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Evidence Based Medicine Guide: Module 2: Acquire

EBM "Filtered" Resoures vs. PubMed

Module 2 is focused on PubMed tools and techniques for finding the current best evidence to answer clinical questions. Before we launch into searching PubMed, though, we want to remind you of EBM "filtered" resources. These were reviewed during the Library's Clinical Skills Week small group sessions.

Filtered resources can make acquiring and appraising the evidence faster and more reliable. Although they may not be as comprehensive as larger databases, they are usually easier to search, they retrieve only articles that have undergone some quality assessment, and they yield smaller sets of results. Unless noted, these resources are not free: they are licensed by Levy Library for the Mount Sinai community.

Starting From the Top: Clinical Decision Support

EBM experts (1) suggest that it is most efficient to begin your search for answers at the top of the 6S Hierarchy and to drill down through the catagories of quality filtered resources before turning to PubMed for answers. 

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

Summaries: Topic Reviews

Databases of monographs intended to support clinical decisions. These are updated frequently and their recommendations are supported by references to primary studies. They may provide "grades" for the strength of evidence of individual references or for their recommendations as a whole. 

Summaries: Practice Guidelines

Practice guidelines straddle the line between evidence and the evidence-based literature. Like systematic reviews, they gather, appaise and synthsize research findings. They usually go beyond systematic reviews, however, in balancing a broader range of issues in a clinical context. When evidence is lacking, authors must rely on expert consensus to make recommendations. This is a list of a few selected resources for finding guidelines.

Article Synopses

You do not always need to do cirtical appraisal yourself. These quality filtered resources provide structured abstracts and expert commentary of individual studies.

EBM Meta-Search

In addition to drilling down for the evidence by searching specialized databases, consider using databases that do a meta-search of EBM filtered resources. 

The Cochrane Review

Many consider the methodology used in Cochrane Reviews to be the gold standard for systematic reviews. But what is a Cochrane Review and what is its relationship to the Cochrane Collaboration, the Cochrane Library, and the Cochrane Database of Systematic Reviews? 

The Cochrane Collaboration is an international voluntary organization that prepares, maintains and promotes the accessibility of systematic reviews of the effects of healthcare. Collaborative Review Groups, each focused on a particular topic area, produce and maintain systematic reviews. 

The Cochrane Library is a database from the Cochrane Collaboration that allows simultaneous searching of six EBM databases. The Cochrane Library is licensed by the Levy Library for the Mount Sinai community.

The Cochrane Database of Systematic Reviews (CDSR) is one of the six databases in the Cochrane Library. It contains the full-text of Cochrane Reviews and review protocols.  

Cochrane Reviews are systematic reviews authored by members of the Cochrane Collaboration and published in the Cochrane Database of Systematic Reviews. They address specific questions about the effects of clinical interventions: treatments, prevention, screening and rehabilitation. Meta-analysis may be performed.

Abstracts of completed Cochrane Reviews are freely available through PubMed and other open-access databases. The full-text of Cochrane Reviews is available to the Mount Sinai community from Cochrane Library. They are also available through databases such as PubMed via Levy Library's journal article linking service, FIND IT.