Applied Evidence Based Medicine
Welcome!
Welcome to the Applied Evidence Based Medicine (AEBM) Library Research Guide!
This research guide will assist you in building the skills required to acquire the literature that you'll consult when working with patients in a clinical setting or with colleagues on research projects.
Our Team and Our Consultation Services
Health Science Librarians are available to answer questions about finding and appraising literature for your assignments. To book a consultation, please email healthsciences@ucalgary.libanswers.com.
If you're new to library research, I encourage you take a look at the University of Calgary Libraries' video suite Building Blocks for Library Research.
Photo of Canmore, Alberta by Dustin Bowdige on Unsplash
Course Resources
AEBM draws on a number of resources, though any testable concepts are covered in lectures and small groups.
The following is a list of online texts, physical books, articles, video tutorials, critical appraisal tools, and evidence based medicine calculators that you can refer to throughout the course. For further resources, search "evidence based medicine" in the library catalogue.
Online Texts
Evidence-Based Medicine by ISBN: 9780702062964Publication Date: 2019Now in its fifth edition, this classic introduction to the practice and teaching of evidence-based medicine is written for busy clinicians at any stage of their career who want to learn how to practice and teach evidence-based medicine (EBM). It is short and practical, emphasizing direct clinical application of EBM and tactics to practice and teach EBM in real-time.
Fundamentals of Evidence Based Medicine by ISBN: 8132217144Publication Date: 2013This is a basic book on evidence-based medicine (EBM). It outlines the relationship between EBM and research and quality of care. Then it goes on to cover the most commonly used modules of EBM (i.e. therapy, diagnosis, prognosis and meta-analysis). Each module starts with an introduction to fundamental concepts, and description of the related research process, and then follows the critical appraisal of a related type of research article. At the end, it covers the different systems of grading of levels of evidence and strength of recommendations.
Physical Books
Users' Guides to the Medical Literature: A Manual for Evidence-based Clinical Practice by Call Number: WB102 .U84 2008ISBN: 9780071590341Publication Date: 2008-05-21This book is a comprehensive guide to understanding and evaluating different types of studies in the areas of therapy, harm, diagnosis, and prognosis. It also covers the topic of systematic reviews (summarizing the evidence) and implementation (moving from evidence to action).
The Rational Clinical Examination: Evidence-Based Clinical Diagnosis by Call Number: WB200 .R236 2009ISBN: 9780071590303Publication Date: 2008-09-15This book is a guide to evidence-based diagnosis for many common conditions. The information on each condition includes pretest probabilities, likelihood ratios, and recommendations of condition-specific diagnostic scoring instruments and calculators.
Care at the Close of Life: Evidence and Experience by Call Number: WB310 .C2702 2011ISBN: 9780071637954Publication Date: 2010-10-25This book offers evidence-based and clinical expert guidance on caring for patients with life-limiting illness, incorporating the words and perspectives of affected patients, their families, and treating clinicians.
Articles
The BMJ contains a number of articles on how to read a paper. Find links to articles in The BMJ that explain how to read and interpret different kinds of research papers here.
Video Tutorials
Duke University's Evidence Based Practice Tutorial provides a good overview of the acquiring and appraising aspects of evidence based medicine, with modules specific to therapy, diagnosis, prognosis, harm, and systematic reviews. Consider reviewing the relevant module for your question type before undertaking your CAT assignment.
Critical Appraisal Tools
These tools and worksheets can help you to appraise studies in areas such as therapy, diagnosis, prognosis, and harm. They are a useful resource for when you start your CATs.
Evidence Based Medicine Calculators
Use these resources to find common calculators for things like number needed to treat and likelihood ratios.
The EBM Pyramid
The image below shows the progression from evidence to evidence-based resources. The "Hierarchy of Evidence" box shows which types of study are considered best (in descending order of quality) for therapy and harm studies (RCTs, for example, are better than observational studies as a general rule). Questions of diagnosis, prognosis, and differential diagnosis require different hierarchies of study design which you can read more about in Users' Guides.
Because there are too many primary studies for anyone to keep up with, there are "processed" publications, such as guidelines and systematic reviews, that attempt to summarize/synthesize evidence and give you an answer that you can apply in your practice.
On the right, the pyramid ranks the order in which practitioners should consult clinical resources: first try to find the answer in a guideline or summary tool like DynaMed. If that doesn't yield an answer, try to find a systematic review or synopsis (such as those published in ACP Journal Club). If you're still not finding answers, you may need to delve into the primary literature and do a PubMed search to find original studies.
Finding Current Best Evidence, Guyatt G, Rennie D, Meade MO, Cook DJ. Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed; 2015. Available at: https://jamaevidence.mhmedical.com/content.aspx?sectionid=69031461&bookid=847&jumpsectionID=69031726 Accessed: April 01, 2020
Further Reading:
- Chapter 4. In: Guyatt G, Rennie D, Meade MO, Cook DJ. eds. Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 2nd ed. New York, NY: McGraw-Hill; 2008.This chapter explains the different levels of evidence-based resources, which may be used to answer foreground versus background questions, and how to choose resources to answer questions quickly at the point of care.