Evidence based medicine

The website of the University of Toronto's Centre for Evidence Based Medicine (www.cebm.utoronto.ca) offers multiple tools to help develop, disseminate, and evaluate resources that can be used in practice and for teaching evidence based medicine (EBM) to undergraduate and postgraduate students. Answers are given to questions such as “What is EBM?” and “Why the sudden interest in EBM?” and so on. The practice sections contain information on common clinical questions and the search for evidence. One section is called Teaching EBM and another is about software tools for EBM on handheld computers. Unfortunately, this website is a little difficult to explore.

Another excellent site, www.cche.net, the Centre for Health Evidence at the University of Alberta is a comprehensive and multidisciplinary initiative of universities, health organisations, and professional associations. This site does not have a directly accessible education section, but the site will give you a complete set of “user guides” for evidence based practice, published in JAMA, which are also useful for critically appraising the literature.

The centre for EBM at the University of Oxford (www.cebm.net) is an interesting and well organised site, with thorough but selected information. It is divided into four sections. Learning EBM is designed for beginners and presents information about what EBM is and what it isn't; a glossary; and the advantages and disadvantages of various study designs. Doing EBM explains how to search evidence, form questions, critically appraise studies, and make decisions. Teaching EBM offers courses and material that you can quickly download. Any EBM Toolbox calculates number needed to treat, pre-test probabilities, and more. This site discusses levels of evidence and clinical applications, and it includes a section of external links, resources for contacts, and news about meetings and events.

If you want your EBM relating to clinical practice predigested (appraised by experts), Bandolier is a good site (www.jr2.ox.ac.uk/bandolier)-“Evidence based thinking about health care.” This site has a useful learning section with content about EBM. Clinical Evidence, owned by the BMJ Publishing Group (www.clinicalevidence.com), summarises the current state of knowledge and uncertainty of nearly 260 clinical conditions, based on thorough searches, critical appraisal, and in-depth review. It has a small section dedicated to learning but is not designed for it.

For more information see “How to read a paper” at http://bmj.com/collections/read.shtml, an excellent guide to the world of EBM.