based Medicine Tutorials
    (Lamar Soutter Library UMass Medical School). After completing these exercises you should be able to: (1) Define a clinical question; (2) Translate a clinical question into a searchable question; (3) Decide on the best type of study to address the question; (4) Perform a literature search.
  • Introduction to Evidence-Based Medicine
    (Duke University Medical Center Library and Health Science Library, UNC-Chapel Hill). This tutorial is intended for any health care practitioner or student who needs a basic introduction to the principles of Evidence-Based Medicine. Upon completion of this self-paced tutorial, you will be able to: (1) define Evidence-Based Medicine (EBM); (2) based on a patient problem, construct a well-built clinical question; (3) identify searching strategies that could improve MEDLINE retrieval; (4) identify key issues that help determine the validity of evidence.
  • A Student's Guide to the Medical Literature
    (Denison Memorial Library, U of Colorado Health Sciences Center). This site has been designed especially for medical students. Some of the features of this site are: (1) a tutorial outlining a simple 4-step approach to reading medical literature; (2) search strategies with links to the best web sites; (3) a guide to critical appraisal of journal articles with step-by-step explanation of the "User’s Guide" approach; (4) an interactive glossary with over 150 statistical terms hyperlinked to the text; (5) calculators for finding relevant outcome measures from a study; (6) student’s guide pocket version to use on our Palm or Pocket PC.
  • User's Guide Interactive
    An online tool to guide clinicians in the appraisal and application of evidence into their everyday practice. Based on the User’s Guides series in JAMA. Access provided to current students, staff and faculty, just click on the "log in" icon.

PDA and Handheld Resources

"Free" evidence based health care downloads for PDAs and handhelds.
  • EBM Calculator
    EBM Calculator is designed to calculate relevant statistics for Diagnostic studies, Prospective Studies, Case Control Studies, and Randomized Control Trials (RCT). This is a palm version of the Stats Calculator.
  • Epocrates Rx: Free mobile drug and formulary reference
    Peer-reviewed drug information including off-label indications and formularies in an easy to use format. PDA software compatible with Palm OS and Windows platforms only. Free online access and free download of PDA/mobile version.
  • Johns Hopkins POC-IT Antibiotic (ABX) Guide
    The Antibiotic Guide is a decision support tool intended to provide clinicians with concise, digested, timely information about the diagnosis and treatment of infectious diseases. The information is arranged so that it is clinically useful at the point of care, instantly. Search by diagnosis, pathogen, or antibiotic name. Palm version also downloadable at http://hopkins-abxguide.org/download_center/download_center.cfm#what_is_handheld
  • MedCalc
    MedCalc is a medical calculator running on Palm-compatible handheld devices. It is designed for rapid calculation of common equations used in medicine (including anesthesiology, pediatrics, emergency, intensive care and internal medicine.
  • mobilePDR
    PDR on a PDA - free registration for physicians, physician assistants, nurse practitioners, medical students and residents.
  • National Guideline Clearinghouse: PDA/Palm
    All National Guideline Clearinghouse Guideline Summaries are available in a text format downloadable to the Palm-based Pesonal Digital Assistant (PDA). This page contains instructions and links to Clinical Practice Guidelines for Handheld Computers from various professional and federal organizations.
  • PICOmaker
    PICOmaker is a free Palm OS-based application that lets users create and store queries in the PICO (Population, Intervention, Comparison, and Outcome) format for later reference. Created by a librarian at the University of Alberta.
  • A Student's Guide to Medical Literature
    PDA version of the University of Colorado Health Science Students Guide to Medical Literature. Topics include reading medical literature, search strategies, journal critique, calculators. Requires AvantGo.

Library Resources
  • Ask a Librarian -- Bio-Medical Library
    -- Use this web-based form to get individualized library research support for your course, or to get help resolving computer and technology problems you encounter in using our library resources.
    • MNCAT Classic
      Search MNCAT, the libraries’ catalog, to find books, journals, etc. owned by the library. Search by keyword, subject, title, or author for materials on your topic. We recommend MNCAT Classic for searching South Asia materials. The authors and titles of South Asian materials often contain non-standard characters that prevent MNCAT Plus from finding them.
      • Electronic Journals
        This link will take you to the University Libraries Electronic Journals page. On that page you can either search for a specific journal, magazine or newspaper title or enter an e-journal vendor site. You will be presented with a list of results. Click on the appropriate title to begin accessing the online version of that periodical. Keyword searching of more than one journal at a time is sometimes possible, depending upon the search capabilities provided by the vendor who supplied the original journal that you referenced.
  • Bio-Medical Library - Services
    -- Services available for students, faculty and staff. Including recalling books and journals, librarian-mediated searches, and reference consultations.

Bibliography
  • Books
    • Clinical evidence
      Contributors from the American College of Physicians & the American Society of Internal Medicine. Location: Bio-Medical Library WB102 C6410 1999- ; latest edition in Reference
    • Ethics and evidence-based medicine: fallibility and responsibility in clinical science.
      Kenneth W. Goodman. Location: Bio-Medical Library W50 G653e 2003
    • Evidence-based clinical practice: concepts and approaches
      Edited by John P. Gyeman, et al. Location: Bio-Medical Library WB102 E927 2000
    • Evidence-based medicine: how to practice and teach EBM (2nd ed.)
      David L. Sackett, et al. Location: Bio-Medical Library Reference WB102 E933 2000
      • CEBM: Centre for Evidence Based Medicine (University of Toronto)
        The goal of this website is to help develop, disseminate, and evaluate resources that can be used to practise and teach EBM for undergraduate, postgraduate and continuing education for health care professionals from a variety of clinical disciplines.This site also serves as a support for the book entitled, Evidence-based Medicine: How to practice and teach EBM by David L. Sackett, Sharon E. Straus, W. Scott Richardson, William Rosenberg, and R. Brian Haynes.
    • Evidence-informed nursing: a guide for clinical nurses.
      Edited by Robert McSherry, et al. Location: Bio-Medical Library WY20.5 E935 2002
    • How to read a paper : the basics of evidence based medicine (2nd ed.)
      Trisha Greenhalgh. Location: Bio-Medical Library WB102 G813h 2001
    • PDQ : evidence-based principles and practice
      Ann McKibbon ; with Angela Eady and Susan Marks. Location: Bio-Medical Library Z699.5.M39 M158p 1999
    • Rational diagnosis and treatment : evidence-based clinical decision-making (3rd ed.)
      Henrik R. Wulff and Peter C. Gøtzsche. Location: Bio-Medical Library WB141 W961r 2000
    • Studying a study and testing a test : how to read the medical evidence (4th ed.)
      Richard K. Riegelman. Location: Bio-Medical Library WA950 R554s 2000
    • Systematic reviews in health care: meta-analysis in context (2nd ed.)
      Edited by Matthias Egger, at al. Location: Bio-Medical Library WA20.5 S995 2001
    • Users' guides to the medical literature : a manual for evidence-based clinical practice
      The Evidence-Based Medicine Working Group ; edited by Gordon Guyatt, Drummond Rennie. Location: Bio-Medical Library WB102 U84 2002
  • Journal Articles
    • Appraising systematic reviews and meta-analyses.
      Bigby M, William H. Archives of Dermatology 139(6):795-8 2003 Jun
    • Evidence-based approach to the medical literature.
      Fletcher RH, Fletcher SW. Journal of General Internal Medicine 12 Suppl 2:S5-14 1997 Apr.
    • Evidence-based medicine: asking the answerable question (question templates as tools)
      Onady, GM, Raslich MA. Pediatrics in Review 24(8):265-8 2003 Aug.
    • The evolution of the randomized controlled trial and its role in evidence-based decision making.
      Devereaux PJ, Yusuf S. Journal of Internal Medicine 254(2):105-113 2003 Aug.
    • Hierarchy of evidence: from case reports to randomized controlled trials.
      Brighton B, Bhandari M, Tornetta P 3rd, Felson DT. clinical Orthopedics and Related Research 413:19-24 2003 Aug.
    • How to find evidence when you need it, part 2: a clinician's guide to MEDLINE: the basics.
      Gallagher, PE, Allen TY, Wyer PC. Annals of Emergency Medicine 39(4):436-440 2002 Apr.
    • Methodologic issues in systematic reviews and meta-analyses.
      Montori VM, Swiontkowski MF, Cook DJ. Clinical Orthopaedics and Related Research 413:43-54 2003 Aug.
    • Methods of meta-analysis: an analysis
      Koretz RL. Current Opinion in Clinical Nutrition & Metabolic Care 5(5):467-74 2003 Sept.
    • Systematic reviews of the literature: the overview and meta-analysis.
      Carr AB. Dental Clinics of North America 46(1):79-86 2002 Jan.
    • Understanding evidence-based medicine: a primer.
      Williams JK. American Journal of Obstetrics & Gynecology 185(2):27508 2001 Aug.
    • What is evidence-based medicine?
      Montori VM, Guyatt GH. Endocrinology & Metabolism Clinics of North America 31(3):521-6, vii 2002 Sept.



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