LibGuides: Evidence-Based Healthcare: Evidence-Based Medicine

Steps in Practicing Evidence-Based Medicine

Guides for Evidence-Based Medicine

Finding the Best Clinical Literature - UIC
The Evidence Cycle: Introduction and Background to EBM
Also from Duke University Medical Center Library, explains the five steps of EBM: Assess, Ask, Acquire, Appraise and Apply.

Levels of Evidence

Oxford Centre for Evidence-based Medicine – Levels of Evidence
Levels of Evidence - Essential Evidence Plus
Most commonly used evidence rating scales explained.
Strength-of-Recommendation Taxonomy (SORT)
UpToDate Grading Guide

Major Organizations for EBM

PICO

The first stage of any evidence-based research is formulating an answerable question. A well-formulated question will facilitate the search for evidence and will assist you in determining whether the evidence is relevant to your question.

An answerable question has a format that follows the PICO concept. The acronym translates to:

P – Populations/People/Patient/Problem
I – Intervention(s)
C – Comparison
O – Outcome

	Example:
P (Problem or Patient or Population)	hospital acquired infection
I (intervention/indicator)	hand washing
C (comparison)	no hand washing; other solution; masks
O (outcome of interest)	reduced infection

Databases for Evidence-Based Medicine

PubMed Clinical Queries
Limit your literature search to systematic reviews or by study type (therapy, diagnosis, prognosis, etc.)

Cochrane Library This link opens in a new window
Contains the Cochrane Database of Systematic Reviews (CDSR), the leading resource for systematic reviews in health care, as well as other reports of randomized and quasi-randomized controlled trials.
Essential Evidence Plus This link opens in a new window
Over 13,000 topics, guidelines, abstracts, tools, images, and summaries covering the most common conditions, diseases, and procedures. Every recommendation carries a strength-of-evidence rating that accurately grades each recommendation's merit on the basis of all of the evidence available in the relevant literature.

POEMs: Patient-Oriented Evidence that Matters
Daily POEMs emerge from continuous review, grading, and critical appraisal of all 3000+ studies published monthly in more than 100 journals. These summaries of relevant and essential evidence-based research are presented in an easy-to-understand format as part of the Essential Evidence Plus database.

PubMed This link opens in a new window
Database of citations and abstracts for biomedical literature from MEDLINE and additional life science journals, including clinical medicine and public health.
This link allows medical residents and all other UTK & UTHSC NetID holders the option to search PubMed and link to resources from Preston Medical Library, University of Tennessee-Knoxville, or UT Health Sciences Center. Note that you will not be able to see the three links if you are logged into MyNCBI.

SUMSearch 2
Simultaneously searches for original studies, systematic reviews, and practice guidelines from PubMed.

TRIP This link opens in a new window
Designed to be as easy to use as Google, this free clinical search engine allows users to quickly and easily find and use high-quality research evidence to support their practice and/or care. It also links directly to clinical guidelines.

Other resources for Evidence-Based Medicine

ACP Journal Club
A monthly feature of the Annals of Internal Medicine, summarizes the best new evidence for internal medicine from over 120 clinical journals.

PubMed Clinical Queries

PubMed Clinical Queries: Quick Searching for the Busy Clinician (7 minutes, 52 seconds) (Kelsey)

The five steps of EBP

Evidence-based practice consists of five steps:

Ask a searchable clinical question;
Find the best evidence to answer the question;
Appraise the evidence;
Apply the evidence with clinical expertise, taking the patient's wants/needs into consideration;
Evaluate the effectiveness and efficiency of the process.

Source: Strauss, S. E. Evidence-Based Medicine: How to Practice and Teach EBM. New York: Churchill Livingstone, 2005.