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Evidence-Based Medicine

"EBM is a systematic approach to clinical problem solving which allows the integration of the best available research evidence with clinical expertise and patient values."

-- Sackett DL, Strauss SE, Richardson WS,et al. Evidence-based medicine: how to practice and teach EBM. London: Churchill-Livingstone, 2000

1. Ask a Clinical Question

Framing Questions with PICO. Video from Yale Medical Library, 4 minutes. Construct a focused and answerable research question.

Asking Focused Questions Development of a PICO-format question, Centre for Evidence-Based Medicine, Oxford

2. Acquire the Best Evidence

EBM Tree Databases, Textbooks, and Websites for finding high quality evidence. Based on the Finding Information Framework. Cohen-Osher M, Davies TA, Flynn DB, Young ME, Hoffman M. Finding Information Framework: A Tool to Teach Life-Long Learning Skills. PRiMER. 2021;5:16.10.22454/PRiMER.2021.934572. Developed through a collaboration between UVM LCOM faculty and Dana Medical Library librarians.

Basic and Advanced PubMed Tutorials The Basic PubMed video (8 min.) demonstrates efficient ways to display and filter results, how to save and email citations, and how to access full articles. The Searching with MeSH video covers how to refine and focus search results using hidden PubMed features (7½ min.). Dana Medical Library.

Haynes' 6S Approach to Finding High Quality Evidence Video with Terry Shaneyfeldt, MD MPH. (11 min.) UAB

3. Appraise the Evidence

Users' Guides to the Medical Literature: I. How to Get StartedJAMA. 1993;270(17):2093-2095.

Users' Guides to the Medical Literature: II. How to Use an Article About Therapy or Prevention A. Are the Results of the Study Valid? JAMA. 1993;270(21):2598-2601.

Users' Guides to the Medical Literature: II. How to Use an Article About Therapy or Prevention B. What Were the Results and Will They Help Me in Caring for My Patients? JAMA. 1994;271(1):59-63

Users' Guides to the Medical Literature: III. How to Use an Article About a Diagnostic Test A. Are the Results of the Study Valid? JAMA. 1994;271(5):389-391.

Users' Guides to the Medical Literature: III. How to Use an Article About a Diagnostic Test B. What Are the Results and Will They Help Me in Caring for My Patients? JAMA. 1994;271(9):703-707.

Users' Guides to the Medical Literature: IV. How to Use an Article About Harm? JAMA. 1994;271(20):1615-1619.

Users' Guides to the Medical Literature: V. How to Use an Article about Prognosis? JAMA. 1994;272(3):234-237.

Users' Guides to the Medical Literature: VIII. How to Use Clinical Practice Guidelines A. Are the Recommendations Valid? JAMA. 1995;274(7):570-574.

Users' Guides to the Medical Literature: VIII. How to Use Clinical Practice Guidelines B. What Are the Recommendations and Will They Help You in Caring for Your Patients? JAMA. 1995;274(20):1630-1632.

Users' Guides to the Medical Literature: How to Read a Systematic Review and Meta-analysis and Apply the Results to Patient Care? JAMA. 2014;312(2):171-179.

5. Assess the Impact and Performance

Self-Evaluation Approaches from the Knowledge Translation Program at St. Michael's Hospital, Toronto

From Nunan, David. Evidence-Based Medicine: What is it and why does it matter? Centre for Evidence-Based Medicine. Oxford. June 2016

  • How is your patient? – Short and long term, safety netting, follow up, handover
  • Did the decision improve the outcome of interest? – Log of activities, recall of patient encounters
  • What did I learn from that? – Reflection, significant event analysis
  • How might I use this experience again? – Building clinical expertise, personal development
  • How might I share this experience with others? – Dissemination of good (and bad) practice 

EBM Tools

Finding the Evidence: A How-to Guide Centre for Evidence-Based Medicine, University of Oxford

Critical Appraisal Worksheets Dartmouth College

Stats Calculators: Odds Radio to NNT Converter; Diagnostic Tests, Prospective Studies, Case-Controlled Studies, RCTs. from the Knowledge Translation Program at St. Michael's Hospital, Toronto