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Clinical Decison Making Resources

Tools and resources for medical students in the Clinical Decision Making course.

Biomedical Databases

Databases that contain primary research biomedical literature, which is unfiltered, unassessed, and can be applied to clinical questions.

Medline (complete file) - The premier database for bibliographic coverage of clinical and biomedical literature.

PubMed Plus - PubMed is the public access version to Medline, the premier database for biomedical literature. PubMedPlus is an enhanced version with links to full-text journals that the Penn Library subscribes to.

OVID Medline versus PubMed - Comparison of OVID Medline and PubMed to help you decide which access version to choose.

EMBASE - Database is strong in drug research, pharmacology, pharmaceutics, side effects and interactions and toxicology, basic biomedical sciences, and human medicine (clinical and experimental).

Evidence-Based Medicine Databases

Full-text evidence-based medicine databases. These databases contain information that has been filtered, assessed, and synthesized.

Cochrane Library - The Cochrane Library consists of a regularly updated collection of evidence-based medicine databases. Look at:

Cochrane Reviews (formerly Cochrane Database of Systematic Reviews [CDSR]) - Reflects the current practice in medicine to base clinical decisions on accumulated evidence from the primary medical literature. Includes the full text of the regularly updated systematic reviews of the effects of healthcare prepared by The Cochrane Collaboration. Methods Reviews (Cochrane Database of Methodology Reviews) are now included in the browse lists for Cochrane Reviews (Cochrane Database of Systematic Reviews), although they retain their own 'tab' in the search results.

Clinical Trials (formerly Cochrane Central Register of Controlled Trials [CCTR]) - Clinical Trials is a bibliographic database of definitive controlled trials. These controlled trials have been identified by the distinguished contributors to the Cochrane Collaboration.

Other Reviews (formerly Database of Abstracts of Reviews of Effectiveness [DARE]) - A full text database containing critical assessments of systematic reviews from a variety of medical journals.

ACP Journal Club - Contains full-text evidence-based article reviews from two journals, ACP Journal Club and Evidence-Based Medicine, with enhanced abstracts and expert commentaries to both methodologically sound and clinically relevant articles from top journals.

UpToDate - A practical clinical reference providing instant access to thousands of original topic reviews written by a recognized faculty of experts who each address a specific clinical issue and provide detailed recommendations. (ONLY accessible from UPHS and School of Medicine locations, NO remote access)

General Clinical Resources

Collection of clinical textbooks, journals, and reference materials. Excellent source for background information.

Access Medicine - McGraw-Hill's AccessMedicine.com is an online reference resource that includes Harrison's Online, Current Medical Diagnosis & Treatment, other core medical texts, Lange clinical review library, USMLE review, drug information, patient education, and many more resources.

MD Consult - Web portal containing full-text content of over 50 publishers and other organizations. Access includes full text textbooks, Clinics of North America, full text journals, practice guidelines, drug information, yearbooks and patient education.

EBM Guides

Levels of Evidence, Types of Questions, and Suggested Types of Studies

These handouts suggest the type of research study that should be used to answer a specific type of EBM question and the level of evidence those studies should be.

The Well Built Clinical Question - University of South Alabama Biomedical Library - Summary of the type of question, the suggested best type of study you will need to answer the question, and the appropriate level of evidence the specific studies should be.

The Evidence Cycle - Duke University Medical Center (DUMC) Library - A brief overview of the five A's of the Evidence Cycle with suggestions and questions to consider when evaluating a specific type of EBM question.

The Steps in the EBM Process and Types of Studies in Medical Literature - University of California, San Francisco Library and Center for Knowledge Management - Brief overview of the EBM process with suggested type of medical study to answer specific types of EBM questions.

EBM Toolkit - This is a collection of tools for identifying, assessing and applying relevant evidence for better health care decision-making. The appraisal tools are adapted from the Users' Guides series prepared by the Evidence Based Medicine Working Group and originally published in JAMA

Users' Guides to the Medical Literature

UGI Interactive: Users' Guides to the Medical Literature - Contains the full text of the Users' Guides to the Medical Literature JAMA series as they were published in the first edition of the Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, and makes this content interactive with dynamic tips, worksheets, calculators, and illustrative clinical cases. Click on the Access UGI button to access the guides.

Users' Guides to the Medical Literature - RefWorks Folder - Listing of articles in the JAMA series, Users' Guides to the Medical Literature, with PennText links, and stored in a RefWorks folder. To access the folder, use Log-in Name: clinical_decision Password: cdm2. Sort by Ref ID to list articles descending sequencial order. Please log out when done.

Users' Guides to Evidence-Based Practice - Centre for Health Evidence - The complete set of the full text pre-publication version of the Users' Guides series published in the Journal of the American Association (JAMA).

General Medical Reference Resources

Clinical Guidelines

National Guideline Clearinghouse - A public resource for evidence-based clinical practice guidelines.

Dictionaries, Glossaries

Concise Medical Dictionary - Concise Medical Dictionary from Oxford Reference Online

Merriam-Webster's Medical Dictionary - From the National Library of Medicne and NIH site, MedlinePlus

EBM Reference Resources

Critically Appraised Topics (CATs)

BestBETs - BETs (Best Evidence Topics) databases were developed in the Emergency Department of Manchester Royal Infirmary, UK, to provide rapid evidence-based answers to real-life clinical questions, using a systematic approach to reviewing the literature. BETs take into account the shortcomings of much current evidence, allowing physicians to make the best of what there is.

EBM for UW (University of Washington) Medicine Residents - CATs by Topic - Topics are arranged by general topics such as renal, pulmonary, dermatiology, etc.

EBOC: Evidence-Based On Call - Affiliated with the Oxford Centre for Evidence-Based Medicine (CEBM) - This is a database of Critically Appraised Topics (CAT).

Evidence-Based Pediatrics: CATs - University of Michigan

UNC CAT Index - Index of CAT Sheets by subject from the  Department of Internal Medicine, University of North Carolina, Chapel Hill.

Dictionaries, Glossaries

Glossary of EBM Terms - Glossary of EBM terms from the Centre for Evidence-Based Medicine

Search Engines

SUMSearch - Developed by the University of Texas Health Science Center, this search engine simultaneously searches multiple web sites and collates the results on one page. The majority of the links provided by SUMSearch come from three Internet sites - the National Library of Medicine (NLM), DARE, and the National Guideline Clearinghouse (NGC).

TRIP - Turning Research Into Practice - Provides access to evidence-based publications in an easy-to-use format with access to full-text articles, medical images, patient leaflets, guidelines, e-textbooks, and more.

Tutorials

Evidence Based Medicine - Finding the Best Clinical Literature - EBM tutorial from the Library of Health Sciences Peoria, University of Illinois at Chicago.

Introduction to Evidence-Based Medicine - Tutorial from Duke University Medical Center Library and University of North Carolina at Chapel Hill Health Sciences Library.

SUNY Downstate EBM Tutorial - Tutorial from SUNY Downstate Medical Center Medical Research Library of Brooklyn.

Useful Sites

Agency for Healthcare Research and Quality (AHRQ) - AHRQ is the lead Federal agency charged with supporting research designed to improve the quality of healthcare, reduce its cost, improve patient safety, decrease medical errors and broaden access to evidence-based information on healthcare outcomes.

Bandolier - "Evidence based thinking about health care" - Bandolier is a print and Internet journal which finds information about evidence of effectiveness (or lack of it), and puts the results forward as simple bullet points of those things that worked and those that did not: a bandolier with bullets. Information comes from systematic reviews, meta-analyses, randomised trials, and from high quality observational studies. Access is free.

Centre for Evidence Based Medicine (CEBM) - Oxford, England

Centre for Health Evidence - Canada - University of Alberta

Evidence-based Medicine Resource Center - From the New York Academy of Medicine in partnership with the Evidence-based Medicine Committee of the American College of Physicians, New York Chapter.

Specialist Libraries - NLH (National Library for Health, United Kingdom) - Specialised collections for different communities of practice. Links to the latest guidelines, systematic reviews and research in your area of interest..