This document discusses selecting appropriate evidence resources for answering clinical questions. It recommends first searching appraised resources that evaluate studies like the Cochrane Database of Systematic Reviews and ACP Journal Club. Next, search larger databases like MEDLINE but add search filters to retrieve higher levels of evidence. Finally, check web resources like TRIP+ and Bandolier using simple searches. Several key appraised resources are described that synthesize evidence including DARE, Clinical Evidence, and UpToDate.

6. Produced by NHS Centre for Reviews and Dissemination at the University of York, England. Identifies and evaluates the best quality systematic reviews. Offers reviews of some topics not included in Cochrane Review database. Full text database updated quarterly. Coverage: 1994-present. OVID version links to MEDLINE and full text articles in Journals@OVID. Evidence for answering foreground questions. Internet access via OVID Web Gateway . Link on Exempla Library Page . Also available for FREE DARE – Database of Abstracts of Reviews of Effects Produced by Cochrane Collaboration. Systematic reviews of controlled trials of therapeutic interventions. Full text database. Evidence for answering foreground questions. Coverage: 1991-present. Updated quarterly. Links to MEDLINE and full text articles in Journals@OVID Internet access via OVID Web Gateway . Link on Exempla Library Page . Cochrane Database of Systematic Reviews DESCRIPTION ACCESS RESOURCES

7. DESCRIPTION ACCESS RESOURCES Collection of evidence and reference material including the POEMs database, Cochrane abstracts, 5-Minute Clinical Consult, a variety of proprietary clinical decision rules and support tools, and clinical guidelines. Evidence for foreground questions. Access is from Exempla Intranet InfoRetriever/POEMs (Patient Oriented Evidence that Matters) POEMs identify and critically review articles related to primary care. Full text database of structured abstracts of studies. Comments on the value of the study for clinical practice. Coverage: 1991-present. OVID version links to MEDLINE and full text articles in Journals@OVID. Evidence for foreground questions. Produced by American College of Physicians. Available in print, online via publisher’s website, or internet access via OVID Web Gateway . Link on Exempla Library Page . ACP Journal Club (ACP Journal Club and Evidence-based Medicine combined into one journal, ACP Journal Club, in North and South America in January 2000) [ISSN: 1056-8751] Produced by cooperative effort of The Cochrane Collaboration, the National Library of Medicine, and Elsevier Science. Bibliographic database of over 300,000 definitive controlled trials in health care. Source of data for systematic reviews of controlled trials – no analysis or commentary. Use for foreground questions. Internet access via OVID Web Gateway . Link on Exempla LibraryPage . Cochrane Central Register of Controlled Trials

8. Electronic clinical reference for internists and medicine subspecialists. Comprised of thousands of original topic reviews written by a recognized faculty of experts and based on a synthesis of evidence-based findings and the authors’ clinical experience. Updated quarterly. Good resource for background questions. Produced by UpToDate, Inc. Available on CD-ROM and on ExemplaWeb UpToDate Compendium of evidence on effectiveness of clinical interventions specifying benefits and harms. Updated monthly with new topics. Topic revisions occur on 8-month cycle. Evidence for background questions. Produced by BMJ Publishing Group. Available in print, online via publisher's website, or internet access via OVID Web Gateway . Clinical Evidence Online electronic textbook for answering background questions. Current, comprehensive and extensively referenced medical information resource covering internal medicine. Produced by WebMD Corp. Scientific American Medicine. Available in print and online . Fee-based. Must enter userid and password. SAM – Scientific American Medicine

9. Bandolier is a print and Internet journal about health care, using evidence-based medicine techniques to provide advice about particular treatments or diseases for healthcare professionals and consumers. The content is 'tertiary' publishing, distilling the information from (secondary) reviews of (primary) trials and making it comprehensible. Evidence for focused questions. Bandolier is produced by Andrew Moore (RAM) as executive editor, with Henry McQuay (HJM) running the web production. The selection of material and the content are determined by RAM and HJM, with neither control nor direction from any other body. Access to the web version is free. Bandolier EBM Web sites with a collection of evidence-based answers to clinical questions. CATs provide a quick way to summarize evidence on common clinical questions with a “hard copy” for future reference. Existing CATs can be used as starting points for seeking and appraising updates in the relevant evidence. Use for foreground questions Any group or organization can produce a collection of CATs. View current CATS at Birmingham Women's Hospital . See additional CATs at the University of Western Ontario Evidence-Based Neurology page. CATs – Critically Appraised Topics A meta-search engine that searches across the Internet for high-quality information. Provides direct, hyperlinked access to EBM literature. Links to the latest evidence by clinical area, peer-reviewed journals, guidelines, e-Textbooks, medical images, and patient information. Also hyperlinks to “Clinical Queries” in PubMed. Created in 1997 to bring together evidence-based resources available on the internet. TRIP Plus TRIP Plus – Transforming Research into Practice

10. Provides structured guideline summaries, comparison of guidelines, and syntheses of selected guidelines. Also provides a utility for side-by-side comparison of guidelines. Use for guideline development. Sponsored by Agency for Healthcare Research and Quality, the American Medical Association, and the American Association of Health Plans. Access via the Internet National Guideline Clearinghouse An online clinical information service providing access to information on clinical care. Provides access to continuously updated reference books, daily updates in medicine, drug information, practice guidelines, and a collection of full text journals including: Evidence-based Cardiovascular Medicine, Evidence-based Health Policy & Management, Evidence-based Healthcare, Evidence-based Obstetrics & Gynecology, and Evidence-based Oncology. Use to answer focused or background questions. Produced by MD Consult , a division of Elsevier Science. Userid and password required. MD Consult Services