Research Guides: Evidence-Based Medicine: Basics of EBM

Introduction

About this Guide

This Guide focuses on the first three steps of the Evidence-Based Practice Model (shown below) and is designed to assist students in:

Understanding core evidence-based medicine (EBM) concepts
Developing research skills necessary for the practice of evidence-based medicine
Accessing evidence-based medicine resources

The EBM Practice Model:

1	Ask	a well-defined, answerable clinical question. Use the PICO framework to define the question.
2	Acquire	the best available evidence from the literature.
3	Appraise	the literature for relevancy, currency, validity, and applicability.

For more information, see:
Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed

Chapter 2: What Is Evidence-Based Medicine? Gordon Guyatt; Roman Jaeschke; Mark C. Wilson; Victor M. Montori; W. Scott Richardson

When referring to this resource in your writing, please attribute with a reference, such as the example below, which is formatted to AMA style:

Seeger CM. Evidence-Based Medicine. Sam Houston State University Libguides. Updated August 5, 2024. Accessed Month day, year. https://shsulibraryguides.org/ebm

1. Ask

Developing a Clinical Question

The PICO(T) Framework is highly recommended for developing clinical questions. PICO(T) is a mnemonic outlining the information essential for finding strong evidence.

The PICO(T) Framework

P	Patient or Problem	Who is the patient or what is the problem?
I/E	Intervention OR Exposure	What intervention will be investigated? What potentially harmful factors will be investigated?
C	*Comparator	What alternative is being investigated?
O	Outcome	What outcome is desired?
(T)	**Timeframe	How long to achieve the outcome OR length of time

*This element is often the standard, or no, intervention, so may not be necessary to include..

**This element is optional. It could include the length of time since diagnosis, to outcome, or the follow-up time

2a. Acquire

Finding Evidence

Databases

Primary (Non-appraised)

CINAHL Complete (Cumulative Index to Nursing & Allied Health Literature) This link opens in a new window Nursing and allied health journals and other publications of the American Nurses' Association and the National League for Nursing.
ProQuest Health Research Premium Collection This link opens in a new window Over 4,500 full text health and medical journals. Plus instructional videos, grey literature, and more. ProQuest's unique mix of training content, scholarly literature, and clinical reference materials is accessible to those preparing for a career in healthcare.
ProQuest Nursing and Allied Health Source This link opens in a new window ProQuest Nursing & Allied Health Source provides reliable healthcare information covering nursing, allied health, alternative and complementary medicine, and much more.
PubMed This link opens in a new window PubMed comprises more than 34 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full text content from PubMed Central and publisher web sites.

Secondary (Pre-appraised)

ACP Journal Club Summarizes the best new evidence for internal medicine from over 120 clinical journals.
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You must create an account within the resource to access full-text.

Clinical Key This link opens in a new window ClinicalKey supports healthcare professionals and students with the latest evidence across specialties in a variety of formats. With more than 1000+ textbooks, 500+ journals, and 5,000+ patient handouts in English and Spanish with over 13,000 videos and millions of images. To access certain features, you will need to register for an account and the setup must be from on-campus , using your SHSU email address.
Cochrane Library This link opens in a new window The gold-standard in Evidence-Based Practice documentation for Nursing, Health and all healthcare related disciplines. Providing high-quality, independent evidence to inform healthcare decision-making, including: Cochrane Database of Systematic Reviews; Cochrane Central Register of Controlled Trials; Cochrane Methodology Register; Database of Abstracts of Reviews of Effects (DARE); Health Technology Assessment Database; and NHS Economic Evaluation Database.
PubMed This link opens in a new window PubMed comprises more than 34 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full text content from PubMed Central and publisher web sites.
UpToDate This link opens in a new window
UpToDate® is a point-of-care resource providing access to evidence-based recommendations covering 25 specialties.

Instruction for mobile (app) access to UpToDate:

1. Login to UpToDate web using your SHSU username and password
2. Click on “Register” on the top right corner to create a personal account
3. Visit iTunes or Google Play Store and download the UpToDate app
4. Open UpToDate app, login using your personal account info
5. Sign in to UpToDate web every 90 days to maintain access to the UpToDate app
For more information on maintaining mobile access, see UpToDate Access Maintenance page

2b. Acquire

Finding Evidence Cont.

Federated Searches

The federated, open-source search engines linked here are designed to let clinicands search all categories (preappraised & non-appraised) of resources.

TRIP Search Engine Turning Research Into Practice - Find high-quality research evidence to support patient care.
PEDro (Physiotherapy Evidence) PEDro is the Physiotherapy Evidence Database, a free database of over 46,000 randomised trials, systematic reviews and clinical practice guidelines in physiotherapy.
ACCESSSS ACCESSSS provides "one-stop" access to pre-appraised evidence to address this key question: what is the current best evidence available to support clinical decisions?
Epistemonikos Combines the best of Evidence-Based Health Care, information technologies and a network of experts to provide a unique tool for people making decisions concerning clinical or health-policy questions.

3. Appraise

Appraising Evidence

When secondary literature is not available for a topic, primary literature must be identified and critically appraised by the clinician. The appraisal process evaluates a study's research methods and determines whether its results can be trusted. The tools linked here are designed too help clinicians systematically evaluate primary sources.

Evidence-Based Medicine: Basics of EBM