Medical College of Georgia |
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Department of Family Medicine
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| Clinical questions arise at knowledge gaps in personal clinical practice | |
| Diagnosis: | How powerful and accurate is a new diagnostic test? |
| Therapy: | What’s the starting dose of this new drug? |
| Prognosis: | What are the latest findings about the progression of the disease my patient has? |
| Prevention: | How can I screen and reduce risk for this disease? |
| Education: | How can I teach my patient about...? |
| Clinical evidence: | How can I gather findings properly and interpret them soundly? |
Define an important, searchable question:
The Well-built Clinical Question (User’s Tips for EBM): (Centres For Health Evidence)
Evidence resources: where to search?
MEDLINE
Produced by the U.S. National Library of Medicine, the MEDLINE database is
widely recognized as the premier source for bibliographic and abstract coverage
of biomedical literature. MEDLINE encompasses information from Index Medicus,
Index to Dental Literature, and International Nursing, as well as other sources
of coverage in the areas of allied health, biological and physical sciences,
humanities and information science as they relate to medicine and health care,
communication disorders, population biology, and reproductive biology. More than
9.5 million records from more than 3,900 journals are indexed, plus selected
monographs of congresses and symposia (1976-1981). Abstracts are included for
about 67% of the records.
EMBASE
the Excerpta Medica database, produced by Elsevier Science, is a major
biomedical and pharmaceutical database indexing over 3,500 international
journals in the following fields: drug research, pharmacology, pharmaceutics,
toxicology, clinical and experimental human medicine, health policy and
management, public health, occupational health, environmental health, drug
dependence and abuse, psychiatry, forensic medicine, and biomedical
engineering/instrumentation. There is selective coverage for nursing, dentistry,
veterinary medicine, psychology, and alternative medicine. EMBASE is one of the
most widely used biomedical and pharmaceutical databases because of its currency
and in-depth indexing. Frequent updates allow access to the latest medical and
pharmacological trends. Approximately 375,000 records are added yearly.
Evidence Based Medicine Reviews: Best Evidence (OVID)
Best Evidence (ACP) is the latest addition to a growing collection of Ovid's
Evidence Based Medicine Reviews collection. The Best Evidence Collection
consists of two journals: ACP Journal Club, a publication of the American
College of Physicians, and Evidence-Based Medicine, a joint publication with the
British Medical Journal Group. The editors of Best Evidence screen the top
clinical journals on a regular basis and identify studies that are both
methodologically sound and clinically relevant. They write enhanced abstracts of
the chosen articles and provide commentaries on the value of the articles for
clinical practice. Using this source, clinicians can quickly understand and
apply to their practices important changes in medical knowledge without having
to read and synthesize for themselves thousands of journal articles.
Cochrane Database of Systematic Reviews (OVID)
The Cochrane Database of Systematic Reviews (COCH) includes the full text of the
regularly updated systematic reviews of the effects of healthcare prepared by
The Cochrane Collaboration. The reviews are presented in two types:
HEALTHSTAR
Contains citations to the published literature on health services, technology,
administration, and research. It focuses on both the clinical and non-clinical
aspects of health-care delivery. The following topics are included: evaluation
of patient outcomes; effectiveness of procedures, programs, products, services
and processes; administration and planning of health facilities, services and
manpower; health insurance; health policy; health services research; health
economics and financial management; laws and regulation; personnel
administration; quality assurance; licensure; and accreditation. HealthSTAR is
produced cooperatively by the U.S. National Library of Medicine and the American
Hospital Association. The database contains citations and abstracts (when
available) to journal articles, monographs, technical reports, meeting abstracts
and papers, book chapters, government documents, and newspaper articles from
1975 to the present. Citations are indexed with the National Library of
Medicine's (NLM) Medical Subject Headings in order to ensure compatibility with
other NLM databases. Information in HealthSTAR is derived from MEDLINE, CATLINE,
the Hospital Literature Index, and selected journals. Additional records
specially indexed for this database do not appear in any other NLM database.
HealthSTAR replaces the former Health Planning and Administration database.
Strategies for Searching the Medical Literature (Centres For Health Evidence)
User’s Guides to the Medical Literature (Centres For Health Evidence)
Validity = proximity to truth.
Importance = potentially useful to you, the clinician.
McMaster University Guide (User’s Map) to assess validity and importance of evidence about:
| Therapy | Decision Analysis |
| Diagnosis | Practice Guideline |
| Harm | Outcome Analysis |
| Prognosis | Quality of Life |
| Overview | Utilization Review |
Tools to help you appraise the evidence:
User’s Tools for the Medical Literature (Centres For Health Evidence)
The EBM Toolbox (Oxford University)
User’s Worksheets for the Medical Literature (Centres For Health Evidence)
For guidelines for applying a valid and important test, prognosis, treatment,
evidence of harm, and/or quality-improving strategy in your practice, see
McMaster University Guide (User’s Map) to assess applicability of evidence
about:
| Therapy | Decision Analysis |
| Diagnosis | Practice Guideline |
| Harm | Outcome Analysis |
| Prognosis | Quality of Life |
| Overview | Utilization Review |
Ask yourself questions about your ability to:
Ask answerable clinical questions
Find the best external evidence
Critically appraise the evidence and evaluate it for its validity and potential usefulness
Integrate critical appraisal of the best available external evidence from systematic research with individual clinical expertise in personal daily clinical practice
| Copyright 2008 Medical College of Georgia All rights reserved. |
Research and Faculty
Development | Department of Family Medicine |
January 10, 2008 |