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Michigan State University

Evidence Based Medicine Guide

Information about and resources for evidence based medicine

EBM is...

"the integration of best research evidence with clinical expertise and patient values." (Sackett, David L., et al., Evidence-based medicine: how to practice and teach EBM. New York: Churchill Livingstone, 2000. p. 1)

Things to remember

1) Processing information into high levels of evidence takes time, and there is no guarantee that evidence exists at all levels for a specific clinical question.

2) Start with the highest level of evidence available.  High-level resources build upon resources found in the lower levels of the pyramid to provide concise and up to date information.

3) Preappraised resources have a strict filtering process to insure that only high-quality information is included.  Good resources will make their filtering processes readily available to users.

Search for Evidence

This guide includes links to several high quality resources to search for evidence. These are often stand-alone products that search a range of literature but do not encompass all the levels of the evidence-based medicine resource ecosystem.

One way to search for many different types of resources at once (systematic reviews, primary literature, guidelines, etc..) is to use a federated search engine. The MSU Libraries has basic access to Turning Research Into Practice (TRIP) one of the best examples of an EBM federated search engine.

6S model pyramid

Levels of Evidence

  • Systems - Computerized decision support systems integrate and summarize all the available relevant research evidence, updates as new evidence becomes available, and automatically links relevant information to a patient's electronic medical record.  
  • Summaries - Includes clinical pathways or textbook summaries.  Summaries integrate evidence for specific clinical problems and regularly update as new evidence becomes available.
  • Synopses of Syntheses - Comprehensive summaries of all the research related to focused clinical questions.
  • Syntheses - Systematic reviews.
  • Synopses of Studies - Highly detailed summaries of original high-quality single studies.  Found in the evidence-based abstraction journals and are accompanied by commentaries that address the clinical applicability of a study's findings.
  • Studies - Original single studies.  Can be preappraised or nonappraised. 

Librarians - Medicine