Clerkship Resources: Evidence Summary Resources
Understanding and Evaulating Filtered EBM Resources
The EBM movement has generated a range of specialized databases and review journals. You are probably familiar with at least one of these filtered resources: UpToDate, a database of clinical topic summaries. A "filtered" resource is any resource in which evidence is collected and synthesized into a summarized format. These resources are often referred to as "Point of Care" or "Clinical Decision Support" tools, as they are designed to assist in the clinical decision making process. Utilizing filtered resources can make the process of acquiring and appraising the evidence faster and more reliable than searching primary a literature database such as PubMed. They are usually easy to search, they retrieve only articles that have undergone some quality assessment, and they yield smaller sets of results.
According to the Users' Guides to the Medical Literature, "numerous EBM resources now provide shorter and more efficient paths. These resources select, process and organize the evidence; some, however are more trustworthy than others." See Chapter 5. Finding Current Best Evidence of the Users' Guides to the Medical Literature for details on how evidence is synthesized in these tools and tips for choosing a high quality filtered resource.
Starting From the Top: Clinical Decision Support
The 6S Hierarchy, a new evidence finding model espoused by EBM experts suggests that it is most efficient to begin your search for answers at the top of the 6S Hierarchy and to drill down through the categories of quality filtered resources before turning to PubMed for answers1. However the realization of this model may not yet be possible due to deficiencies in electronic health records (EHR) systems.
1. DiCenso A, Bayley L, Haynes RB. ACP Journal Club. Editorial: Accessing preappraised evidence: fine-tuning the 5S model into a 6S model. Ann Intern Med. 2009 Sep 15;151(6):JC3-2, JC3-3. DOI:10.7326/0003-4819-151-6-200909150-02002