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  PedsCCM and IntensiveCare.com:
Resources for Practicing Evidence-based Medicine

 

 

What is EBM?

Critical Appraisal of
the Literature

Statistics
and Trial Design

Systematic Reviews

EBM in Critical Care

EBM Groups on
the Web

EBM Databases

MEDLINE Search
Strategies

Pediatric and General
Online Journal Clubs,
Teaching Resources &
Tutorials

 

 

What is Evidence Based Medicine?

 

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What is EBM?

Critical Appraisal of
the Literature

Statistics
and Trial Design

Systematic Reviews

EBM in Critical Care

EBM Groups on
the Web

EBM Databases

MEDLINE Search
Strategies

Pediatric and General
Online Journal Clubs,
Teaching Resources &
Tutorials

 

 

How to Critically Appraise the Medical Literature

User's Guide to Medical Literature;
A series from the Evidence-Based Medicine Informatics Project at McMaster University, available at: The Canadian Centres for Health Evidence

Now available as a reference book, CD, and handbook at: Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice

How to use an article about:

  • Users' Guides to the Medical Literature XXII: How to Use Articles About Clinical Decision Rules. McGinn TG, Wyer PC, Naylor CD et al. JAMA. 2000;284:79-84. [full-text for subscribers only]
  • Users' Guides to the Medical Literature XX. Integrating Research Evidence With the Care of the Individual Patient. McAlister FA, Straus SE, Guyatt GH, Haynes RB et al. JAMA. 2000;283:2829-2836. [abstract] [full-text for subscribers only]
  • Users' guides to the medical literature, XIX: Applying clinical trial results, A: how to use an article measuring the effect of an intervention on surrogate end points. Bucher HC, Guyatt GH, Cook DJ, et al. JAMA 1999;282:771-778. [citation] [full-text for subscribers only]
  • Users' Guides to the Medical Literature XIX. Applying Clinical Trial Results B. Guidelines for Determining Whether a Drug Is Exerting (More Than) a Class Effect. McAlister F, Laupacis A, Wells GA, et al. [citation] [full-text for subscribers only]
  • Users' Guides to the Medical Literature XXI. Using Electronic Health Information Resources in Evidence-Based Practice. Hunt DL, Jaeschke R, McKibbon A. et al. JAMA 2000; 283:1875-1879. [full-text for subscribers only]
  • Users' Guides to the Medical Literature XXIII. Qualitative Research in Health Care A. Are the Results of the Study Valid? Mita K. Giacomini; Deborah J. Cook; for the Evidence-Based Medicine Working Group JAMA. 2000;284:357-362. [full-text for subscribers only]
  • Users' Guides to the Medical Literature XXIII. Qualitative Research in Health Care B. What Are the Results and How Do They Help Me Care for My Patients? Mita K. Giacomini; Deborah J. Cook; for the Evidence-Based Medicine Working Group JAMA. 2000;284:478-482. [full-text for subscribers only]
  • Users' guides to the medical literature: XXIV. How To use an article on the clinical manifestations of disease. Richardson WS, Wilson MC, Williams JW Jr, Moyer VA, Naylor CD. JAMA. 2000;284(7):869-75. [abstract] [full-text for subscribers only]
  • Guyatt GH, Haynes RB, Jaeschke RZ, Cook DJ, Green L, Naylor CD, Wilson MC. Users' guides to the medical literature: XXV. evidence-based medicine: principles for applying the Users' guides to patient care. JAMA. 2000;284(10):1290-6. [abstract] [full-text for subscribers only]

    An alternate complete Users' Guide listing is maintained at UCSF as well

How to read a paper:
A series in the British Medical Journal on database searching and article appraisal

Other resources

 

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What is EBM?

Critical Appraisal of
the Literature

Statistics
and Trial Design

Systematic Reviews

EBM in Critical Care

EBM Groups on
the Web

EBM Databases

MEDLINE Search
Strategies

Pediatric and General
Online Journal Clubs,
Teaching Resources &
Tutorials

 

 

Statistics and Trial Design for Clinicians

Fundamental Concepts

  • A new series on how to learn and teach evidence-based medicine starts in the Canadian Medical Association Journal : [new]

    This series is associated with a new, interactive website full of EBM tips: Evidence Based Practice Tips: Learning Tools for Evidence-based Practice
    • Wyer PC, Keitz S, Hatala R et al. Tips for learning and teaching evidence-based medicine: introduction to the series. Can Med Assoc J 2004;171 347-348 [full-text]
    • Barratt A, Wyer PC, Hatala R et al. Tips for learners of evidence-based medicine: 1. Relative risk reduction, absolute risk reduction and number needed to treat. Can Med Assoc J 2004;171 353-358 [full-text]
    • Montori VM, Kleinbart J, Newman TB, Keitz S, Wyer PC, Moyer V, Guyatt G, for The Evidence-Based Medicine Teaching Tips Working Group . Tips for learners of evidence-based medicine: 2. Measures of precision (confidence intervals). Can Med Assoc J 2004;171 611-615 [full-text]

    Canadian Medical Association Journal: Collected Series on Statistics (the previous four "basics" articles on no longer online...)

    Two articles published in the British Medical Journal

    A series in Annals of Internal Medicine

    • Goodman SN. Toward Evidence-Based Medical Statistics. 1: The P Value Fallacy. Annals of Internal Medicine 1999;130:995-1004. [full-text for a limited time]
    • Goodman SN. Toward Evidence-Based Medical Statistics. 2: The Bayes Factor. Annals of Internal Medicine 1999;130:1005-1013. [full-text for a limited time]
    • Davidoff F. Standing Statistics Right Side Up. Annals of Internal Medicine 1999; 130:1019-1021. [full-text for a limited time]
    Other articles discussing statistical principles and clinical epidemiology:

    Trial Design: Consistency of Reporting

    • Moher D, Schulz KF, Altman D. The CONSORT Statement: Revised Recommendations for Improving the Quality of Reports of Parallel-Group Randomized Trials. JAMA. 2001;285:1987-1991. [abstract][full-text]
    • Chan KBY, Man-Son-Hing M, Molnar FJ, Laupacis A. How well is the clinical importance of study results reported? An assessment of randomized controlled trials. Can Med Assoc J 2001;165(9):1197-202 [full-text]
    • Montori VM, Guyatt GH. Intention-to-treat principle. Can Med Assoc J 2001;165(10):1339-41 [full-text]

    Online Statistics Texts, Calculators and General Web Resources

  •  

    What is EBM?

    Critical Appraisal of
    the Literature

    Statistics
    and Trial Design

    Systematic Reviews

    EBM in Critical Care

    EBM Groups on
    the Web

    EBM Databases

    MEDLINE Search
    Strategies

    Pediatric and General
    Online Journal Clubs,
    Teaching Resources &
    Tutorials

     

     

    Understanding Systematic Reviews

    A full-text series in the Ann Intern Med on Systematic Reviews:

    A full-text series on meta-analysis in the British Medical Journal:

    Other relevant references
    • van Nieuwenhoven CA, Buskens E, van Tiel FH, Bonten MJM. Relationship Between Methodological Trial Quality and the Effects of Selective Digestive Decontamination on Pneumonia and Mortality in Critically Ill Patients. JAMA. 2001;286:335-340. [abstract; full-text for subscribers]
    • DerSimonian R, Levine RJ. Resolving Discrepancies Between a Meta-analysis and a Subsequent Large Controlled Trial. JAMA 1999;282:664-670. [abstract; full-text for subscribers only]
    • The Hazards of Scoring the Quality of Clinical Trials for Meta-analysis. Jüni P, Witschi A, Bloch R, Egger M. JAMA. 1999;282:1054-1060. [full-text or pdf for limited time] [abstract] With an accompanying editorial: Measuring the Quality of Trials: The Quality of Quality Scales. Berlin JA, Rennie D. JAMA 1999; 282:1083-1085. [full-text or pdf for limited time]
    • Numbers needed to treat derived from meta-analyses, sometimes informative, usually misleading. Smeeth L, Haines A, Ebrahim S. Br Med J 1999;318:1548-155. (full-text)
    • Anderson P, Roberts I. Should journals publish systematic reviews that find no evidence to guide practice? Examples from injury research. Br Med J 2000;320:376-377. [full-text]
    • Jadad AR, Moher M, Browman GP, et al. Systematic reviews and meta-analyses on treatment of asthma: critical evaluation. Br Med J 2000;320:537-540. [full-text]
    • Gotzsche PC. Why we need a broad perspective on meta-analysis. Br Med J 2000; 321: 585-586. [full-text]
    • Deeks JJ. Systematic reviews of evaluations of diagnostic and screening tests. Br Med J 2001;323:157-162. [full-text]
    • Altman DG. Systematic reviews in health care: Systematic reviews of evaluations of prognostic variables. Br Med J 2001;323 224-228. [full-text]

     

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    What is EBM?

    Critical Appraisal of
    the Literature

    Statistics
    and Trial Design

    Systematic Reviews

    EBM in Critical Care

    EBM Groups on
    the Web

    EBM Databases

    MEDLINE Search
    Strategies

    Pediatric and General
    Online Journal Clubs,
    Teaching Resources &
    Tutorials

     

     

    Evidence-Based Medicine in Critical Care

    IntensiveCare.com: tutorials, evidence alerts, research networks, information systems, and more.

    The PedsCCM Evidence-Based Journal Club: Peer-reviewed critical analyses of clinical trials pertinent to pediatric critical care medicine

    • Examples include:
      • Schindler MB, Bohn D, Cox PN, McCrindle BW, Jarvis A, Edmonds J,
        Barker, G. Outcome of out-of-hospital cardiac or respiratory arrest in children. N Engl J Med 1996; 333:1473-9. [abstract]
        Critical Appraisal
        by A. Randolph (Posted 3/17/97)
      • Raad D, Darouiche ER, Dupuis J. Central venous catheters coated with
        minocycline and rifampin for the prevention of catheter-related
        colonization and bloodstream infections. Ann Intern Med
        1997;127:267-274. [abstract]
        Critical Appraisal by S. Schexnayder (Posted 1/29/98)


    From the Evidence Based Critical Care Medicine series in Critical Care Medicine:

    • Evidence based critical care medicine; what is it and what can it do for us? Evidence Based Medicine in Critical Care Group. Cook DJ, Sibbald WJ, Vincent JL, Cerra FB. Crit Care Med 1996; 24:334-337. [abstract]
    • How to keep up with the critical care literature and avoid being buried alive. Cook DJ, Meade MO, Fink MP. Crit Care Med 1996; 24:1757-1768. [abstract]
    • Evidence based medicine in critical care: will it take us over the cutting edge? Niederman MS. Crit Care Med 1997;25:1448-1449. (editorial; no abstract available)
    • How to use diagnostic test articles in the intensive care unit: diagnosing weanability using f/Vt. Jaeschke RZ, Meade MO, Guyatt GH, Keenan SP, Cook DJ. Crit Care Med 1997; 25:1514-1521. [abstract]
    • How to use an article on therapy or prevention: pneumonia prevention using subglottic secretion drainage. Cook DJ, Hebert PC, Heyland DK, Guyatt GH, Brun-Buisson C, Marshall JC, Russell J, Vincent JL, Sprung CL, Rutledge F. Crit Care Med 1997; 25:1502-1513. [abstract]
    • How to use articles about harm: the relationship between high tidal volumes, ventilating pressures, and ventilator-induced lung injury. Meade MO, Cook DJ, Kernerman P, Bernard G. Crit Care Med 1997; 25:1915-1922. [abstract]
    • How to use practice guidelines in the intensive care unit: Diagnosis and management of unstable angina.Cook DJ, Ellrodt AG, Calvin J, Levy MM. Crit Care Med 1998 Mar;26(3):599-606.  [abstract]
    • How to use a review article: prophylactic endoscopic sclerotherapy for esophageal varices. Cook DJ, Levy MM, Heyland DK.  Crit Care Med 1998; 26: 692-700. [abstract]
    • Prognosis in the intensive care unit: finding accurate and useful estimates for counseling patients. Randolph AG, Guyatt GH, Richardson WS. Crit Care Med 1998; 26: 767-772. [abstract]
    • Understanding articles comparing outcomes among intensive care units to rate quality of care. Randolph AG, Guyatt GH, Carlet J. Crit Care Med 1998; 26: 773-781. [abstract]
    • Understanding articles describing clinical prediction tools. Randolph AG, Guyatt GH, Calvin J, Doig G, Richardson WS. Crit Care Med 1998; 26: 1603-1612. [abstract]
    • How to use the results of an economic evaluation. Heyland DK, Gafni A, Kernerman P, et al. Crit Care Med 1999; 27: 1195-1202. [abstract]
    • How to use articles about diagnostic technology: Gastric tonometry. Keenan SP, Guyatt GH, Sibbald WJ, et al. Crit Care Med 1999;27:1726-1731. [abstract]

     

    Critical Care Clinics, July 1998 issue, is dedicated to evidence based critical care. Articles include:

    • Evidence-based medicine. A tool for enhancing critical care practice. Cook DJ, Levy MM. Crit Care Clin 1998; 14:353-8. [abstract]
    • Interpreting and using clinical trials. Doig GS. Crit Care Clin 1998; 14:513-525. [abstract]
    • Evidence-based medicine and cost-effectiveness analysis. Chalfin DB. Crit Care Clin 1998; 14:525-37. [abstract]
    • with other management-specific articles cited throughout the PedsCCM File Cabinet

    The status of EBM in Critical Care Medicine

    • Villar J, Perez-Mendez L, Aguirre-Jaime A, Kacmarek RM. Why are physicians so skeptical about positive randomized controlled clinical trials in critical care medicine? Intensive Care Med. 2005 Feb;31(2):196-204 [citation] [new]
    • Vincent JL. Evidence-Based Medicine in the ICU: Important Advances and Limitations. Chest 2004;126 592-600 [abstract]

    How well do we understand our interventions?

    • Ferreira F, Vincent JL, Brun-Buisson C et al. Doctors' perceptions of the effects of interventions tested in prospective, randomised, controlled, clinical trials: results of a survey of ICU physicians. Intensive Care Med, 2001; DOI 10.1007/s001340000749 [abstract, full-text for subscribers]

    Generalizability of clinical trials

    • Padkin A, Rowan K, Black N. Using high quality clinical databases to complement the results of randomised controlled trials: the case of recombinant human activated protein C. Br Med J 2001;323:923-926. [full-text]

     

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    What is EBM?

    Critical Appraisal of
    the Literature

    Statistics
    and Trial Design

    Systematic Reviews

    EBM in Critical Care

    EBM Groups on
    the Web

    EBM Databases

    MEDLINE Search
    Strategies

    Pediatric and General
    Online Journal Clubs,
    Teaching Resources &
    Tutorials

     

     

    EBM Groups on the WWW

     

    Return to Top

     

     

    What is EBM?

    Critical Appraisal of
    the Literature

    Statistics
    and Trial Design

    Systematic Reviews

    EBM in Critical Care

    EBM Groups on
    the Web

    EBM Databases

    MEDLINE Search
    Strategies

    Pediatric and General
    Online Journal Clubs,
    Teaching Resources &
    Tutorials

     

     

    Evidence-Based Medicine Databases and Directories

    Databases

    Directories

     

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    What is EBM?

    Critical Appraisal of
    the Literature

    Statistics
    and Trial Design

    Systematic Reviews

    EBM in Critical Care

    EBM Groups on
    the Web

    EBM Databases

    MEDLINE Search
    Strategies

    Pediatric and General
    Online Journal Clubs,
    Teaching Resources &
    Tutorials

     

     

     

     

    Medline Search Strategies

     

     

    Return to Top

     

    What is EBM?

    Critical Appraisal of
    the Literature

    Statistics
    and Trial Design

    Systematic Reviews

    EBM in Critical Care

    EBM Groups on
    the Web

    EBM Databases

    MEDLINE Search
    Strategies

    Pediatric and General
    Online Journal Clubs,
    Teaching Resources &
    Tutorials

     

     

    Pediatric and General Online Journal Clubs, Teaching Resources & Tutorials

      Online Journal Clubs and Critically Appraised Topic "Banks"

    Pediatric-specific Resources


    Other Resources for Teaching EBM

    • Coomarasamy A, Khan KS. What is the evidence that postgraduate teaching in evidence based medicine changes anything? A systematic review. Br Med J. 2004 Oct 30;329(7473):1017. [abstract; full-text] [new]
    • Frohna JG, Park SM. Promoting the use of evidence-based medicine in pediatrics. J Pediatr 2002; 141:599-600. [full-text]
    • CAT-Maker Software developed at the Centre for Evidence Based Medicine in Oxford to produce critically appraised topics (CATs) by Douglas Badenoch.
    • Centre for Evidence Based Medicine A range of teaching materials including scenarios and checklists.
    • Centre for Evidence Based Mental Health This site has examples of mental health scenarios to be used in critical appraisal workshops.
    • EBM Toolbox from the University of Alberta. Not to be confused with the Centre for Evidence Based Medicine's resource of the same name, this is a Canadian based collection of resources to support EBM.
    • Evidence Calculator for Therapeutic Decisions; from B Djulbegovic, University of South Florida.


    Online Tutorials


    Courses for Learning EBM & How to Teach EBM

    • Fritsche L, Greenhalgh T, Falck-Ytter Y, Neumayer H-H, Kunz R. Do short courses in evidence based medicine improve knowledge and skills? Validation of Berlin questionnaire and before and after study of courses in evidence based medicine. Br Med J 2002;325: 1338-1341. [full-text]
    • Workshop on How to Teach Evidence Based Medicine at McMaster University Department of Clinical Epidemiology and Biostatistics have assembled sets of readings dealing with evidence-based medicine and critical appraisal issues in therapy, diagnosis, prognosis, harm, overviews and economic analysis. A similar workshop is held at Oxford University and they post a Calendar of Events on the WWW.
    • CAMS - Critical Appraisal for Medical Students
      CAMS is a student-led group dedicatedto provide exciting opportunities to develop the skills of applying papers to patients.
    • North Thames Research Appraisal Group. This regional initiative runs a series of training courses designed to equip clinical staff with the skills required to find and to appraise the evidence.
    • How to find the evidence; a self-directed web course on locating research evidence for translation into practice.

     

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    created and maintained by: Adrienne G Randolph, MD, MSc and Barry Markovitz, MD
    Multidisciplinary Intensive Care Unit, Department of Anesthesia
    Children's Hospital and Harvard Medical School, Boston, Massachusetts
    and
    Departments of Anesthesiology and Pediatrics
    St. Louis Children's Hospital, Washington University School of Medicine

    back to IntensiveCare.com Home Page | back to PedsCCM EB Journal Club

     

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    Document last modified May 15, 2006
    http://pedsccm.org/EBJ/EB_Resources.html