PubMed, available via the NCBI Entrez retrieval system, was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM), located at the U.S. National Institutes of Health (NIH). Entrez is the text-based search and retrieval system used at NCBI for services including PubMed, Nucleotide and Protein Sequences, Protein Structures, Complete Genomes, Taxonomy, OMIM, and many others. PubMed provides access to citations from biomedical literature, as well as access to full-text articles at journal Web sites and other related Web resources. PubMed also provides access and links to the other Entrez molecular biology resources. PubMed Clinical Queries is a subset of articles in PubMed offering a user-friendly approach to find evidence-based information. Clinical Queries provides clinicians with a simple and fast way to find reliable clinical studies. It is divided into 3 sections: 1) Search by Clinical Study, 2) Find Systematic Reviews, and 3) Medical Genetic Searches.
EMBASE.com is a biomedical and pharmacological bibliographic database, which provides access to the most up-to-date citations and abstracts from biomedical and drug literature via EMBASE and Medline. It contains over 19 million indexed records from 7,000+ peer reviewed journals, covering 1947 to date, with more than 600,000 additions annually. EMBASE is indexed using the Elsevier life science thesaurus, EMTREE and Medline records are mapped to EMBASE before adding to EMBASE.com.
The Research and Development Resource Base (RDRB) is a bibliographic database of literature that houses a collection for 3 distinct yet inter-related fields: Continuing Education & Knowledge Translation, Interprofessional Literature, and Faculty Development. Each article in the RDRB has extensive keywords, and many offer a link to a short abstract or summary. Searches can be broadly based or very specific, depending on the selection of keywords.
SUMSearch is a single gateway that attempts to provide references to answer clinical questions around diagnosis, aetiology, prognosis and therapy (plus physical findings, adverse treatment effects and screening/prevention) by searching only high-quality sources. In addition to articles on primary studies, SUMSearch always searches: 1) Merck Manual, 2) MEDLINE for review articles and editorials that have full texts available, 3) National Guideline Clearinghouse from the Agency for Health Care Policy and Research (AHCPR), 4) Database of Abstracts of Reviews of Effectiveness (DARE), 5) MEDLINE for original research. Depending on the focus requested SUMSearch will search PubMed with the highest sensitivity filters developed by Haynes et al.
McMaster PLUS is a division within the McMaster Health Knowledge Refinery that includes the process of critically appraising articles through the Critical Appraisal Process to identify those that are methodologically sound, and rating past articles by clinicians for relevance and newsworthiness through the McMaster Online Rating of Evidence system. The McMaster PLUS is used to select content for evidence-based journals (pre-selected according to prestated criteria) of primary studies and review articles (ACP Journal Club, Evidence-Based Medicine and Evidence-Based Nursing), and for a suite of services that provide e-mail alert and searchable database of best primary evidence and reviews of best evidence from the medical literature (EvidenceUpdates, OBESITY+ and Nursing+).
The Cochrane Collaboration is an international not-for-profit and independent organization, dedicated to providing up-to-date, accurate information about the effects of healthcare readily available worldwide. It produces and disseminates systematic reviews of healthcare interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. The major product of the Collaboration is the Cochrane Database of Systematic Reviews which is published quarterly as part of The Cochrane Library. Those who prepare the reviews are mostly healthcare professionals who volunteer to work in one of the many Cochrane Review Groups, with editorial teams overseeing the preparation and maintenance of the reviews, as well as application of quality standards. One of such Cochrane Review Groups is the Cochrane Effective Practice and Organisation of Care Group (EPOC). EPOC produces systematic reviews of educational, behavioural, financial, regulatory and organisational interventions designed to improve health professional practice and the organisation of health care services, potentially spanning any clinical area.
UpToDate is an evidence-based and literature-driven updating system; more than 430 journals are monitored by editors and authors, and anytime something of importance is published, it is incorporated into the program. UpToDate is not a journal watch. New studies are not simply added, but rather they are placed in the context of what has already been published in that field. More than 4,000 physician authors and editors, who are experts in their respective fields, write topic reviews that cover all the major aspects of a particular condition, including symptoms, tests and diagnosis, and treatment options. All topics are also subjected to rigorous peer review. UpToDate covers more than 7,700 topics in 14 medical specialties.
EBMR is a resource for electronic information in the evidence based medicine (EBM) movement that combines 7 of the most trusted EBM resources into a single, fully-searchable database. EBMR helps clinicians practice EBM through a combination of resources that provide: systematic reviews of topics; article reviews; access to definitive controlled trials; and comprehensive integration with MEDLINE.
Clinical Evidence is an international peer reviewed journal publishing systematic reviews of important clinical conditions. The reviews published are constantly being updated and integrated with a range of additional evidence based medicine (EBM) resources to provide clinicians with access to the very latest and most relevant medical knowledge for treatment decisions. Clinical Evidence systematic reviews summarize the current state of knowledge and uncertainty about the prevention and treatment of clinical conditions, based on thorough searches and appraisal of the literature. It describes the best available evidence from systematic reviews, RCTs, and observational studies where appropriate, and if there is no good evidence it says so.
MacPLUS Federated Search is a product of the McMaster Health Knowledge Refinery. It is a continuously updated resource for evidence-based clinical decisions. Searching MacPLUS FS yields content that is hierarchically organized as Systems (providing patient-specific computerized decision support), Summaries (providing the best summarization of evidence for clinical topics), Synopses (brief abstracts of high quality original studies and systematic reviews), Syntheses (systematic reviews of original studies), and Studies (published original studies).
Review Manager (RevMan) provides a platform for preparing and maintaining Cochrane Reviews, including protocols and full reviews. It is most useful when the question for the review has been formulated. In this case, it allows you to prepare the text, build the tables showing the characteristics of studies and the comparisons in the review, and add study data. It can perform meta-analyses and present the results graphically.
The Physicians' Information and Education Resource (PIER), published by the American College of Physicians (ACP), is an electronic, evidence-based decision support tool for primary care physicians. All PIER modules are written by academic authors commissioned by PIER, peer reviewed, and updated on a continual basis by PIER editorial consultants. PIER can be accessed by members of the ACP through the PIER web site. PIER has contracted with the Health Information Research Unit (HIRU) at McMaster University to provide authors and editorial consultants with recent citations for their modules. The ongoing work of HIRU provides an opportunity to filter references so that authors and editorial consultants receive high-quality relevant articles that are of clinical interest. In addition, HIRU provides foundation searches to newly commissioned PIER authors on their topics.
Harrison's Practice delivers essential information on the diagnosis and management of the most common medical conditions based on best available evidence synthesized from sources like the McMaster Premium Literature Service. In addition to delivering Diagnosis and Treatment Information to desktop, PDA, or wireless device at the point-of-care, recently it also provides the latest evidence-based diagnosis and treatment protocols/guideline based on 1) recommendations from the world's leading experts, 2) the most recent studies in the primary literature that will change medical practice, determined by the McMaster Premium Literature Service, and 3) the most recent developments in prescribing trends.
Tools for developing, adapting and evaluating guidelines
AGREE stands for "Appraisal of Guidelines Research and Evaluation". It originates from an international collaboration of researchers and policy makers who work together to improve the quality and effectiveness of clinical practice guidelines by establishing a shared framework for their development, reporting and assessment. The purpose of the AGREE Instrument is designed to provide a framework for assessing the quality of clinical practice guidelines.
The ADAPTE framework is a systematic approach to aid in the adaptation of guidelines produced in one setting to be used in a different cultural and/or organizational context. The ADAPTE framework is based on the following core principles: 1) respect of evidence-based principles for guideline development, 2) reliable and consistent methods to ensure the quality of the adapted guideline, 3) participation of key stakeholders to foster acceptance and ownership of the adapted guideline, 4) explicit consideration of context to ensure relevance for local practice and policies, 5) transparent reporting to promote confidence in the recommendations of the adapted guideline, 6) flexible format to accommodate specific needs and circumstances, 7) respect for and acknowledgement of source guidelines material. The ADAPTE framework is intended to be used by different groups, i.e. guideline developers, health care providers and policy makers at the local, national and international level.
The GuideLine Implementability Appraisal (GLIA) is a tool for the appraisal of the implementability of clinical guidelines. Implementability refers to a set of guideline characteristics that predict potential challenges to effective implementation. In addition to a series of questions that inquire about global aspects of a guideline's implementability, the instrument explores the following dimensions of individual recommendations: 1) Decidability, 2) Executability, 3) Effect On Process Of Care, 4) Presentation & Formatting, 5) Measurable Outcomes, 6) Apparent Validity, 7) Novelty/Innovation, 8) Flexibility, 9) Computability
Tools for developing, implementing and evaluating patient decision aids:
Ottawa Health Research Institute explores better ways to help patients make "tough" healthcare decisions that may have 1) multiple options, 2) uncertain outcomes, and 3) benefits and harms that people value differently, such as supporting the development and implementing patient decision aids, helping patient to become involved in decision making by providing information about the options and outcomes and by clarifying personal values. For the development of decision aid, the OHRI provides development toolkit that makes available information for developers and researchers interested in producing decision aids. For the implementation of decision aid, the OHRI provides implementation toolkit that makes available tools and training for incorporating decision support in practice centres.
The International Patient Decision Aids Standards (IPDAS) establishes an internationally approved set of criteria to determine the quality of patient decision aids. These criteria will be helpful to a wide variety of individuals and organizations that use and/or develop patient decision aids, for example: 1) Patients or other individuals who are making a health decision, 2) Practitioners guiding patients in making health decisions, 3) Developers of patient decision aids, 4) Researchers or evaluators of patient decision aids, and 5) Policy makers or payers of patient decision aids.
