This document provides an overview of evidence-based medicine resources for pediatrics. It defines evidence-based medicine and discusses the importance of both clinical expertise and best external evidence. It then lists various computer systems, journals, and the Cochrane Library that can help find evidence. It explains how to formulate clinical questions using the PICO framework and identifies the best study designs to answer different types of clinical questions. An example clinical question is provided. Finally, it lists several websites that provide evidence-based care guidelines, journal reviews, and other pediatric EBM resources.

1. CLISTA CLANTON, MSLS, AHIP JANUARY 15, 2009 EBM Resources for Pediatrics

3. Haynes, RB. ACPJC Nov/Dec 2006;145(3):A8-9 Start at top and work your way down

5. Computer system Clinical Evidence, Dynamed, PIER, UpToDate ACP Journal Club, PedsCCM Journal Club Cochrane Library, PubMED Clinical Queries, guidelines Original Studies

7. Type of Question Suggested Best Type of Study Therapy RCT > cohort > case control > case series Diagnosis Prospective, blind comparison to gold standard Etiology / Harm RCT > cohort > case control > case series Prognosis Cohort study > case control > case series Prevention RCT > cohort study > case control > case series Clinical Exam Prospective, blind comparison to gold standard Cost Economic analysis Questions of therapy, etiology and prevention which can best be answered by RCT can also be answered by a meta-analysis or systematic review.

8. Evidence Pyramid Case Series/Case Reports Case Control Studies Cohort Studies Randomized Controlled Trial Systematic Review Meta-analysis Animal Research

9. Question: In hospitalized infants with bronchiolitis , does the use of nebulized hypertonic saline help to reduce symptoms and LOS? Type of question: Type of study: Therapy RCT > cohort > case control > case series In patient with [Patient/ Problem] does [Intervention] or [Comparison, if any] affect [Outcome]