Medical Education & Technologies Informationist
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Incoming Medical Students-On the Wards
Anatomy, H&P
- Physical Exams (Multimedia): Neurology, Ophthalmology, Orthopedics
- Patient Interview (Multimedia): Interview techniques
Bates' Visual Guide to Physical Examination
Evidence Based Medicine
Evidence Based Medicine is defined in different ways, depending on the discipline. While the core of the message remains the same, one of the best known definitions of evidence based medicine is by Dr. David Sackett, considered by many to be one of the "fathers of ebm." Dr. Sackett wrote in a 1996 BMJ article: "Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research."[1]
Dr. Sackett also stated in the same article what EBM was not. He stated: "Evidence based medicine is not 'cookbook' medicine. Because it requires a bottom up approach that integrates the best external evidence with individual clinical expertise and patients' choice, it cannot result in slavish, cookbook approaches to individual patient care..."[1]
So instead of relying on anecdotal experiences to treat patients, evidence from studies is used to treat patients. You can read his article here.
1. Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ. 1996;312(7023):71-72. doi:10.1136/bmj.312.7023.71
There are a number of presentations related to levels of evidence. Below are some illustrative models. The key point is that the more something is reviewed and analyzed, the higher the level of evidence.
Citation: Chapter 5 Finding Current Best Evidence, Guyatt G, Rennie D, Meade MO, Cook DJ. Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed; 2015. Available at: http://jamaevidence.mhmedical.com.proxy.library.emory.edu/content.aspx?bookid=847§ionid=69031461#1131780031 Accessed: July 31, 2020 Copyright © 2020 American Medical Association. All rights reserved
Another representation of levels of evidence is called the Pyramid of Evidence: this pyramid illustrates that the amount of review, the higher the level of evidence.
EBM Pyramid and EBM Page Generator, copyright 2006 Trustees of Dartmouth College and Yale University. All Rights Reserved.
Produced by Jan Glover, David Izzo, Karen Odato and Lei Wang.
DynaMed is a point of care (poc) tool that provides synthesized published evidence related to patient care. Search by condition or topic and navigate to the section you need. For instance, if you were interested in the incidence and prevalence of resistant hypertension, search resistant hypertension and go to that section:
The video provides an overview of DynaMed.
This video provides an overview of the DynaMed app.
Produced by McGraw-Hill and the JAMA Network, this resource helps define what evidence based medicine is and how to apply it to patient care. It includes:
- Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice
- The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
- JAMA Guide to Statistics and Methods
- Care at the Close of Life: Evidence and Experience
- Education Guides
- Calculators
- Glossary (study types, ebm concepts, etc.)
- Learning Tools (Critical Appraisal Worksheets, Information Cycle Worksheets)
- Audio: "A monthly series of discussions of core issues in evidence-based medicine by leading practitioners in the field."
The video below provides an overview of some of the key features in JAMAevidence
Review Questions
There are review questions within our eBook collections that you can use to review for exams and Step 1.