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More Internet resources for learning about evidence-based practice
OCTOBER 2000, VOL 72, NO 4 RESEARCH CORNER
More Internet resources for learning about evidence-based practice
I
he Internet and the World Wide Web have created many opportunities for clinicians and patients to learn more about evidence-based practice. A recent Internet search on the phrase “evidence-based practice” resulted in more than 10,OOO hits related to this topic. Many of these sites provide users with resources to learn more about the evidencebased process and offer strategies and links to help users find evidence. Continuing with last month’s theme, this column identifies and describes some of the helpful web sites that offer background information, analytical tools, glossaries, and search strategies, as well as articles, tutorials, software, discussion lists, and education related to evidencebased practice. GETTING STARTED One helpful place for clinicians to begin their journey to learn more about evidence-based practice is the Mt Sinai Hospital-University Health Network Centre for EvidenceBased Medicine (EBM) at www.library.utoronto.ca/ medicine/ebm/. This web site’s goal is to develop, disseminate, and evaluate resources that can be used to practice and teach EBM. The intended audience includes individuals involved in undergraduate, graduate, and continuing education programs for health care professionals. Within this site, users will find a number of options to learn more about EBM.
There are resources for practicing or teaching EBM, as well as a complete glossary of EBM terms and links to additional evidence resources. Also available on the site are syllabi for practicing EBM in general surgery, general practice, neonatal medicine, nursing, physiotherapy, critical care medicine, and six other specialty areas. Although this site still is under development, its resources provide extensive background and helpful clinical information. Additional tools available in the EBM “toolbox” include statistical tools, selfevaluation tools, and tips on critical appraisal of the evidence. The National Health Service’s Centre for Evidence-Based Medicine (http://cebm.jr2.ox.ac .uk) was one of the first centers in the United Kingdom to provide resources and support to clinicians practicing and teaching EBM. This site comes complete with an EBM toolbox, teaching activities and materials, and the CATbank, which allows users to create, store, and retrieve critically appraised topics (CATS).The toolbox provides a glossary, a guide for searching for the best evidence, a comparison of study designs, and information about the levels of evidence and grades of recommendation. The teaching materials include a self-contained, seven-session course in practicing EBM for clinicians, scenarios for problems-based learning, and worksheets for critical appraisals of various types of research reports. 708 AORN JOURNAL
Another useful site is the Canadian Centres for Health Evidence (www.cche.net/). According to the web site, the Centres were established to help patients, practitioners, and policy makers “know what to do, do what is known, and understand what is done.”’ Within this site, one can find a users’ guide to evidence-based practice that is based on publications on the same topic previously published in JAMA (www.cche.net/ principles/content-a1l.asp). This online reference provides a stepby-step guide on how to get started using evidence and how to use primary studies and integrative reports. This site also provides worksheets for critiquing research reports as well as resources for educating clinicians about EBM. USING RESOURCES FOR EVIDENCE-BASED SURGERY Resources for evidence-based surgery can be found at www .rcseng.ac.uk/pubiic/infores/ reso-ir.htm, a web site provided and maintained by the Royal College of Surgeons in England. It includes links to medical databases (eg, Medline), comprehensive guides to evidence-based practice, and links to surgery related clinical practice guidelines and systematic reviews. This site offers a variety of links to Internet resources, along with many e-mail discussion groups for surgeons. One helpful resource linked to this page is a listing of the
OCTOBER 2000, VOL 72, NO 4
Table 1 ADDITIONAL INTERNET SITES FOR EVIDENCE-BASED PRACTICE
Internet site
Web address
The Cochrane Collaboration
http://hiru.mcmaster,ca/cochrane
The Joanna Briggs Institute for Evidence Based Nursing and Midwifery
www.joannabriggs.edu.au/links.html
The American College of Physicians (ACP) Journal Club
www.acponline.org/journals/acpjc/jcmenu.htm
National Institute for Clinical Evidence
www.nice,org.uk
Health ServicedTechnology Assessment Text at the National Libraly of Medicine
hitp://text.nlm.nih.gov/
Centers for Disease Control and Prevention
www.cdc.gov
The University of York Centre for Evidence-Based Nursing
www.york.ac.uk/depts/hstd/centres/evidence/ev-intro.htm
Evidence-Based Medicine Tool Kit
www.med.ualberta.ca/ebm/ebm.htm
Evidence-Based Practice Centers
www.ahcpr.gov/clinic/epc
Cochrane Systematic Reviews related to surgery. Organized according to one of 13 surgical specialties, these guidelines provide up-to-date integrated reviews of the pertinent research. The Royal College of Surgeons’ web site also provides links to resources that support evidence-based surgery, as well as links to medical gateways, search engines, educational resources, textbooks online, images, atlases, medical news, and reference materials. For example, the British Journal of Surgery link provides a current list of randomized trials and meta-analyses related to vascular, lower and upper gastrointestinal, and general surgery. Visitors to this site can easily access the Internet Pathology Laboratory for Medical Education (http://www-medlib.med.utah .edu/WebPath/webpath.html)to examine more than 1,900 images, along with text, tutorials, laboratory exercises, and examination items that demonstrate gross and microscopic pathologic findings.
SumSearch, available at http://sumsearch.uthscsa.edu/ searchform45.htm, provides a meta-search service that searches i the Merck Manual, i Medline (ie, for review articles from high quality, general journals that have full text available and for original research), i the National Guideline Clearinghouse, and i Database of Abstract of Reviews of Effectiveness (DARE). According to the web site, SumSearch selects the best resources for each question, formats each question for each resource, and performs additional searches based on the results. Each search can be focused based on treatment, prognosis, diagnosis, etiology, physical findings, adverse treatment reaction, screening/prevention,or age. A search on cholelithiasis revealed more than 1,082 research articles and provided strategies to narrow the search and reduce the number of articles.
NOTE 1. “Canadian Centres for Health Evidence.”
LEARNING ON YOUR INTERNET JOURNEY The intent of this column is to provide a starting point for exploring the Internet, fully acknowledging that by the time this column is published, new web sites related to EBM will be available for exploration and learning. Hopefully, these suggested sites and those listed in Table 1 provide you with a starting point for an Internet journey to learn more about evidence-based practice. Each clinician and patient has a responsibility to learn more about EBM. Start your learning by exploring some of the identified resources discussed in this column and work toward finding additional web-based resources on EBM. Have fun on your journey. SUZANNE C. BEYEA RN, PHD, CS AORN DIRECTOR OF RESEARCH Editor‘s note: Medline is a registered irademark of the National Library of Medicine, Washington, DC; SumSearch is a irademark of the Universiiy of Texas Health Science Center at Son Antonio.
Available from www.cche.net/. Accessed 9 August 2000.
711 AORN JOURNAL
More Internet resources for learning about evidence-based practice
I
he Internet and the World Wide Web have created many opportunities for clinicians and patients to learn more about evidence-based practice. A recent Internet search on the phrase “evidence-based practice” resulted in more than 10,OOO hits related to this topic. Many of these sites provide users with resources to learn more about the evidencebased process and offer strategies and links to help users find evidence. Continuing with last month’s theme, this column identifies and describes some of the helpful web sites that offer background information, analytical tools, glossaries, and search strategies, as well as articles, tutorials, software, discussion lists, and education related to evidencebased practice. GETTING STARTED One helpful place for clinicians to begin their journey to learn more about evidence-based practice is the Mt Sinai Hospital-University Health Network Centre for EvidenceBased Medicine (EBM) at www.library.utoronto.ca/ medicine/ebm/. This web site’s goal is to develop, disseminate, and evaluate resources that can be used to practice and teach EBM. The intended audience includes individuals involved in undergraduate, graduate, and continuing education programs for health care professionals. Within this site, users will find a number of options to learn more about EBM.
There are resources for practicing or teaching EBM, as well as a complete glossary of EBM terms and links to additional evidence resources. Also available on the site are syllabi for practicing EBM in general surgery, general practice, neonatal medicine, nursing, physiotherapy, critical care medicine, and six other specialty areas. Although this site still is under development, its resources provide extensive background and helpful clinical information. Additional tools available in the EBM “toolbox” include statistical tools, selfevaluation tools, and tips on critical appraisal of the evidence. The National Health Service’s Centre for Evidence-Based Medicine (http://cebm.jr2.ox.ac .uk) was one of the first centers in the United Kingdom to provide resources and support to clinicians practicing and teaching EBM. This site comes complete with an EBM toolbox, teaching activities and materials, and the CATbank, which allows users to create, store, and retrieve critically appraised topics (CATS).The toolbox provides a glossary, a guide for searching for the best evidence, a comparison of study designs, and information about the levels of evidence and grades of recommendation. The teaching materials include a self-contained, seven-session course in practicing EBM for clinicians, scenarios for problems-based learning, and worksheets for critical appraisals of various types of research reports. 708 AORN JOURNAL
Another useful site is the Canadian Centres for Health Evidence (www.cche.net/). According to the web site, the Centres were established to help patients, practitioners, and policy makers “know what to do, do what is known, and understand what is done.”’ Within this site, one can find a users’ guide to evidence-based practice that is based on publications on the same topic previously published in JAMA (www.cche.net/ principles/content-a1l.asp). This online reference provides a stepby-step guide on how to get started using evidence and how to use primary studies and integrative reports. This site also provides worksheets for critiquing research reports as well as resources for educating clinicians about EBM. USING RESOURCES FOR EVIDENCE-BASED SURGERY Resources for evidence-based surgery can be found at www .rcseng.ac.uk/pubiic/infores/ reso-ir.htm, a web site provided and maintained by the Royal College of Surgeons in England. It includes links to medical databases (eg, Medline), comprehensive guides to evidence-based practice, and links to surgery related clinical practice guidelines and systematic reviews. This site offers a variety of links to Internet resources, along with many e-mail discussion groups for surgeons. One helpful resource linked to this page is a listing of the
OCTOBER 2000, VOL 72, NO 4
Table 1 ADDITIONAL INTERNET SITES FOR EVIDENCE-BASED PRACTICE
Internet site
Web address
The Cochrane Collaboration
http://hiru.mcmaster,ca/cochrane
The Joanna Briggs Institute for Evidence Based Nursing and Midwifery
www.joannabriggs.edu.au/links.html
The American College of Physicians (ACP) Journal Club
www.acponline.org/journals/acpjc/jcmenu.htm
National Institute for Clinical Evidence
www.nice,org.uk
Health ServicedTechnology Assessment Text at the National Libraly of Medicine
hitp://text.nlm.nih.gov/
Centers for Disease Control and Prevention
www.cdc.gov
The University of York Centre for Evidence-Based Nursing
www.york.ac.uk/depts/hstd/centres/evidence/ev-intro.htm
Evidence-Based Medicine Tool Kit
www.med.ualberta.ca/ebm/ebm.htm
Evidence-Based Practice Centers
www.ahcpr.gov/clinic/epc
Cochrane Systematic Reviews related to surgery. Organized according to one of 13 surgical specialties, these guidelines provide up-to-date integrated reviews of the pertinent research. The Royal College of Surgeons’ web site also provides links to resources that support evidence-based surgery, as well as links to medical gateways, search engines, educational resources, textbooks online, images, atlases, medical news, and reference materials. For example, the British Journal of Surgery link provides a current list of randomized trials and meta-analyses related to vascular, lower and upper gastrointestinal, and general surgery. Visitors to this site can easily access the Internet Pathology Laboratory for Medical Education (http://www-medlib.med.utah .edu/WebPath/webpath.html)to examine more than 1,900 images, along with text, tutorials, laboratory exercises, and examination items that demonstrate gross and microscopic pathologic findings.
SumSearch, available at http://sumsearch.uthscsa.edu/ searchform45.htm, provides a meta-search service that searches i the Merck Manual, i Medline (ie, for review articles from high quality, general journals that have full text available and for original research), i the National Guideline Clearinghouse, and i Database of Abstract of Reviews of Effectiveness (DARE). According to the web site, SumSearch selects the best resources for each question, formats each question for each resource, and performs additional searches based on the results. Each search can be focused based on treatment, prognosis, diagnosis, etiology, physical findings, adverse treatment reaction, screening/prevention,or age. A search on cholelithiasis revealed more than 1,082 research articles and provided strategies to narrow the search and reduce the number of articles.
NOTE 1. “Canadian Centres for Health Evidence.”
LEARNING ON YOUR INTERNET JOURNEY The intent of this column is to provide a starting point for exploring the Internet, fully acknowledging that by the time this column is published, new web sites related to EBM will be available for exploration and learning. Hopefully, these suggested sites and those listed in Table 1 provide you with a starting point for an Internet journey to learn more about evidence-based practice. Each clinician and patient has a responsibility to learn more about EBM. Start your learning by exploring some of the identified resources discussed in this column and work toward finding additional web-based resources on EBM. Have fun on your journey. SUZANNE C. BEYEA RN, PHD, CS AORN DIRECTOR OF RESEARCH Editor‘s note: Medline is a registered irademark of the National Library of Medicine, Washington, DC; SumSearch is a irademark of the Universiiy of Texas Health Science Center at Son Antonio.
Available from www.cche.net/. Accessed 9 August 2000.
711 AORN JOURNAL