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Subject Guides - Evidence-based Medicine/Practice

Subject Guides > Health Sciences

 

What is evidence-based medicine/practice?

"The integration of best research evidence with clinical expertise and patient values."
— [Sackett, David L., et al. (2000) Evidence-based medicine: How to practice and teach EBM. 2nd. ed.]


Systematic Reviews & Meta-analyses

Systematic reviews and meta-analyses are at the top of evidence hierarchies and are important for summarizing what we know about health care.

As defined by the Cochrane Collaboration, a systematic review identifies an intervention for a specific disease or other problem in health care, and determines whether or not this intervention works. To do this, authors locate, appraise and synthesize evidence from as many relevant scientific studies as possible. They summarize conclusions about effectiveness, and provide a unique collation of the known evidence on a given topic, so that others can easily review the primary studies for any intervention. Systematic reviews differ from other tyes of review in that they adhere to a strict design in order to make them more comprehensive, thus minimizing the chance of bias, and ensuring their reliability. (Cochrane Library User Guide 2004)

A meta-analysis literally aggregates the findings from multiple separate studies and applies quantitative methods to summarize results.

Sources:

Cochrane Database of Systematic Reviews
Has been described as one of the single most reliable sources for evidence on the effects of healthcare. Considered the gold standard of sytematic reviews. See a sample Cochrane systematic review.
 
DARE (Database of Abstracts of Reviews of Effectiveness)
Also searchable via the Cochrane Library. Includes structured abstracts of systematic reviews which have been evaluated by reviewers at the National Health Service Centre for Reviews and Dissemination in the UK. Complements the Cochrane Database of Systematic Reviews.
 
PubMed
Search for systematic reviews from the "Clinical Queries" page. Meta-analyses may be found by selecting the publication type, "meta-analysis," from the limits screen and searching it in combination with a topical search. Systematic reviews can also be found in searches of other databases such as PsycINFO and CINAHL.
 
Agency for Healthcare Research and Quality
AHRQ's stated mission is to mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. "The evidence developed through AHRQ-sponsored research and analysis helps clinicians, consumers, patients, and health care institutions to make informed choices about what treatments work, for whom, when, and at what cost."
 
Campbell Collaboration
Prepares and maintains systematic reviews of studies of the effects of policies and practices in education, and the social and behavioral sectors. Focus is on randomized field trials first and on high quality nonrandomized field trials second.
 
What Works Clearinghouse
From the U.S. Department of Education. "Collects, screens, and identifies studies of effectiveness of educational interventions (programs, products, practices, and policies)."
 
ENT and Audiology Specialist Library
A British based site that provides systematic reviews and evidence summaries as well as guidelines and care pathways from national or professional sources.
 


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Research Article Critiques

ACP Journal Club
From the American College of Physicians. The stated purpose of this resource is "to select from the biomedical literature articles that report original studies and systematic reviews that warrant immediate attention by physicians attempting to keep pace with important advances in internal medicine." Articles are summarized and commented on by clinical experts. The ACP Journal Club is available via the Preston Medical Library. Off-campus access requires registration with Preston for a username and password that are different from NetID and password.
 

Clinical Guidelines

National Guideline Clearinghouse
A public resource for evidence-based clinical practice guidelines. An initiative of the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services.
Additionally, you can search PubMed using the "practice guideline" publication type combined with a topical search.
 

Primary Research

Searches of databases such as PubMed, PsycINFO, CINAHL, and ERIC will lead to citations of articles that report original research.

Use PubMed's Clinical Queries to help you execute searches that target specific clinical study categories and allow for searches to be either broad and sensitive or narrow and specific. Clinical Queries employ finely crafted search strategies that do an excellent job of finding evidence based information.

 

Meta Search Sites

SUMsearch
Performs a one-stop search of PubMed, DARE, and the National Guideline Clearinghouse for evidence-based clinical information.
Trip
Searches across multiple sources of evidence-based practice and medicine.

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Learn More About EBM/P

Center for Evidence-Based Medicine
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Need Help?

Contact
Lana S. Dixon,
Health Sciences
Reference Librarian
ldixon@utk.edu
974-4700

 

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