LibGuides: Evidence-Based Clinical Practice: Acquiring evidence using databases

Evidence pyramid

Levels of Evidence

Categories of evidence are conceptualized as a hierarchy, with the top levels considered the best evidence for clinical decision-making. These higher levels are considered secondary literature, which synthesizes, filters, and evaluates the primary (lower level) literature. The hierarchy can include:

Systematic Reviews: A review of all research available on a given topic, conducted with strict methods of locating and synthesizing the research.
Systematic Reviews with Meta-Analyses: Reviews that pool and summarize the data from each study included in the review.
Critically-Appraised Topics: A critical appraisal of clinically relevant studies.
Critically-Appraised Individual Articles: Articles that are selected and rated for clinical relevance by physicians.
Randomized Controlled Trials: A study wherein the subjects are divided into two groups: one that received the genuine treatment, and one that receives a placebo treatment.
Cohort Studies: A study that compares outcomes between two groups studied over a period of time.
Case-Controlled Studies: A study that compares groups with differing outcomes with respect to their exposure to a suspected causal attribute.
Case Series: A study that measures the outcome of a group of patients who receive the same treatment, with no control group.
Case Reports: Reports on the treatment and outcome of a single patient.

Database tutorials

Using PubMed in Evidence-Based Practice Training Course
When conducting research, evidence-based practice is a method for framing clinical questions that will help yield optimal search results. PubMed.gov is a free research tool from the National Library of Medicine®. This course will show you how to use evidence-based practice when searching clinical questions using PubMed®.

Sources of filtered information

Filtered sources are secondary sources that have been appraised by experts and summarize and synthesize the available evidence.

CINAHL Complete (EBSCOhost)
Full-text nursing and allied health journals. There are currently 33 chiropractic journals available within CINAHL Complete.
Cochrane Library
A collection containing different types of evidence-based medicine databases. Includes Cochrane Database of Systematic Reviews, Cochrane Clinical Answers, Cochrane Central Register of Controlled Trials, and Cochrane Clinical Answers.
Dynamed
Clinical reference tool primarily intended for point-of-care use. Contains clinically organized summaries for more than 3,200 conditions, pharmaceuticals, and related topics.

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
Medscape Drugs & Diseases
Medscape is a point of care tool from WebMD. Find comprehensive medical reference information including disease symptoms, diagnoses, treatments, and follow-up. Free with account.

NatMed Pro
Authoritative resource on food, herbs & supplements, natural medicines, sports medicine and complementary, alternative and integrative therapies.

PubMed Clinical Queries
This tool uses predefined filters to help you quickly refine PubMed searches on clinical or disease-specific topics

PEDro: Physiotherapy Evidence Database
Includes randomized trials, systematic reviews and clinical practice guidelines in physiotherapy.
Rehabilitation Reference Center
A clinical tool designed for use by rehabilitation clinicians, physical therapists, and occupational therapists at the point of care.

StatPearls
More than 8,000 authors and editors have published nearly 10,000 peer-reviewed PubMed-indexed articles on virtually every clinical topic in healthcare.

Trip Medical Database
A smart, fast tool to find high quality clinical research evidence. Content types include images, videos, patient information leaflets, educational courses and news.

Sources of unfiltered information

Unfiltered sources are primary sources that describe original research.

ClinicalTrials.gov
Clinical Trials.gov has been developed by the U.S. National Institutes of Health to provide patients, family members and members of the public current information about clinical research studies.
ICL: Index to Chiropractic Literature
Covers 1985-present chiropractic journal literature. It includes several web pages linking free chiropractic research articles, electronic books and patient education handouts. Links to other important chiropractic web sites are also included.
MEDLINE Complete (EBSCOost)
Provides authoritative medical information on all health sciences, including chiropractic, nursing, dentistry, veterinary medicine, the health care system, pre-clinical sciences, and much more.
SPORTDiscus (EBSCOhost)
Providing hundreds of full-text sports medicine journals, it is an essential tool for health professionals and researchers studying fitness, health and sports.