1. EBM process – 4 steps Question? Search for information Critical review Application ······················································································

2. The main step Search for information 1. Search wide (high sensitivity) 2. Limit irrelevant hits (high specificity) 3. Use a good hit to find other relevant articles ······················································································

3. Choose the right database Search for information in this order: 1. The Cochrane Library 2. Mega-search engine (SUMSearch) 3. Other secondary databases (BestBets) 4. Clinical guidelines (Clinical Evidence) 5. …first now MEDLINE (PubMed) ······················································································

4. Some addresses www.thecochranelibrary.com http://sumsearch.uthscsa.edu www.tripdatabase.com www.scirus.com www.bestbets.org www.clinicalevidence.com www.pubmed.gov ······················································································

5. Evaluation of scientific quality Why?- Purpose In what way?- Design How good?- Quality How large?- Effect size How accurate?- Reliability So what?- Relevance/Importance ······················································································

6. The level of evidence LevelMeaning Background AGood Meta-analysis, syst. reviews. large RCT BModerate Small RCT, cohort-, case- control- and cross sectional studies CLow Case reports, expert opinion DNone No studies available ······················································································