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Richard German Tel 03 479 7403 Email richard.german @otago.ac.nz

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Evidence-based Medicine Web Resources

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Please note that many links are to US sites. Readers should be cautious of nomenclature, especially with regard to the naming of drugs.

Introduction and Tutorials

Introduction to Evidence-based Medicine (19K in PDF format) - Tony Egan, of the Dunedin School of Medicine, provides an overview of EBM, supported by a wide range of web resources, tutorials and guides.
Introduction to EBM - Developed by the University of North Carolina, uses clinical problems to contruct a "well-built clinical question", then how to find and evaluate the research literature
UNC Educational Resources - CATs, tables of likelihood ratios and clinically significant drug interactions

Advanced EBM

Centre for Evidence-based Medicine - Advanced analysis of evidence of level types from Oxford (UK)
CEBM Study Design - Various research designs, also from Oxford University
Introduction to Information Mastery - Modules on diagnosis, therapy, prognosis, systematic reviews, decision analysis, asking clinical questions, and advanced tutorials
Guides to Evidence-based practice - From the Canadaian Centre for Health Evidence, based on the original series in JAMA
Glossary of Terms - By Katherine McLucas, University of Colorado. Excellent for statistical definitions

Databases of Reviews, Critically Appraised Topics (CATs)

Identification, evaluation and application of relevant evidence can be beyond the capacity of individual clinicians.

"Best evidence" journals and systematic reviews of health care interventions provide relevant, carefully assessed and rapidly accessible information for immediate use in the clinical setting.

Cochrane Library (via MOH) - Includes: Cochrane Database of Systematic Reviews, Cochrane Database of Methodology Reviews, Database of Abstracts of Reviews of Effectiveness, Cochrane Controlled Trials Register, NHS Economic Evaluation Database, Health Technology Assessment Database, Cochrane Methodology Register
EBM Reviews (formerly via Ovid) - No longer accessible via Ovid, but all resources still available:

Cochrane Library via Wiley (listed under key databases for Medicine). Cochrane Central Register of Controlled Trials , Cochrane Database of Systematic Reviews (CDSR), and Database of Abstracts of Reviews of Effects (DARE).
ACP Journal Club - (via library catalogue). Two journals: ACP Journal Club and Evidence-Based Medicine.

CRD Reviews (University of York, Centre for Systematic Reviews and Dissemination) - Includes: NHS Economic Evaluation; Health Technology Assessment; Effective Healthcare Bulletins. Lists completed reviews: abstracts available
Bandolier Knowledge - Collects good quality evidence under a variety of different headings: systematic reviews of treatments, evidence about diagnosis, epidemiology or health economics
UNC CAT Index (University of North Carolina)

Clinical Guidelines and Audit

These aim to provide evidence-based advice on best practice.

New Zealand Guidelines Group - Includes evidence for practice, guidelines and publications, and links to other sources of evidence
National Guidelines Clearinghouse - US national guidelines sponsored by the Agency for Healthcare Research and Quality (AHRQ)
Clinical Practice Guidelines (for Primary Care) - From University of California San Francisco School of Medicine
Published Guidelines (and Cancer Service Guidance) - From the UK National Institute of Health and Clinical Excellence (NICE)
Best Practice in Clinical Audit - Effectively a textbook on clinical audit from NICE (downloadable)

Conducting your own EBM

Critical appraisal Worksheets - Diagnosis, harm, prognosis and therapy from the University of Toronto (downloadable)

Patient-centred Medicine

Sackett's definition of EBM includes reference to the patient's values and expectations. These are unique and present in every clinical encounter, and determine the overall value of the encounter for the patient.

Including 'non-clinical' patient information in the problem's formulation and management plan, Sackett recognises the "person" in the patient. This is an extension of the clinical method referred to as "the patient-centred clinical method".

Overview of the patient-centred clinical method - By W.Wayne Weston and Judith Belle Brown, Department of Family Medicine, University of Wisconsin
Best treatments - Clinical evidence for patients from the BMJ
Consultation skills - from the Calgary-Cambridge observation guide
Patient-centred medicine - descriptions of the skills and attributes of an ideal GP. Useful for training or re-accreditation

JAMA Rational Clinical Examination series bibliograpy - References on 'useful' or 'useless' clinical examination findings, based on the quality of evidence.

Kate.thompson@otago.ac.nz

Last revised: 21 January, 2008