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  1. 1. EVIDENCE-BASED MEDICINE Definitions: 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 harness 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. The term “evidence based medicine” (no hypen) was coined at Mc Master Medical School in Canada in the 1980’s to label this clinical learning strategy, which people at the school had been developing for over a decade. http://cancerweb.ncl.ac.uk/cgi-bin/omd?evidence-based+medicine Evidence-based medicine/healthcare is looked upon as a new paradigm, replacing the traditional medical paradigm which is based on authority. It is dependent on the use of randomised controlled trials, as well as systematic reviews (of a series of trials) and meta-analysis, although it is not restricted to these. There is also an emphasis on the dissemination of information, as well as its collection, so that the evidence can reach clinical practice. It therefore has commonality with the idea of research-based practice. It is also closely linked with the Cochrane Collaboration which is a worldwide network of centres, whose aim is to promote and foster this approach. Call Numbers for Browsing WB18.2 WA950; WB39; WB102; WB950; QV737 Books: WB 102 K44 2001 Key topics in evidence-based medicine / Dermot P.B. McGovern, 2001 WB 102 E933 ’00 Evidence-based medicine: how to practice and teach EBM / David L. Sackett, 2000. WB 100 M4903 ’83 Medicine, essentials of clinical practice WB 100 M49053 ’83 Medicine for the practicing physician Journals: Evidence-based healthcare (W1 EV255)
  2. 2. PubMed Abstracts: These are found on the PubMed site on the Internet:http://www.pubmed.gov Rossi A, Barraco A, Donda P. Fluoxetine: a review on evidence based medicine. Ann Gen Hosp Psychiatry. 2004 Feb 12 [Epub ahead of print] Gabel P. Evidence based medicine for third party (Insured) patients using generalized assessment of body and limbs (GABAL) outcome measure protocols. J Hand Ther. 2004 Jan-Mar; 17 (1) : 85. No abstract available. O’Mahony C, Elks R. Gonorrhoea, test of cure, evidence-based medicine and the Emperor’s new clothes! Int J STD AIDS. 2004 Jan; 15 (1) : 68. No abstract available. Myrmel T, Lai DT, Miller DC. Can the principles of evidence-based medicine be applied to the treatment of aortic dissections? Eur J Cardiothorac Surg. 2004 Feb; 25 (2) : 236-42. E-Journals: Bandolier http://www.jr2.ox.ac.uk/bandolier/ Internet Links: Cochrane Library http://cochrane.bireme.br OR http://www.cochrane.org The best single source of reliable Evidence about the effects of health care. The access to The Cochrane Library in VHL is available to health professionals from Latin America and Caribbean Region through cooperation among BIREME/PAHO, The Cochrane Collaboration and Brazilian Cochrane Centre. ClinicalTrials.gov http://www.clinicaltrials.gov/ ClinicalTrials.gov provides regularly updated information about federally and privately supported clinical research in human volunteers and should be used in conjunction with advice from health care professionals. PubMed Clinical Queries http://www.ncbi.nlm.nih.gov/entrez/query/static/clinical.shtml This site provides specialized PubMed searches for clinicians: Search by Clinical Study Category – Find Systematic Reviews – Medical Genetics Searches.
  3. 3. DARE http://www.york.ac.uk/inst/crd/darehp.htm Provides research-based information about the effects of interventions used in health and social care. IntensiveCare.Com Supporting Evidence-Based Practice in Critical Care http://intensivecare.com/ A comprehensive list of resources with links to full-text articles. Evidence-based Medicine Resource Centre http://www.ebmny.org/ Evidence-based medicine is a methodology for evaluating the validity of research in clinical medicine and applying the results to the care of individual patients. Evidence is gathered through systematic review of the literature, and is critically appraised. Evidence Based Medicine: the University of Massachusetts Medical School http://library.umassmed.edu/EBM/ More recently it has been described as the "integration of best research evidence with clinical expertise and patient values." MedBioWorld http://www.medbioworld.com/cgi-bin/displaycontents.cgi? table=med&type=Journals&filecode=(M)%20Evidence This site is the largest medical and bioscience resource directory on the Internet. More than 32 million documents from 2,800 publications Monash University: the Centre for Clinical Effectiveness http://www.med.monash.edu.au/healthservices/cce/ The Centre for Clinical Effectiveness (CCE) aims to enhance patient outcomes through the clinical application of the best available evidence. It undertakes teaching and research activities, and answers requests for evidence from the staff of Southern Health, Melbourne, Australia. Evidence-Based Medicine (EBM) http://www.med.usf.edu/CLASS/Gene/ebm.htm EBM definition, reasons for learning different approaches to solve related problems. North Carolina: Evidence-Based Medicine Education Centre of Excellence http://www.hsl.unc.edu/ahec/ebmcoe/pages/index.htm This site provides a collection of resources that support teaching and learning in Evidence-Based Medicine (EBM) for faculty, librarians, students, and other health care professionals. Evidence-Based Occupational Therapy http://www.cebm.utoronto.ca/syllabi/occ/ This site provides a collection of resources that support teaching and learning in Evidence-Based Medicine (EBM) for faculty, librarians, students, and other health care professionals.
  4. 4. A ScHAAR Introduction to Evidence Based Practice on the Internet http://www.nettingtheevidence.org.uk/ The multidisciplinary syllabi for practicing EBM is taken from the book Evidence-Based Medicine: How to practice and teach. Teaching/Learning Resources for Evidence Based Practice (EBP) http://www.mdx.ac.uk/www/rctsh/ebp/main.htm These resources have been adapted from existing materials to suit the groups we primarily work with: nurses and the professions allied to medicine. Consists primarily of rewriting materials avoiding the use of technical, research and medical terminology. Learning and Information Services, subject resources http://www.herts.ac.uk/lis/subjects/health/ebm.htm#ebmint This is a site with direct interest and relevance to all health teaching and research in the University. Norris Medical Library: Evidence based medicine web tutorial. http://www.usc.edu/hsc/nml/lis/tutorials/ebm.html Includes critical appraisals and guidelines. To track down the evidence, try using the following sites that offer critically appraised information: Oxford, Centre for Evidence-Based Medicine http://www.cebm.net/toolbox.asp Used the toolbox metaphor because an assortment of materials which are very useful for practitioners of EBM. Primary Care Clinical Practice Guidelines.. Evidence Based Medicine: the University of Massachusetts Medical School http://library.umassmed.edu/EBM/ Includes EBM resource collections with essential resources for UMMS users, free resources for all users, complete collections and JAMA Users’ Guide to the Medical Literature. Evidence Based Medicine Tool Kit http://www.med.ualberta.ca/ebm/ebm.htm 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. Evidence-Based: a Framework for Clinical Practice http://www.findarticles.com/cf_dls/m3225/6_60/56959120/p1/article.jhtml Search engine for over 10,000,000 articles on all subjects including free articles some of which are on EBM. Evidence-based Medicine http://www.ahcpr.gov/browse/evidmed.htm Database for EBM on Tools for resources, conferences, research. Evidence-based Medicine: Hayward Medical Communications http://www.evidence-based-medicine.co.uk/ Hayward Medical Communications' evidence-based medicine (EBM) web pages feature details of our catalogue of publications in this field.