Evidence Based Clinical Practice: EBCP Tools

This guide provides resources for searching and critical appraisal.

Summaries

DynaMed DynaMed Plus (Dynamic Medical Information System) is a quick and easy-to-use medical reference system designed for use at the point of care. It contains clinically organized summaries of thousands of topics and is updated several times daily from review of the research literature. Providing the most current, unbiased, evidence-based information to enable physicians to help them provide the best care possible to their patients, DynaMed is a useful resource in clinical, educational and research settings.

Type: Evidence-based summary; point of care tool
Highlights: Organized in a structured note format, content is easy to navigate; both overall recommendations and specific study results are included; app available.
EBM: References are provided for recommendations. These references are given a grade based on the level of evidence behind the recommendation.

BMJ Best Practice Best Practice has been designed and built from the ground up for use specifically as a decision-support tool at the point of care. Latest research evidence, guidelines and expert opinion are combined in a single source and presented in a step-by-step approach, covering prevention, diagnosis, treatment and prognosis. Provides a second opinion, without the need for checking multiple resources.

Type: Evidence-based summary; point of care tool
Highlights: Latest research evidence, guidelines and expert opinion are combined in a single source and presented in a step-by-step approach, covering prevention, diagnosis, treatment and prognosis.
EBM: Referenced studies are listed, and full text is linked where available.

UpToDate UpToDate is a practical clinical information service designed to provide instant access to just the information you need. It is written by a recognized faculty of experts who each address a specific clinical issue. They synthesize the latest evidence and best practices and provide detailed recommendations. [Access to UpToDate is co-funded by the Carver College of Medicine and the University of Iowa Health Care.]

Type: Evidence-based summary; point of care tool
Highlights: Part of ClinicalKey. To access directly from ClinicalKey, use the dropdown menu by the search box and select Clinical Overviews. In the app, after searching, look for results labeled Clinical Overviews.
EBM: References are provided for recommendations.

Essential Evidence Plus and AHFS DI Essentials Essential Evidence Plus is a clinical decision support system (formerly called InfoPOEMS) which includes over 13,000 conditions, diseases, and procedures. Every recommendation carries a strength-of-evidence rating that accurately grades each recommendation's merit on the basis of all of the evidence available in the relevant literature, including Cochrane Systematic Reviews.

Type: Evidence-based summary; point of care tool
Highlights: Part of Stat!Ref. Essential Evidence is a powerful, one-stop, state-of-the-art reference that includes best-evidence answers to your most important clinical questions concerning symptoms, diseases, and treatment.
EBM: Each topic has a "strength of evidence" rating for every recommendation.

Clinical Overviews Formerly known as First Consult and part of ClinicalKey, these overviews provide easy-to-scan, actionable information for clinicians on diagnosis, treatment, monitoring, screening, and prevention of diseases and conditions. They are developed by Elsevier’s Point of Care Editorial team with new topics added regularly.

Type: Evidence-based summary; point of care tool
Highlights: Contains over 9,000 topics in 19 specialties. Written and edited by a global community of 4,800 physicians. Recommendations are often graded in terms of supporting evidence.
EBM: Provides a grading system for recommendations that shows whether the recommendation is weak or strong and whether or not there is evidence to support the recommendation.

ECRI Guidelines Trust ECRI Guidelines Trust is a publicly available web-based repository of objective, evidence-based clinical practice guideline content. It provides physicians, nurses, and other clinical specialties with up-to-date, clinical practices to advance safe and effective patient care. It includes evidence-based guidance developed by nationally and internationally recognized medical organizations and societies. Registration for a free account is required on the site.

Type: Source for clinical guidelines
Highlights: A centralized repository that includes guidelines developed by nationally and internationally recognized medical organizations and medical specialty societies.
EBM: Uses the TRUST Scorecard (TRUST = Transparency and Rigor Using Standards of Trustworthiness) to assess clinical practice guidelines against the Institute of Medicine (IOM) standards for trustworthy guidelines.

Synposes of Syntheses

Cochrane Clinical Answers "Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care. Each Cochrane Clinical Answer contains a clinical question, a short answer, and an opportunity to ‘drill down’ to the evidence from relevant Cochrane reviews."

Type: Synopsis of synthesis; Truncated summaries of Cochrane systematic reviews
Highlights: Easy to read, clinically focused entry point to Cochrane systematic reviews. Designed to be actionable and to inform decision making at the point of care. Each contains a clinical question, a short answer, and an opportunity to drill down to the evidence from relevant Cochrane reviews.
EBM: The Cochrane Collaboration is world renowned for their quality evidence-based publications.

Syntheses

Cochrane Library The Cochrane Library contains high-quality, independent evidence to inform healthcare decision-making. It includes reliable evidence from Cochrane and other systematic reviews, clinical trials, and more. Cochrane reviews bring you the combined results of the world's best medical research studies, and are recognised as the gold standard in evidence-based healthcare.

Type: Synthesis--Cochrane Database of Systematic Reviews
Highlights: Includes the Cochrane Database of Systematic Reviews, which are the gold standard of medical literature, providing comprehensive research analyses on a variety of medical treatments.
EBM: The Cochrane Collaboration is world renowned for their quality evidence-based publications.

Synopses of Studies

ACP Journal Club
ACP Journal Club, a monthly feature of Annals of Internal Medicine, summarizes the best new evidence for internal medicine from over 120 clinical journals. Research staff and clinical editors rigorously assess the scientific merit of the medical literature as it is published.

Individual Studies

PubMed Provides access to bibliographic information in Medline and other sources. (See the available Help Sheet). For full functionality, log in to your MyNCBI account..

PubMed Clinical Queries

Locates articles in PubMed based on Clinical Question domain.

Type: Studies; Locates articles in PubMed based on Clinical Question domain
Highlights: This PubMed interface focuses your search by study type (etiology, diagnosis, therapy, prognosis or clinical prediction guides) or for systematic reviews, evidence-based practice guidelines, and meta-analyses.
EBM: Clinical trials, systematic reviews, meta-analyses, and practice guidelines are labeled, but other evidence levels must be self-identified.

Cochrane Library The Cochrane Library contains high-quality, independent evidence to inform healthcare decision-making. It includes reliable evidence from Cochrane and other systematic reviews, clinical trials, and more. Cochrane reviews bring you the combined results of the world's best medical research studies, and are recognised as the gold standard in evidence-based healthcare.

Type: Studies--Cochrane Controlled Register of Trials (aka CENTRAL)
Highlights: Includes CENTRAL, which provides a repository of clinical trial citations.
EBM: The Cochrane Collaboration is world renowned for their quality evidence-based publications.

CINAHL RECOMMEND USING CHROME [Help Sheet for Search CINAHL - PDF] CINAHL Plus provides indexing for 3,024 journals from the fields of nursing and allied health, with indexing back to 1937. CINAHL Plus also contains searchable cited references for more than 1,160 journals. Full text material includes more than 80 journals plus legal cases, clinical innovations, critical paths, drug records, research instruments and clinical trials. Offering complete coverage of English-language nursing journals and publications from the National League for Nursing and the American Nurses' Association, CINAHL covers nursing, biomedicine, health sciences librarianship, alternative complementary medicine, consumer health and 17 allied health disciplines. NB: 20 concurrent user limit
Embase Due to higher security needed, EMBASE now requires a login for all exports. Help Searching Embase A biomedical and pharmaceutical database contains bibliographic records with abstracts from EMBASE (1974-present) and Medline (1966-present) deduplicated and searchable with EMTREE. (See the available Help Sheet)
PsycINFO The APA PsycINFO database from the American Psychological Association (APA) covers the professional and academic literature in psychology and related disciplines including medicine, psychiatry, nursing, sociology, education, pharmacology, physiology, linguistics, and other areas. PsycINFO's peer-reviewed coverage is worldwide, and includes references and abstracts to 2,400 journals in more than 30 languages, and book chapters and books in the English language. Coverage spans 1600s – present and includes over 5 million peer-reviewed records.

EBM for Herbs & Supplements

NatMed Pro (formerly Natural Medicines)
NatMed Pro provides unbiased, evidence-based information and ratings on over 90,000 dietary supplements, natural medicines, and integrative therapies. This resource includes evidence-based monographs, commercial product ratings for over 90,000 dietary supplement products, an interaction checker, an effectiveness checker, and a nutrient depletion checker. (This resource was previously called Natural Medicines).