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Welcome
The goals of this guide are to:
- Provide essential information about Evidence-Based Medicine/Practice (EBM/EBP).
- Direct clinicians, practitioners, and students to relevant EBM/EBP resources available through the Calder Library.
This guide is intended for medical students and other health professionals interested in Evidence-Based Medicine/Practice resources and information.
You may navigate this guide by using the Tabs at the top of each page.
Subject Guide Editor
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John Usseglio
Education and Outreach Librarian
Contact Us
Department of Learning, Research, and Clinical Information Services
- Email: reference@miami.edu
- Phone: 305-243-6648
- Ask a Librarian
Types of Clinical Questions
Etiology: how to identify causes for disease (including its iatrogenic forms).
Diagnosis: how to select and interpret diagnostic tests, in order to confirm or exclude a diagnosis, based on considering their precision, accuracy, acceptability, expense, safety, etc.
Prognosis: how to estimate our patientâs likely clinical course over time and anticipate likely complications of the disorder.
Therapy: how to select treatments to offer our patients that do more good than harm and that are worth the efforts and costs of using them.
Prevention: how to reduce the chance of disease by identifying and modifying risk factors and how to diagnose disease early by screening.
FROM: User's Guides to the Medical Literature: essentials of evidence-based clinical practice G. Guyatt et al (eds) New York, 2008.
Ask a Searchable Clinical Question
PICO is a useful tool for asking focused clinical questions.
PICO clarifies the question, determines search concepts and type of study that is most appropriate to answer the question type.
PICO
P.I.C.O. Model for Clinical Questions
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P |
Patient, Population, or Problem |
How would I describe a group of patients? |
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I |
Intervention, Prognostic Factor, or Exposure |
Which main intervention, prognostic factor, |
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C |
Comparison or Intervention (if appropriate) |
What is the main alternative to compare |
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O |
Outcome you would like to measure or achieve |
What can I hope to accomplish, measure, |
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What type of question are you asking? |
Diagnosis, Etiology/Harm, Therapy, Prognosis, |
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Type of study you want to find |
What would be the best study design? |
Evidence Pyramid
Study Design
Centre for Evidence-Based Medicine: Study Designs
This page gives a brief comparison of the advantages and disadvantages of the different types of studies.
Understanding Research Study Designs
In order to find the best possible evidence, it helps to understand the basic designs of research studies. The following basic definitions and examples of clinical research designs follow the hierarchy of evidence.
Levels of Evidence
GRADE Working Group
Grading of Recommendations Assessment, Development and Evaluation (GRADE). The working group has developed a common, sensible and transparent approach to grading quality of evidence and strength of recommendations
Levels of Evidence and Grades of Recommendations
Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence
Selecting the Resources
Evidence-based practice requires that clinicians search the literature to find answers to their clinical questions. There are literally millions of published reports, journal articles, conference proceedings, and research studies available to clinicians. Choosing the best resource to search is an important decision.
Practice Guidelines
Electronic Textbooks and Libraries
Includes Harrison's Online and Goodman and Gilman's Pharmacology. McGraw-Hill's AccessMedicine.com is an online resource that provides students, residents, clinicians, and researchers with instant answers to clinical questions from the most trusted sources. Updated daily and expanded continuously, AccessMedicine is designed for direct access to the information necessary for completing evaluations, diagnoses, case management decisions, conducting research, medical education, or self-assessment and board review.
ClinicalKey is a clinical search engine that supports clinical decisions by making it easier to find and apply relevant knowledge.
Pre-Appraised Resources
ACP Journal Club
The content is carefully selected from over 100 clinical journals through reliable application of explicit criteria for scientific merit, flowed by assessment of relevance to medical practice.
BMJ Best Practice
Updated daily using robust evidence-based methodology and expert opinion, BMJ Best Practice provides you with access to the very latest clinical information.
Clinical Decision Support Tools
DynaMed is the next-generation clinical reference tool physicians can rely on for fast, easy access to point-of-care decision
support. Written by a team of specialized physicians and researchers, content is updated several times daily to include information
on the latest evidence-based research, providing practice-changing answers to clinical questions with optimized speed.
Clinical decision support tool designed to answer clinical questions that arise in daily practice. Subscription database with access for UM/JMH authorized users.
Databases
Center for Review and Dissemination (DARE)
Assists decision-makers by identifying and describing systematic reviews and economic evaluations, appraising their quality, and highlighting their relative strengths and weaknesses.
Cochrane Library
Collection of health databases providing independent evidence to inform clinical treatment decisions and other health related decisions. Includes: Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, Database of Abstracts of Reviews of Effects, Cochrane Methodology Register, Health Technology Assessment Database and NHS Economic Evaluation Database.
PubMed Clinical Queries
Allows you to quickly focus your PubMed search on clinical studies and systematic reviews. Find out more in the Using PubMed in Evidence-Based Practice tutorial.
Embase PICO Framework Search
Unique search feature that allows you to search Embase using a PICO framework. Enter keywords for each concept, automatically map those keywords to Emtree subject headings, and choose whether to include automatically generated keyword synonyms relevant for part of the PICO framework.
Meta-Search Engines
TRIP (Turning Research Into Practice)
Access more than 15,000 links to EBM and peer-reviewed articles and practice guidelines at more than 61 sites of high quality medical information. Also searches PubMed using EBM filters.
Appraising the Evidence
Evidence-based practice requires that clinicians critically appraise the articles they are using to answer their clinical questions. There are critical appraisal tools designed to evaluate specific types of study designs. Choose the appropriate tool below based on the type of article you are appraising.
Prognosis
Practice Guidelines
Diagnosis
Systematic Reviews
EBM eBooks / Books
How to Read a Paper: The Basics of Evidence-Based Medicine
by Greenhalgh
Users' Guides to the Medical Literature : A Manual for Evidence-Based Clinical Practice
by Guyatt
Painless Evidence-Based Medicine
by Dans, Dans, Silvestre
Symptom to Diagnosis: An Evidence-Based Guide
by Stern, Cifu, Altkorn
Evidence-Based Physical Diagnosis
by McGee
Studying a Study & Testing a Test: Reading Evidence-Based Health Research
by Riegelman, Nelson
Achieving Evidence-Based Practice: A Handbook for Practitioners
by Hamer, Collinson
The Philosophy of Evidence-Based Medicine
Howick
Evidence-Based Practice Workbook: Bridging the Gap Between Health Care Research and Practice
by Salisbury, Glasziou, Del Mar, Salisbury
EBM Calculators
An Introduction to Evidence-Based Medicine
"Evidence-Based Practice: What It Is and What It Is Not" (2010)
- Evidence-Based Practice Overview (4 min.)
- Defining Evidence-Based Practice (4 min.)
- Developing an Evidence-Based Question (1 min.)
- Critical Appraisal (23 sec.)
- Implementing Evidence-Based Practice (3 min.)
- Apply the Findings and Evaluate (2 min.)
- Resources (3 min.)
Cochrane Training: Evidence Essentials
The Centre for Evidence-Based Medicine
CEBM.net is a microsite dedicated to the dissemination of evidence reviews about the coronavirus pandemic.