Medical Student Perspectives: Evidence-Based Medicine Resources for Medical Students
Physicians have been practicing based on "evidence" for many decades. However, traditionally due to multitude of reasons, including limited availability of sound clinical research and limited access to available data, they heavily relied on anecdotal evidence, which was primarily derived from their clinical experience, the recommendations of their colleagues and the writings of the "authorities" in their field. Over the past two decades, with the advances in technology, in particular the advent of the electronic age, the ability to disseminate more objective evidence has greatly increased and there has been a shift toward relying more on such evidence over the anecdotal approaches of the past.
The term "Evidence-Based Medicine" (EBM) with its modern meaning was first coined by Dr. Gordon Guyatt and his team in a 1992 publication in the Journal of the American Medical Association(JAMA). Later EBM was defined by Dr. David Sackett as "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient."
Since its formal introduction, EBM has gradually become the standard for the practice of medicine. As future physicians, we will be practicing in an environment that requires detailed knowledge and regular practice of EBM. However, not all studies meet the threshold for integration into daily clinical practice and require careful evaluation by the reader. Given the rigorous curriculum of medical school and the vast number of studies that are published on a daily basis, it is impossible to critically evaluate each and every study to extract relevant data. Therefore, it is important to identify reliable resources that provide high-quality evidence for various clinical needs. The following list identifies a number of these resources, which at the time of this publication are free to medical students. It must be noted that this is not a comprehensive list of all available resources, and some of the following sites may require registration for free membership prior to use.
Government-Funded Resources:
National Guideline Clearinghouse:
http://www.guideline.gov
Central database for clinical practice guidelines published by
various organizations. Also publishes expert commentaries and
summaries. The guidelines are sorted based on their specific topics
and based on their publishing organization.
U.S. Preventive Services Task Force
(USPSTF):
http://www.uspreventiveservicestaskforce.org/
Evidence-based recommendations of an independent panel of
non-federal experts for preventive services in primary care.
ClinicalTrials.gov:
http://www.clinicaltrials.gov/
Registry and results database of federally and privately supported
clinical trials conducted in the United States and around the
world.
Secondary Journals:
ACP Journal Club:
http://www.annals.org/site/acpjc/
Summarizes the best new evidence for internal medicine from over
130 clinical journals. These include articles related to general
internal medicine and subspecialties of internal medicine.
Additionally, the ACP Journal Club PLUS provides notifications
based on your preferences regarding newly published evidence. Both
services are FREE to ACP Medical Student Members.
Background Information:
Medscape Reference:
http://reference.medscape.com/
Great resource for background information regarding diseases,
conditions, procedures, drugs and anatomy. Available online and on
most mobile devices.
EBM Tutorials:
Centre for Evidence Based Medicine
(Oxford):
http://www.cebm.net/
Provides an online tutorial regarding effective practice of
evidence-based medicine. Also, includes original research as well
as monthly publication of an extensive list of noteworthy articles
from various international journals.
Centre for Evidence-Based Medicine
(Toronto):
http://ktclearinghouse.ca/cebm/
Provides a basic tutorial regarding EBM.
Amirala S. Pasha
Vice Chair, ACP Council of Student Members
University of New England, College of Osteopathic Medicine,
2012
Email: apasha@une.edu
Disclaimer: All information, including but not limited to website addresses, availability and pricing is subject to change without prior notice. This list does not constitute sponsorship by the American College of Physicians (ACP) or the ACP's Council of Student Members.
References:
- Evidence-Based Medicine Working Group. Evidence-based medicine. JAMA. 1992; JAMA. 268 (17), 2420-25.
- Sackett D., Rosenberg W., Gray M., Haynes B., Richardson S. Evidence based medicine: what it is and what it isn't. BMJ.1996; 312 (7023): 71-2.