Research Guides

Evidence-Based Medicine subjectId: 603182

Welcome

The goals of this guide are to:

Provide essential information about Evidence-Based Medicine/Practice (EBM/EBP).
Guide clinicians, practitioners, and students to relevant EBM/EBP resources 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 links in the Table of Contents at the left or by using the Tabs at the top of each page.

Training Tutorials:

Using PubMed in Evidence-Based Practice
Module 1: Evidence-based Medicine under Evidence Essentials | Cochrane Training

Databases:

EBM Calculators:

Subject Guide Editor

John Usseglio

Education and Outreach Librarian

Contact Us

University of Miami Miller School of Medicine Louis Calder Memorial Library

Department of Learning, Research, and Clinical Information Services

Email: reference@miami.edu
Phone: 305-243-6648
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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

P	Patient, Population, or Problem	How would I describe a group of patients?
I	Intervention, Prognostic Factor, or Exposure	Which main intervention, prognostic factor, or exposure am I considering?
C	Comparison or Intervention (if appropriate)	What is the main alternative to compare with the intervention?
O	Outcome you would like to measure or achieve	What can I hope to accomplish, measure, improve, or affect?
	What type of question are you asking?	Diagnosis, Etiology/Harm, Therapy, Prognosis, Prevention
	Type of study you want to find	What would be the best study design?

Formulating the Clinical Question

Formulating answerable clinical questions.
PICO worksheet
Well-built clinical question: A key to evidence-based decisions.

Evidence Pyramid

Study Design

Oxford University Study Design
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

ACP Clinical Practice Guidelines

Electronic Textbooks and Libraries

AccessMedicine

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
ClinicalKey is a clinical search engine that supports clinical decisions by making it easier to find and apply relevant knowledge.

eBooks available through Calder Library

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 Clinical Evidence
Clinical Evidence describes the best available evidence from systematic review, RCTs, and observational studies when appropriate for assessing the benefits and harms of treatment.

DynaMed
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.

UpToDate
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 our online tutorial.

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.

Therapy

Therapy Critical Appraisal Worksheet

Prognosis

Prognosis Critical Appraisal Worksheet

Practice Guidelines

Calder Library Video Training Sessions

How to Construct a Well-Built Clinical Question (PICO)
Learn from this live Calder Library Training Session the basics of contructing the PICO question.

Centre for Evidence-Based Medicine
CEBM.net is a microsite dedicated to the dissemination of evidence reviews about the coronavirus pandemic.