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Evidence-Based Medicine: Introduction

This guide is designed to point medical students toward literature appropriate for evidence-based medicine.

Introduction

Forming a Question

The EBM process begins when a clinician (You) is presented with a scenario that has some uncertain end or unanswered question.  Evidence-based practice uses the PICO model for formulating a searchable question.

Background
(Clinical Summaries, Textbooks, etc)

Background sources are the best place for clinicians to get up to speed on unfamiliar topics and to fill holes in their knowledge base. Several of these resources are (or act as) clinical textbooks with either brief or detailed entries on conditions and interventions. Keep an eye on currency; background resources are often a few years out of date.

Secondary Literature
(Meta-analyses, Systematic Reviews, Evidence-based Guidelines)

Secondary literature sources summarize the medical literature by finding (via explicit, thorough literature search) and appraising relevant individual studies to answer a particular clinical question. In most cases, clinicians should initiate a search for answers to clinical questions with the secondary literature. Please note that we have placed evidence-based guidelines into this category; the best clinical guidelines can provide an answer to a clinical question based on the best evidence. Again, keep an eye on currency.

Primary Literature
(Controlled Trials, Cohort Studies, Case Studies, etc.)

Primary literature is where researchers publish their findings first. In the health field this is usually journal articles outlining methodology, data, results, and conclusions. The evidence based approach emphasizes a hierarchy of evidence based on study types. When searching for single studies on a topic, clinicians should utilize database tools (limits and filters) to obtain the highest level of evidence to answer a clinical question.

About EBM

Find here a collection of EBM guides & tutorials, a depiction of the EBM Pyramid, and the library session PowerPoint.

Textbooks & RSS Feeds

Locate electronic and/or print versions of the course textbooks Users' Guides to the Medical Literature and How to Read a Paper.  View current RSS feeds from the journals ACP Journal Club and Evidence Based Medicine.

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Jane Moran
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