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Health Research Guide  Tags: health nursing rehabilitation medicine  

Last update: Nov 18th, 2009 URL: http://nyu.libguides.com/health  Print Guide  RSS Updates

Evidence-Based Practice             Print Page
  
 

Evidence Based Pyramid

 

Evidence-Based Health Care Resources 

 

Evidence-Based Medicine (EBM) is defined as: "The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients." *

Evidence-Based Nursing (EBN) expands the above definition to include "patient preferences" and "clinical expertise" as sources of evidence.**

Evidence-Based Health Services Management is the "systematic application of the best available evidence to the evaluation of managerial strategies for improving the performance of health services organizations." ***

Evidence-Based Dentistry (EBD) "is an approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient's oral and medical condition and history, with the dentist's clinical expertise and the patient's treatment needs and preferences." ****

CLICK ON A SEGMENT OF THE PYRAMID BELOW TO ACCESS LINKED RESOURCES at NYU
TRIP Database Filtered Information Systematic Reviews Critically-Appraised Topics Critically-Appraised Individual Articles Unfiltered Information Background Information / Expert Opinion

http://tinyurl.com/nyupyramid

(NOTE: linked resources are customized for nyu.edu users. Off-campus users will be prompted for NYU NET ID and password to access licensed resources)

EBM Pyramid and EBM Page Generator, copyright 2006 Trustees of Dartmouth College and Yale University.
All Rights Reserved. Produced by Jan Glover, David Izzo, Karen Odato and Lei Wang.
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Meta-Search Tools


TRIP (Turning Research Into Practice) Database Plus

This meta-search engine simultaneously searches evidence-based sources of systematic reviews, practice guidelines, and critically-appraised topics and articles -- including most of those listed above and many more. Also searches MEDLINE’s Clinical Queries, medical image databases, e-textbooks, and patient information leaflets.

SUMSearch Combines meta-searching and contingency searching in order to automate searching for medical evidence. Simultaneously searches multiple Internet sites and collates the results into one page.

 

Filtered Resources

 

Systematic Reviews / Meta-Analyses

The Cochrane Database of Systematic Reviews
Consists of detailed, structured topic reviews of hundreds of articles. Teams of experts complete comprehensive literature reviews, evaluate the literature, and present summaries of the findings of the best studies. Published by the International Cochrane Collaboration.

The Database of Abstracts of Reviews of Effects (DARE)
Full-text database containing structured abstracts of systematic reviews from a variety of medical journals. DARE is produced by the National Health Services' Centre for Reviews and Dissemination (NHS CRD) at the University of York. DARE records cover topics such as diagnosis, prevention, rehabilitation, screening, and treatment.

OT Seeker
Free site contains abstracts of systematic reviews and RCTs relevant to occupational therapy.  (Critically appraised and rated to assist you to evaluate their validity and interpretability).

Systematic Reviews and Meta-Analyses are also searchable in individual databases:

     

  • CINAHL Plus via Ebsco: Use Refine Search tab to limit by Publication type: systematic review.

  • MEDLINE via Ovid : Enter your search query. Click on the “Limits” icon; select “Systematic Reviews” under “Subject Subsets.” OR limit your search to publication type: meta-analysis.

  • MEDLINE via PubMed :
    • In Advanced Search,  perform search, then scroll to the “Limit by Topics, Languages, and Journal Groups” choices, and select  limit by Subset: systematic reviews. 
    • OR, in Advanced Search,  perform search, then scroll to More Resources/Clinical Queries or Topic Specific Queries feature to search by:  Clinical Study Category, Find Systematic Reviews, or other Topic-Specific PubMed Queries targeted for clinicians and health services researchers.

  • Proquest: Search topic in (citation and abstract) AND systematic review (subject).  In addition to retrieving articles that are systematic reviews, contents of the publication title:  Evidence Summaries--Joanna Briggs Institute, will be retrieved.  (Notice that articles about systematic reviews may also be retrieved.) You may also search  topic in (citation and abstract) AND evidence summaries (document type) to retrieve Evidence Summaries--Joanna Briggs Institute.

 

Critically-Appraised Topics

AHRQ Evidence Based Practice [with links to Evidence-based Practice Center (EPC) Evidence Reports] Click on a category of Completed Reports (for example, "Eye Conditions," to view individual evidence reports and summaries.

Annual Reviews  Authoritative, analytic reviews in 37 focused disciplines within the Biomedical, Life, Physical, and Social Sciences.

Clinical Evidence
Summarizes the current state of knowledge about the prevention and treatment of clinical conditions, based on thorough searches and appraisal of the literature. It describes the best available evidence from systematic reviews, RCTs, and observational studies where appropriate, and if there is no good evidence it says so.

Clinical Practice Guidelines (EBM Resource Center, New York Academy of Medicine) List of clinical practice guidelines, including lists organized by issuing authority and by topic. http://www.ebmny.org/cpg.html

Evidence Summaries--Joanna Briggs Institute, searchable A-Z list; or view the JBI Best Practice Information Sheets  (From the Joanna Briggs Institute. http://www.joannabriggs.edu.au/pubs/best_practice.php )

HSTAT U.S. Health Services Technology Assessment Text includes a searchable collection of clinical practice guidelines: http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat

National Guideline Clearinghouse
A comprehensive database of evidence-based clinical practice guidelines and related documents produced by the Agency for Health Care Research and Quality, in partnership with the American Medical Association and the American Association of Health Plans. Updated weekly.
Note: Guideline evidence varies from expert opinion to high levels of evidence.

Natural Standard: Provides evidence-based information about complementary and alternative therapies. It contains three sub-databases: Herbs & supplements, condition center, and alternative modalities. For each therapy covered by Natural Standard, a research team gathers scientific data and expert opinions. Validated rating scales are used to evaluate the quality of available evidence. Information is incorporated into comprehensive monographs which are designed to facilitate clinical decision making. All monographs undergo blinded editorial and peer review prior to inclusion in Natural Standard databases.

OT CATS
Critically appraised topics (CATs) and critically appraised papers (CAPs) focussing on occupational therapy interventions.
http://www.otcats.com/

OT Seeker
Free site contains abstracts of systematic reviews and RCTs relevant to occupational therapy.  (Critically appraised and rated to assist you to evaluate their validity and interpretability).

PEDro is the Physiotherapy Evidence Database from the Centre for Evidence-Based Physiotherapy (CEBP) at the University of Sydney. Free web-based database with access to bibliographic details and abstracts of over 5500 RCTs, systematic reviews and evidence-based clinical practice guidelines in physiotherapy. Most trials on the database have been rated for quality to help you quickly discriminate between trials which are likely to be valid and interpretable and those which are not.

PIER
(enter StatRef, click on "accept")

Evidence-based clinical guidance designed for rapid access to clinical information at the point of care. PIER is peer-reviewed, updated continually and includes recommendations based on all levels of medical evidence. Recommendations also include strength-of-recommendation ratings based on the quality of the underlying evidence. From the American College of Physicians.

Practice Guidelines are also also searchable in MEDLINE and CINAHL

  • Perform a search in CINAHL Plus via Ebsco , use Refine Search to limit to publication type: Practice Guidelines (Other publication types to consider: Care Plan OR Clinical Innovations OR Critical Path OR Protocol OR Standards)
  • Perform a search in MEDLINE, limit to publication type: Practice Guideline

Critically-Appraised Individual Articles

The ACP Journal Club
The editors of this journal screen the top 100+ clinical journals and identify studies that are methodologically sound and clinically relevant. An enhanced abstract, with conclusions clearly stated, and a commentary are provided for each selected article. Published by the American College of Physicians-American Society of Internal Medicine. from Ovid menu choose: ALL EBM Reviews to access ACP Journal Club

Bandolier
Bandolier is an independent journal about evidence-based healthcare published in the UK. It includes “information about evidence of effectiveness (or lack of it), and put[s] the results forward as simple bullet points of those things that worked and those that did not: a bandolier with bullets. Information comes from systematic reviews, meta-analyses, randomised trials, and from high quality observational studies.”

bmjupdates
Quality articles from over 110 clinical journals are selected by research staff, and then rated for clinical relevance and interest by an international group of physicians. Includes a searchable database of the best evidence from the medical literature and an email alerting system. From BMJ Publishing Group and McMaster University's Health Information Research Unit.

“Evidence-Based…” Journal series
Primary research articles within the discipline are selected for quality and clinical relevance. A structured abstract and expert commentary are provided for each study.

The following are examples (not a complete list) of journals that use predefined criteria to publish evaluated abstracts of the literature and comment on the methodology of each published study.

Evidence-Based Complementary and Alternative Medicine (electronic access only)

Evidence-Based Dentistry (electronic access only)

Evidence-Based Medicine (electronic access only)

Evidence Based Mental Health
Bobst RA410.A1 E95

Evidence-Based NursingBobst RT85.5.E95Recommended reading: "Purpose and Procedure," "EBN Notebook," columns in each issue. The inside back cover of each print issue includes a glossary of terms used in evidence-based health care.

Journal of Evidence Based Dental Practice (electronic access only)

Worldviews on Evidence Based Nursing (electronic access only)

Faculty of 1000 Medicine the world's top clinicians and researchers select, rate and evaluate the most important and influential articles, presenting a continuously updated, authoritative guide to the medical literature>

KT+ Knowledge Translation Plus (a knowledge translation site provided by McMaster University’s Health Information Research Unit) provides access to the current evidence on "T2" knowledge translation* (ie, research addressing the knowledge to practice gap), including published original articles and systematic reviews on health care quality improvement, continuing professional education, computerized clinical decision support, health services research and patient adherence. Its purpose is to inform those working in the knowledge translation area of current research as it is published. Includes alerting service; free registration required.

 

Unfiltered Resources

  • CINAHL Plus via Ebsco (Cumulative Index to Nursing and Allied Health Literature; indexes nursing and allied health literature, 1982-present) To limit your CINAHL search to the best evidence-producing studies: Click on the ‘Refine Search’ icon to use Clinical Queries or Publication types (e.g., systematic review).

    [Using the  Search Options,  "Evidence-Based Practice" limiter searches the Special Interest field for the value "Evidence-Based Practice."  Applying this limiter allows you to limit results to:
    * Articles from evidence-based practice journals  * Articles about evidence-based practice  * Research articles (including systematic reviews, clinical trials, meta analyses, etc.) * Commentaries on research studies (applying practice to research)]


  • EMBASE
    Major biomedical and pharmaceutical database covering drug research, pharmacology, pharmaceutics, toxicology, clinical and experimental human medicine, health policy and management, public health, occupational health, environmental health, drug dependence and abuse, psychiatry, forensic medicine, and biomedical engineering/instrumentation. Produced by Excerpta Medica and updated weekly. To limit your EMBASE search to the best evidence-producing studies: Click on the ‘Limits’ icon to use ‘Clinical Queries’.
  • Medline via PubMed
    • OR, In Advanced Search,  perform search, then scroll to the “Limit by Topics, Languages, and Journal Groups” choices, and select  limit by Subset: systematic reviews.
    • In Advanced Search,  perform search, then scroll to the “Limit by Topics, Languages, and Journal Groups” choices, and select Article Type, to select one or more publication types, e.g., clinical trial, meta-analysis, randomized controlled trial, etc.
    • OR, in Advanced Search,  perform search, then scroll to More Resources/Clinical Queries or Topic Specific Queries feature to search by:  Clinical Study Category, Find Systematic Reviews, or other Topic-Specific PubMed Queries targeted for clinicians and health services researchers.
  • Medline via Ovid
    To limit your Ovid MEDLINE search to the best evidence-producing studies, Clinical Queries (See PubMed) is searchable in Ovid; click on the "Additional Limits" icon. There are nine categories provided, and the emphasis may be Sensitive (i.e., most relevant articles but probably some less relevant ones), Specific (i.e., mostly relevant articles but probably omitting a few), or Optimized (i.e., the combination of terms that optimizes the trade-off between sensitivity and specificity).These filters, based on the work of R. Brian Haynes MD, PhD et al. of the Health Information Research Unit (HIRU) at McMaster University, are intended for clinicians. A detailed explanation of the strategies behind these limits can be found at http://hiru.mcmaster.ca/hedges/ 
  • OT Search (AOTA Occupational Therapy Search)  Includes monographs, proceedings, reports, doctoral dissertations, master's theses and retrospective collection of OT journals and newsletters held in the Wilma L. West Library, a national clearinghouse of occupational therapy information for AOTA members and personnel. Link to content list.
  • PsycINFO
    International coverage of the professional and academic literature in psychology, medicine, psychiatry, nursing, sociology, education, pharmacology, physiology, linguistics, and other areas. To limit your PsycINFO search to the best evidence-producing studies: Click on the "Refine Search" tab icon to limit to ‘methodology’ types.
  • Statistical Universe provides detailed abstracts, indexing, and locator information for all statistical reports of general research value issued by the federal government since the early 1960's. It also indexes the publications of state and private agencies, and the statistical publications of such IGO's (Intergovernmental Organizations) as the IMF, UN, OECD, World Bank and more. There are direct links to all key statistical data available on federal agency World Wide Web sites as well as direct links to hundreds of reports stored within the Universe service itself.
  • Web of Science International multidisciplinary index to the literature of the social, behavioral, and related sciences. In addition to the over 1700 social sciences journals, relevant social sciences items are indexed from over 3400 natural and physical sciences journals. Some of the subject categories included that are relevant to health science researchers are: special education, family studies, geriatrics & gerontology, health policy & services, language & linguistics, legal medicine, nursing, psychiatry, psychology, public health, rehabilitation, biomedical social issues, substance abuse, and women's studies. The Web of Science databases have the ability to link to relevant prior research and perform cited reference searches to track subsequent research.

 

Background Information/Expert Opinion

Note: Evidence in these resources may vary from expert opinion to high levels of evidence.

  • Access Medicine: more than 50 medical texts including Harrison's online, drug monographs, images and illustrations, interactive self-assessment, case files, diagnostic tools, patient education, Quick Answers from Current Medical Diagnosis & Treatment (CMDT), more.

  • ACP Medicine Electronic textbook of general medicine; updated continually.

  • Biomedical eBooks by title Full-text electronic books.

  • Clin-eguide Clinical Decision Support
    Simultaneously searches textbooks, evidence-based guidelines and articles, Facts and Comparisons Drug Information, Medline (1996-present), CINAHL national guidelines and patient handouts. Search nursing content by clicking on the menu item: "The Nursing Advisor."

  • ebrary collection of electronic books in all disciplines.
  • eMedicine Physician authors and editors contribute to the eMedicine Clinical Knowledge Base, which contains articles on 7,000 diseases and disorders. The evidence-based content provides the latest practice guidelines in 62 medical specialties. eMedicine's professional content undergoes multiple levels of physician peer review.

  • Electronic texts for drug information

  • Gale Virtual Reference Library: encyclopedias and specialized reference sources for multidisciplinary research. SCROLL to view publications in medicine,  including the Gale Encyclopedia of Public Health, Encyclopedia of Pain, Encyclopedia of Cancer, Encyclopedia of Nursing & Allied Health, Encyclopedia of Medicine, Encyclopedia of Public Health, Encyclopedia of Alternative Medicine, sources for patients and caregivers, and MORE.

  • Harrison's Online Searchable and continually updated version of Harrison's Principles of Internal Medicine.

  • MD Consult: bundled information resources designed to meet the clinical content needs of physicians and other health care professionals. Includes full-text access to medical reference books, journals and clinics; clinical practice guidelines; drug updates; patient education handouts, and clinical updates.
  • Oxford Reference Online Medicine subset searches Oxford Companion to the Body; Dictionary of Food and Nutrition; Concise Medical Dictionary; A-Z of Medicinal Drugs; Oxford Companion to Medicine; Dictionary of Nursing; Dictionary of Psychology; Dictionary of Public Health; Dictionary of Sports Science & Medicine.
  • STATREF Medical Reference Library. Full-text medical and drug information for healthcare professionals. Includes more than 25 medical resources such as Current Medical Diagnosis and Treatment, Current Pediatric Diagnosis and Treatment, DSM-IV-TR (Text Revision 2000), USP DI Vols 1 and 2, AHFS Drug Information and many more.

  • UpToDate (available only from specified desktops at NYU medical campus locations only) A clinical information resource, which offers up-to-date, fully referenced expert answers to patient-care, diagnosis, and treatment questions. Topic reviews are written by recognized authorities who review the topic, synthesize the evidence, summarize key findings, and provide specific recommendations.
  • UptoDate for Patients freely available, continuously updated consumer literature reviews on health topics from A to Z. 

Evidence-Based Medicine Information Sites

  • Centre for Evidence-Based Medicine (Oxford University) The Centre promotes evidence-based health care and provide support and resources to anyone who wants to make use of them. Includes the EBM Toolbox, an assortment of materials which are very useful for practitioners of EBM, and EBM Teaching Materials, including PowerPoint presentations.
  • Centre for Evidence-Based Medicine (Toronto) Includes many resources for practicing and teaching EBM.
  • Evidence-Based Medicine A selective list of additional EBM websites developed and maintained by Duke University Medical Center Library.
  • Netting the Evidence From the School of Health and Related Research (ScHARR) at the University of Sheffield, UK. Includes a comprehensive list of EBM databases, journals, articles, and other information sources.
  • Users' Guides to Evidence-Based Practice From the University of Alberta's Centre for Health Evidence. Includes the complete set of EBM Users' Guides originally published as a series in the Journal of the American Medical Association (JAMA).

Tutorials

References

*Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn't. British Medical Journal, 312(7023), 71-72. link to article
**DiCenso, A., Guyatt, G., & Ciliska, D. (2005). Evidence based nursing : A guide to clinical practice. St. Louis, Mo.: Elsevier Mosby. ( Bobst call no: RT42 .D53 2005)
*** Kovner, A. R., & Rundall, T. G. (2006). Evidence-based management reconsidered. Frontiers of health services management, 22(3), 3-22. link to article
**** ADA Policy on Evidence-Based Dentistry: http://www.ada.org/prof/resources/positions/statements/evidencebased.asp

EBM Pyramid and EBM Page Generator, copyright 2006 Trustees of Dartmouth College and Yale University. All Rights Reserved.
Produced by Jan Glover, David Izzo, Karen Odato and Lei Wang.

 
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