Evidence Based Medicine


Find critically appraised articles back to 1991 at this website. The American College of Physicians/American Society of Internal Medicine (ACP/ASIM) has begun a program called Physicians' Information and Educational Resource (PIER). If you are a PIER user in current clinical practice in internal medicine or its subspecialties, or family practice, your are encouraged to become a Sentinel Reader. You will receive "hot of the press" articles, matched to your interests. You will rate the article for relevance to your clinical practice and for newsworthiness.

Your ratings will be collated with others & used to alert PIER authors about articles relevant to their mofules and to choose articles to abstract in ACP Journal Club. If you are interested, please contact MORE@mcmaster.ca. The website contains review of effectiveness from Annals of Internal Medicine, Journal Club, and EBM journals. The caveat is that not every critical appraisal is available to non-ACP/ASIM surfers. In order to access the site to the fullest you must be a member of the ACP/ASIM and enter your membership number each time to retrieve the results of your search. However,current issues of the review journals are available full text and many past issues as well! ACP Journal club is also accessible via UT e-resources - EBM reviews in Ovid.



Go to Bandolier's knowledge libraryor use their search engineto find critically appraised information. Bandolier is a print and Internet journal about health care, using evidence-based medicine techniques to provide advice about particular treatments or diseases for healthcare professionals and consumers. The content is 'tertiary' publishing, distilling the information from (secondary) reviews of (primary) trials and making it comprehensible. Bandolier is produced from Pain Research by Andrew Moore (RAM) as executive editor, with Henry McQuay (HJM) running the web production. The selection of material and the content are determined by RAM and HJM, with neither control nor direction from any other body.



Dr. Michael Evans (editor of this CFP series which began in 1997) is based at the Toronto Western Hospital Department of Family & Community Medicine as a practicing clinician. He is also a research scholar in the Department of Family & community Medicine and the Knowledge Translation Program at the University of Toronoto. This critical appraisal series is available with pdf copies of all articles in this series from 2001-current. It is an excellent Canadian source of evidence based summaries about studies that matter to family practitioners. If you have a idea for a critical appraisal e-mail: michael.evans@utoronto.ca



Access to the content of this BMJ on-line publication is NOT free unless your are accessing the link from a UofT computer. Go toUofT e-resourcesand type in Clinical Evidence. The original paper based version and the continuously updated web version aims to cover common or important clinical conditions seen in primary and hospital care. To decide which conditions to cover they review national data on consultation rates, morbidity and mortality, and take account of national priorities for health care such as those outlined in the UK National Service Frameworks and in the US Institute of Medicine reports, and, as well, they will take advice from generalist clinicians and patient groups.



Researchers may browse or search updates of the abstracts of Cochrane Reviews, without charge, at the website above. Reviewers from the Centre for Reviews and Disseminationat the University of York in the UK also produce the Database of Abstracts of Reviews of Effects (DARE), which consists of abstract type summaries of studies selected for possible inclusion in published systematic reviews. Additionally the Health Technology Assessment Database (HTA) and the NHS Economic Evaluation Database (EED) are also available without charge.



Informed Health Online is produced by the Health Research and Education Foundation Ltd. The Foundation is a not-for-profit health promotion organization based in Melbourne, Australia. The Foundation aims to provide information & resource tools that enable people to keep up-to-date with reliable, evidence-based information. The Foundation promotes research literacy & individual and community use of high quality research.

A key goal is to promote the accessibility of health information from the Cochrane Collaboration, and based on Cochrane reviews & other reliable research on the effects of health care. The Foundation is working with translation partners to identify resources to assist in translation of Informed Health Online into major community languages. Review of the week is front and centre on the homepage and the site has an 'advanced search page' for easy access to specific topic based information.



The Cochrane Library is an electronic publication from Update Software designed to supply high quality evidence to inform people providing and receiving care, and those responsible for research, teaching, funding and administration at all levels. Go to the Electronic Information Resourcespage and type in Cochrane. If you are on a UofT networked computer you will be connected to the new entry page. For information about off-campus access please see the my.accessweb site.



Des membres du Département de médecine familiale de l’Université Laval y résument et commentent chaque semaine deux articles tirés des numéros récents des grands journaux médicaux. Le commentaire comporte une critique inspirée des principes de la médecine fondée sur les données probantes (« Evidence-based Medicine ») et une évaluation de l’impact de la recherche sur la pratique médicale. Tous les manuscrits sont révisés par des pairs qui possèdent une formation en recherche clinique ou épidémiologique.



BMJ publishing group now provides free e-access to selected critical appraisals originally published in this journal. The site contains both searching and browsing (Collections section) but may not give you 'free' access to all critical appraisals. A clever feature is their list of the TOP 10articles of the previous year. Evidence Based Mental Healthis also available from the BMJ publishing group but also with only a selected number of full text critical appraisals but they do allow you to browse pdf files of the Articles selected for appraisal with links to these article citations within PubMed.



Patient Oriented Evidence that Matters (POEMs) are available for PDA (PocketPC, Palm), Internet, and Windows Desktop. Individual, group and institutional pricing apply to all subscriptions as access via the web is not free. POEMs are featured in a number of professional journals,including the Journal of Family Practice, the British Medical Journal and the American Family Physician. On occasion some POEMs are selectively provided to clinicians electronically via several sites, services, charitable groups, non-profits, and associations. Promotions offering limited 'free access' can also be obtained from their displays at medical conferences. WONCAwebsite provides free access for the latest six months of POEMs.


Behind the Headlines



Check it out as this kind of comprehensive resource should be available in Canada. It does have a free component consisting of an archive of world health headlines called Behind the Headlines- Staff of the NHS Centre for Reviews and Dissemination (CRD) at the University of York provide a assessment of the original research behind the news stories, related systematic reviews in the Cochrane database or the Database of Abstracts of Reviews of Effectiveness (DARE) and other recommended evidence based clinical e-resources in the section of this national e-library treasure.



As of Sept 21, 2004 Journal Club is in the process of being redesigned as a Weblog, using MovableType weblog software. When this is complete, users will be able to utilize all of the functionality of the Weblog system. This should take place within the next week or two. In the past Dr. Michael Jacobson as developed research summaries and comments on an articles from the recent medical literature. Feedback from readers is appended to the article summaries. The articles are primarily in the field of adult internal medicine and mainly from the New England Journal of Medicine, Annals of Internal Medicine, JAMA and the Lancet. Although not prolific in output this site was interactive in that it accommodates feedback from it's readers ASAP. There was no commercial funding for this project originally. It was intended as an independent forum where the medical literature can be summarized and critiqued. It was created in November, 1995 and in 2003 it averaged over 3,000 visitors per week, one third from outside the U.S.



TRIP was created in 1997 to bring together all the 'evidence-based' healthcare resources available on the Internet. It started with 1100 links recorded from 15 sources and since then it has grown rapidly in both coverage and usability. It searches critically appraised topics (CATs) or Evidence Based Synopses, systematic reviews, practice guidelines, e-textbooks and more. It is excellent for quick searches of high quality information.



U of Michigan Health System - Dept. of Pediatric and Communicable Diseases -WS Mott Childrens Hospital - Ann Arbor, Michigan has been steadily adding to the list of critically appraised topics (CATs). They use a standard format for developing their CATs based on research articles considered 'hot' in their field since 1998 and access is currently free.