منابع EBM در كتابخانه ديجيتال پزشكي

BMJ CLINICAL UPDATES

November 2006

نمایش میزان اعتبار شواهد ذکر شده

November 2006

Guidelines 9/12/2015 EBM Resources 20 Clinical Practice Guidelines may be  Explicit evidence-based  Evidence-based  Research-based (highly referenced)  Opinion-based  “expert consensus”

ClinicalTrials.gov 9/12/2015 EBM Resources 21 NIH, NLM, FDA sponsored Studies in progress February studies US and CA – 80 countries

ایراد بزرگی بر ما وارد است که هیچ منبع جمع آوری شده ای از تحلیل های انتقادی براساس مطالعات بالینی کنترل شده که توسط متخصصین و فوق متخصصین مرتبا بروز شود، ایجاد نکرده ایم. دکتر آرچی کوکرین – اپیدمیولوژیست

Cochrane Library 9/12/2015 EBM Resources 27 The current resource with the highest methodological rigor For each clinical question, all of the English literature meticulously searched for randomized trials Large systematic reviews with valid methods + collaborative effort Conclusions are based on all the evidence from valid randomized trials

Cochrane Library Included in OVID subscription Limitations  limited to English  only addresses questions amenable to randomized trials  most of medicine has not been studied enough to allow for conclusions  $235/year or abstracts only 9/12/2015 EBM Resources 28

What is The Cochrane Library? The Cochrane Library is the single most reliable source for evidence on the effects of health care. The Cochrane Library brings together in one place research on the effectiveness of healthcare treatments and interventions.

What is in The Cochrane Library? Cochrane Database of Systematic Reviews (Cochrane Reviews) Database of Abstracts of Reviews of Effects (Other Reviews) Central Register of Controlled Trials (Clinical Trials) Cochrane Methodology Register (Methods Studies) Health Technology Assessment Database (Technology Assessments) NHS Economic Evaluation Database (Economic Evaluations) It also contains information about The Cochrane Collaboration and The Cochrane Collaborative Review Groups

The Cochrane Database of Systematic Reviews How large is The Cochrane Reviews database? It comprises over 3464 complete reviews and 1856 protocols (Reviews in progress) in html & PDF format How often is the database updated? every 3 months

Source: Chart by Paul Glasziou The Cochrane Database of Systematic Reviews

Database of Abstracts of Reviews of Effects Database of Abstracts of Reviews of Effects (Other Reviews). اين مجموعه حاوي بيش از 5700 چكيده و متن كامل مقالات مروري نظام مند كوكرن، نشريه هاي كالج پزشكان آمريكا (ACP) ، انجمن پزشكان داخلي (ASIM=Am. Society of Internal Med) ، و ” پزشكي مبتني بر شواهد BMJ است كه توسط پزشكان مركز ملي مطالعات و اشاعه خدمات بهداشتي دانشگاه يورك NHS CRD= National Health Services Center for Reviews and Dissemination تهيه و توليد مي شود. ركوردهاي آن بطور خاص مواردي چون پيشگيري و كنترل، بازتواني، غربالگري و درمان بيماري ها را پوشش مي دهد كه در واقع مفهوم ” اثر بخشي “ را مي رساند.

Central Register of Controlled Trials Cochrane Central Register of Controlled Trials (Clinical Trials( اين پايگاه توسط نويسندگان معتبر و برجسته گروه كوكرن و با همكاري كتابخانه ملي پزشكي آمريكا NLM و موسسه ريد الزوير Reed Elsevier در هلند، توليد كننده پايگاه اكسرپتا مديكا تهيه و توليد مي شود. بيش از 480 هزار كارآزمايي باليني در بهداشت و پزشكي جمع آوري شده بر اساس استانداردهاي كنترل كيفيت در تحقيق توسط گروه كارشناسان كوكرن

Cochrane Methodology Register The Cochrane Methodology Register (Method Studies). متدولوژي هاي به كار رفته و ثبت شده در كارآزمايي هاي باليني. مشتمل بر مقالات پژوهشي، كتاب و مقالات كنفرانس هاست. حاصل جستجو در پايگاه مدلاين

Health Technology Assessment Database Health Technology Assessment Database (Technology Assessments). تهيه شده توسط CRD مركز ملي مطالعات و اشاعه خدمات بهداشتي دانشگاه يورك در انگلستان مشتمل بر ارزيابي هاي تكميل شده و در حال انجام در زمينه فناوري هاي بهداشتي ( تاثيرات اقتصادي، اجتماعي ، اخلاقي و باليني مداخلات مراقبت هاي بهداشتي ) هدف از تشكيل اين پايگاه، بهبود كيفيت و هزينه سودمندي مراقبت هاي بهداشتي است..

ACP Journal Club 9/12/2015 EBM Resources 38 About 100 journals systematically surveyed Highest-validity articles abstracted Structured abstracts to guide critical appraisal Clinical commentary Included in our OVID subscription

ACP Journal Club Limitations  individual article summaries may not account for the “big picture”  may have to read multiple items  No “control” over what is covered  $78/year ? 9/12/2015 EBM Resources 39

DynaMed 9/12/2015 EBM Resources 42 Designed as entry point to information Textbooks and Medline not efficient Intuitive clinical organization Brief summarized information presented Links and references if more details needed ICD-9 codes and links to patient information handouts

DynaMed format 9/12/2015 EBM Resources 43 Description Etiology Increased Risks Associated Conditions Complications History (cc, HPI, etc.) Physical Diagnostic (including Rule out, Tests to order) Prognosis Treatment Prevention Screening References Patient Information

DynaMed Sources 9/12/2015 EBM Resources primary journals – e.g. BMJ, JAMA, Lancet, NEJM, Pediatrics 12 secondary literature sources – e.g. Alternative Therapies, ACP Journal Club, Cochrane Library, InfoPOEMs 4 drug info sources – e.g. The Medical Letter, FDA MedWatch

DynaMed Limitations  variable quality  online only  areas with a lot of research can get hard to navigate  $200/year or effort 9/12/2015 EBM Resources 45

Medical InfoRetriever 9/12/2015 EBM Resources journals surveyed for Evidence-Based Practice Newsletter Over 1300 article synopses Cochrane abstracts Selected evidence-based guidelines Basic drug info Clinical calculators/prediction rules 5 Minute Clinical Consult

InfoRetriever Comes in web, desktop and PDA (30M) versions Limitations  individual article summaries may not account for the “big picture”  may have to read multiple items  $249/year 9/12/2015 EBM Resources 48

PDxMD 9/12/2015 EBM Resources 49 Online and PDA (10M) versions By MDConsult Differential Diagnosis Disease Information Patient Education Handouts

آیا اقدامات جراحی معده در مقایسه با رژیم درمانی در درمان چاقی موثرند؟ Obesity Surgery Diet Weight reduction Patient Intervention Comparison Outcome

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