Evidence-based health practice

ACP Journal Club

ACP Journal Club's general purpose is to select from the biomedical literature those articles reporting original studies and systematic reviews that warrant immediate attention by physicians attempting to keep pace with important advances in internal medicine. These articles are summarized in "value added" abstracts and commented on by clinical experts.

Australian Centre for Evidence Based Clinical Practice (ACEBCP)

The ACEBCP "was established in early 2000 as a resource centre to support clinical practitioners of all disciplines to respond effectively to the challenges of implementing evidence based clinical practice" The Centre, based at Flinders, offers "resources, including advice, practical support .. to healthcare professionals and consumers wishing to improve clinical care through the application of best evidence".

Australian Clinical Trials Registry (ACTR)

The Australian Clinical Trials Registry (ACTR) is a national on-line register of clinical trials being undertaken in Australia. It is funded for 5 years by the NHMRC. The Registry includes trials from the full spectrum of therapeutic areas including trials of pharmaceuticals, surgical procedures, preventive measures, lifestyle, devices, treatment and rehabilitation strategies and complementary therapies. It has nationwide coverage of all clinical trials involving Australian researchers or Australian participants.

Bandolier

Bandolier is an independent, well-respected and authoritative NHS publication that covers the complex subject of evidence-based medicine in a straightforward, practical and sometimes amusing way. The impetus behind Bandolier was to find information about evidence of effectiveness (or lack of it), and put the results forward as simple bullet points of those things that worked and those that didn't. Information comes from systematic reviews, meta-analyses, randomised trials, and from high quality observational studies.

BestBETS

BETs 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. Although BETs initially had an emergency medicine focus, there are a significant number of BETs covering cardiothoracics, nursing, primary care and paediatrics. It is a fully searchable database by title and topic.

Centres for Health Evidence.

This Canadian based centre was established to help patients, practitioners, and policy makers: "know what to do, do what is known and understand what is done." It's User Guides to Evidence Based Practice are extremely valuable resources to assist clinicians in critically appraising the information they receive. These guides include 'How to use guidelines or recommenations about screening', 'How to use an article about therapy or prevention' and 'Applying clinical trial results.

Clinical Evidence

Clinical Evidence is an international source of the best available evidence on the effects of common clinical interventions. It summarises the current state of knowledge and uncertainty about the prevention and treatment of clinical conditions, based on thorough searches and appraisal of the literature. It is neither a textbook of medicine nor a set of guidelines. It describes the best available evidence from systematic reviews and RCTs, and if there is no good evidence it says so. "It aims to help people make informed decisions about which treatments to use and can also show where more research is needed"

ClinicalTrials.gov

ClinicalTrials.gov provides regularly updated information about U.S. federally and privately supported clinical research in human volunteers. ClinicalTrials.gov gives you information about a trial's purpose and also links to published articles and reports on the trial. It is searchable by condition, location, treatment, sponsor etc. The site also provides useful background information explaining and describing clinical trials.

Cochrane Library

The Cochrane Library is the main output of the Cochrane Collaboration and aims to bring together in one place reliable information about the effects of health care treatments or interventions. A major source for evidence-based health practice.It consists of several databases including:

The Cochrane Database of Systematic Reviews. This database contatins the full text of the regularly updated systematic reviews of topics prepared by the Cochrane Collaboration. The reviews are presented as either complete reviews or protocols for reviews currently being prepared.

DARE (Database of Reviews of Effects). DARE includes systematic reviews (other than Cochrane systematic reviews), identified by the NHS Centre for Reviews and Dissemination by searching key medical journals, bibliographic databases and by scanning grey literature.

Cochrane Controlled Trials Register. CCTR is a bibliographic database of definitive controlled trials. The register provides bibliographic information (i.e. abstracts rather than full-text) for more than 350,000 reports of trials identified by contributors to the Cochrane Collaboration. It provides individual reviewers with easy and reliable access to the maximum possible number of trials relevant to their review topic.

HTA (Health Technology Assessment database). Many organisations and government agencies around the world carry out health technology assessments. These assessments look at the medical, social, ethical & economic implications of health technologies (eg. pharmaceuticals, vaccines, medical and surgical procedures) with a view to informing policy decisions. The HTA database contains over 2500 records of completed and ongoing assessments.

NHSEED (NHS Economic Evaluation Database). Contains abstracts of full economic evaluations. These are studies in which a comparison of two or more treatments or care alternatives is undertaken and in which both the costs and outcomes of the alternatives are examined.This database contains 10,000 published economic evaluations of health care interventions from around the world, (the majority of which have been quality assessed) and include a structured summary that outlines the practical implications.

DARE (Database of Abstracts of Reviews of Effects) see Cochrane Library or search the original DARE database separately via the NHS Centre for Reviews and Dissemination

DoPHER

The Database of Promoting Health Effectiveness Reviews (DoPHER) is a specialised register produced by the Evidence for Policy and Practice Information (EPPI) Centre, based at the University of London. The EPPI Centre is a collaborating partner of the Cochrane Health Promotion and Public Health Field. DoPHER is a searchable database of references to systematic and non-systematic reviews of health promotion effectiveness. All reviews are keyworded according to their health focus and to the methods used to conduct the review.

Evidence-based Practice Centers (U.S.)

These Centres "review all relevant scientific literature on clinical, behavioral, and organization and financing topics to produce evidence reports and technology assessments". The EPCs also conduct research on methodologies and the effectiveness of their implementation, and provide technical assistance in translating the reports and assessments into quality improvement tools and in helping to inform coverage policies.With this program, the Agency for Healthcare Research and Quality became a "science partner" with private and public organizations in their efforts to improve the quality, effectiveness, and appropriateness of clinical care by facilitating the translation of evidence-based research findings into clinical practice"

Filtering the literature

These sites give guidance on how to filter the higher quality evidence from Medline. The majority of them utilise the research conducted by McMaster University

Geneva Foundation for Medical Education and Research

International database of guidelines, reviews, position statements, recommendations and standards for Obstetrics, Gynaecology and Reproductive Medicine; and for Traditional/Alternative/Complementary Medicine.

FirstConsult

First Consult is an evidence-based clinical information tool for health care providers, part of the MD Consult Clinical Knowledge System. In collaboration with an Editorial Board of respected authors and opinion leaders, FIRSTConsult synthesizes findings from journals and other respected references into a templated knowledge base.

HSTAT

HSTAT provides access to full-text documents useful for providing health information and for health care decision making. HSTAT's audience includes health care providers, health service researchers and policy makers. It provides access to a wide variety of publications, including: clinical practice guidelines, quick- reference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ's Put Prevention Into Practice.

HTA (Health Technology Assessment database) see Cochrane Library or search the original HTA database separately via the NHS Centre for Reviews and Dissemination

Joanna Briggs Centre for Evidence-based Nursing

An International Research Collaboration for Evidence Based Nursing and Midwifery based at the Royal Adelaide Hospital and the Adelaide University with collaborating centres in Australia, New Zealand and Hong Kong. Includes access to Best Practice Information Sheets and Changing Practice Information Sheets.

Medical Journal of Australia - Clinical guidelines

Clinical guidelines published by the MJA represent the "consensus opinion of experts based on review of the scientific literature".

metaRegister of Controlled Trials

mRCT is an international searchable database combining registers of ongoing randomised controlled trials in all areas of healthcare. It also contains some completed trials. When using evidence from controlled trials mRCT can help users ensure they are aware of all of the trial evidence relevant to a particular question. Also useful for research funding agencies who want to take their funding decisions in the light of information about relevant ongoing research, both to avoid duplication of effort and to promote collaboration;

National Guideline Clearinghouse (U.S.)

The NGC mission is to provide health professionals, health care providers, health plans, integrated delivery systems, purchasers and others with an international comprehensive searchable collection of evidence-based clinical practice guidelines and related documents to further their dissemination, implementation and use.

National Health and Medical Research Council - Clinical practice guidelines
The NHMRC aims to foster a critical, evidence-based approach to developing health advice on priority health issues for Australia. The Council's over arching committee, the Health Advisory Committee (HAC) , manages and coordinates health advice on a range of issues, including communicable diseases, environmental health, and illness prevention and health promotion.

Netting the Evidence

An extremely comprehensive UK-based site providing links to numerous sources and resources in the evidence based health area. It's Virtual Library has been put together by assembling links to full text documents on all aspects of Evidence Based Practice and includes tools for critical appraisal and evaluation of the literature.

NHS Research and Development Centre for Evidence-Based Medicine

Based in Oxford. Its broad aim is "to promote evidence-based health care and provide support and resources to anyone who wants to make use of them". Their detailed two page Levels of Evidence, compiled by R.B. Haynes among others, is available here.

NHSEED (NHS Economic Evaluation Database). see Cochrane Library or search the original NHSEED database separately via the NHS Centre for Reviews and Dissemination

NZHTA

New Zealand Health Technology Assessment Clearing House for Health Outcomes and Health Technology Assessment. The main function of NZHTA is to identify effective health care interventions and technologies and thereby facilitate evidence-based policy making and purchasing by the New Zealand funders of health and disability services. Browseable by topic.

OMNI

OMNI (Organising Medical Networked Information) is a gateway to evaluated, quality Internet resources in health and medicine, aimed at students, researchers, academics and practitioners in the health and medical sciences. OMNI is created by a core team of information specialists and subject experts based at the University of Nottingham. It indexes evidence-based resources and can be searched or browsed using MESH headings.

OTseeker

OTseeker is a database that contains abstracts of systematic reviews and randomized controlled trials relevant to occupational therapy. Trials have been critically appraised and rated to assist users to evaluate their validity and interpretability. These ratings will help in judging the quality and usefulness of trials for informing clinical interventions. It is produced by the University of Queensland.

Oxford Pain Internet Site

This site is firmly based in the principles of evidence-based medicine and has pulled together systematic reviews with pain as an outcome.

PEDro

PEDro is the Physiotherapy Evidence Database. It has been developed to give rapid access to bibliographic details and abstracts of randomised controlled trials, systematic reviews and evidence-based clinical practice guidelines in physiotherapy. Most trials on the database have been rated for quality to help users quickly discriminate between trials which are likely to be valid and interpretable and those which are not. It is produced by the School of Physiotherapy at the University of Sydney.

PubMed - Clinical Queries

This specialized search is intended for clinicians and has built-in search "filters". PubMed Clinical Queries offers a streamlined approach to evidence-based searching within the Medline database. The Clinical Queries are pre-set research methodology filters designed by RB Haynes et al. to assist busy practitioners to access the best available evidence by providing expedient and efficient access to reliable clinical studies via four study categories (therapy, diagnosis, etiology and prognosis) and two types of retrieval emphasis (specific and sensitivity). There is also a Systematic Reviews option, which retrieves systematic reviews and meta-analysis studies for your search topic.

SUMSearch

SUMSearch "uses 'fuzzy logic,' and tries to approximate to human 'common sense'. SUMSearch bypasses the quirky syntax differences between the various database search systems." The team from UTHSCSA aim to provide an easy-to-use method for searching links to valid medical evidence.

TRIP+ (Turning Research into Practice)

This database was created in 1997 to bring together all the 'evidence-based' healthcare resources available on the Internet. Since then it has developed and grown rapidly in both coverage and usability. This expansion has encompassed the addition of new forms of material, including peer-reviewed journals and eTextbooks, giving the site a more rounded clinical appeal.

TRoPHI (Trials Register of Promoting Health Interventions)

Searchable database that contains exclusively randomized controlled trials and controlled trials (non-randomized) on health promotion effectiveness. This database contains over 1,000 records and is produced by the Evidence for Policy and Practice Information (EPPI) Centre, based at the University of London. The EPPI Centre is a collaborating partner of the Cochrane Health Promotion and Public Health Field.

WHO/Europe Heath Evidence Network (HEN)

HEN gives rapid access to reliable health information and evidence. It provides answers to policy questions in the form of evidence-based reports and summaries and provides easy access to evidence and information from a number of web sites, databases and documents.

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