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Evidence-Based Medicine

6S Pyramid

Systems

Integrating information from the lower levels of the hierarchy with individual patient records, systems represent the ideal source of evidence for clinical decision-making. An example of a system in this context would be a Clinical decision support system (CDSS).

Learn more: Biomedical informatics: computer applications in health care and biomedicine
 

Summaries

Summaries are regularly updated clinical guidelines or textbooks that integrate evidence-based information about specific clinical problems

Clinical Practice Guidelines

Evidence-Based Texts

  • Dynamed Plus
    Dynamed Plus is a clinical reference tool created by physicians for physicians and other health care professionals for use at the point-of-care. Clinicians can view the Overviews & Recommendations section of DynaMed Plus topics to get a quick summary of the topic and recommended actions based on the most current evidence. 
  • UpToDate
    Up to Date is an evidence-based clinical information resource that provides the information in an encyclopaedic format with references to clinical trials. When you connect to Up To Date, a user ID code is sent to them where they can anonymously, but uniquely, identify you and your customized profile. NOTE: Up To Date is now only available for current UofT Students and Residents. For clarification about the access change, please read this message. If you have trouble connecting to UpToDateUpToDate try barcode and pin if UTORid is unsuccessful.
  • BMJ Clinical Evidence
    Comprises an international database of high-quality, rigorously developed systematic overviews assessing the benefits and harms of treatments, and a suite of EBM resources and training materials.
  • Bandolier
    The Bandolier knowledge database contains abstracts which synthesize information from systematic reviews of treatment, diagnosis, epidemiology and health economics. The database is browsable and organized alphabetically by topic.

Synopses of Syntheses

Synopses of syntheses, summarize the information found in systematic reviews.  By drawing conclusions from evidence at lower levels of the pyramid, these synopses often provide sufficient information to support clinical action.

  • NHS Centre for Reviews and Dissemination Database includes: 
    • Database of Abstracts of Reviews of Effectiveness (DARE)
      Focused primarily on systematic reviews that evaluate the effects of health care interventions and the delivery and organisation of health services.
    • Economic Evaluation Database 
      Focused primarily on the economic evaluation of health care interventions and aims to help decision makers interpret an increasingly complex and technical literature. 
    • Health and Technology Assessment Database
      Focused on completed and ongoing health technology assessments from around the world. 
  • Cochrane Summaries
    Freely available summaries of Cochrane Systematic Reviews. 
  • Cochrane Podcasts
    Listen to audio summaries of selected Reviews from The Cochrane Library and other collections

Syntheses

Commonly referred to as a systematic review, a synthesis is a comprehensive summary of all the evidence surrounding a specific research question.    

  • Cochrane Library
    Updated quarterly, it includes The Cochrane Database of Systematic Reviews (complete reviews as well as protocols of reviews in progress), Database of Abstracts of Reviews of Effectiveness (citations to other systematic reviews produced outside of the Cochrane Collaboration), The Cochrane Central Register of Controlled Trials, and The Cochrane Database of Methodology Reviews (a bibliography of articles on the science of research synthesis), Health Technology Assessment, and NHS Economic Evaluation Database. 
  • Agency for Healthcare Research & Quality EPC Evidence-based Reports
    The EPCs review all relevant scientific literature on clinical, behavioural, and organization and financing topics to produce evidence reports, technical reviews (covering nonclinical methodological topics), and technology assessments.
  • PubMed Health "PubMed Health provides information for consumers and clinicians on prevention and treatment of diseases and conditions.PubMed Health specializes in reviews of clinical effectiveness research, with easy-to-read summaries for consumers as well as full technical reports. Clinical effectiveness research finds answers to the question “What works?” in medical and health care." Systematic Reviews are available on the right side of the page when you do a search.
     

     

Synopses of Single Studies

Synopses of single studies summarize evidence from high-quality studies. The following evidence-based abstract journals are the best place to find this type of information:

Single Studies

Studies represent unique research conducted to answer specific clincial questions.

Controlled Vocabulary Databases - use subject headings for high-specificity searching

  • OVID Databases
    Medline, EMBASE, PsychINFO, AMED, HAPI, etc.
  • PubMed
    (Medline + Life science journals + e-books).
  • CINAHL  
    Cumulative Index of Nursing and Allied Health Literature

Multidisciplinary Citation Indexes - keyword searching only

  • Web of Science  
    Multidisciplinary coverage of literature of sciences, social sciences, and arts & humanities
  • Scopus
    Offers broad coverage of scientific, technical, medical, and social sciences literature

Meta-Searchers

Meta-Searches search for evidence across multiple resources.  These tools return information from all levels of the pyramid:

Grey Literature

Grey Literature is any literature that has not been published through traditional means. It is often excluded from large databases and other mainstream sources.

For grey literature resources, see the Grey Literature tab on the Comprehensive Searching in the Health Sciences Guide 

Acknowledgments

McMaster Guide: http://hsl.mcmaster.libguides.com/ebm