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Evidence Based Medicine (EBM) Resources. Spring, 2008. www.library.health.ufl.edu `Nita Ferree nferree@ufl.edu 352.273.8422. Why “Evidence Based”. Most health professionals consult:. -> Other colleagues
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Evidence Based Medicine(EBM) Resources Spring, 2008 www.library.health.ufl.edu `Nita Ferree nferree@ufl.edu 352.273.8422
Why “Evidence Based” Most health professionals consult: -> Other colleagues -> Personal collections of articles (or browse through favorite professional journals) -> Electronic resources -> Medical library
Then in the 1990’s, along came: Evidence-Based Medicine, “the integration of best research evidence with our clinical expertise and our patient’s unique values and circumstances.” Professor David Sackett Cochrane Collaboration, Chair Former Director, Centre for Evidence-Based Medicine Nuffield Department of Clinical Medicine Oxford, England -http://www.minervation.com/cebm2/docs/sackett.html
Evidence Based Medicine Steps Step 1: Ask an answerable question. Step 2: Determine the nature of the question. Step 3: Identify the best type of research study. Step 4: Determine the best resource(s) or database(s) to search. Step 5: Search the resource(s) and database(s). Step 6: Evaluate the evidence based upon the patients’ preferences and your clinical expertise.
The Clinical Question: An otherwise normal 10 year old child presents with a sore throat. How does a clinical exam compare to a throat culture in diagnosing a strep infection? 10 year old child w/ sore throat Clinical exam Throat culture Diagnosis / Strep Infection
Okay. So, Where’s the Information…
http://www.healthsystem.virginia.edu/internet/library/wdc-lib/collections/ebm/pyramid.cfmhttp://www.healthsystem.virginia.edu/internet/library/wdc-lib/collections/ebm/pyramid.cfm
http://hlwiki.slais.ubc.ca/index.php?title=Point_of_care_decision-making_tools_-_Overviewhttp://hlwiki.slais.ubc.ca/index.php?title=Point_of_care_decision-making_tools_-_Overview
This is from a really great EBM tutorial at : http://www.hsl.unc.edu/services/Tutorials/EBM/index.htm
Meta-Analysis As a sub-set of Systematic Reviews, they are comprehensive surveys af several valid studies on a specific topic using statistical techniques to combine the results as if they were one large study. All Meta-Analysis are Systematic Reviews, but not all Systematic Reviews are Meta-Analysis. Systematic Reviews Also known as summaries of the evidence, these literature reviews identify, appraise, and synthesize quality studies (usually randomized controlled trials) that focus on a single question or clinical topic. Randomized Controlled Trials Controlled experiments designed to compare the effect of two or more therapies or interventions on indiviuals. Subjects are randomly assigned to groups to reduce the effects of bias or other factors.
Start at the top and work your way down until you find the information you need. Meta-Analysis Systematic Reviews Randomized Controlled Trials
The Resources: -> PubMed’s Clinical Queries http://www.library.health.ufl.edu/resources/index.htm -> Ovid’s Evidence Based Medicine Reviews (EMBR) http://www.library.health.ufl.edu/resources/index.htm Other Free Resources -> Trip Database http://www.tripdatabase.com/index.html -> SumSearch http://sumsearch.uthscsa.edu/ -> National Guidelines Clearinghouse http://www.guideline.gov/