Evidence is everywhere
The term “evidence-based medicine” first appeared in the medical literature in the early 1990s. Today the concept is almost ubiquitous in clinical practice, with its attendant high expectation of improvement in outcome.
To paraphrase David Sackett, evidence-based medicine is the combination of judicious use of current best evidence, clinical expertise, and patient preferences in clinical decision making. But determining what evidence is best evidence can be a complicated undertaking. Barriers to the adoption of these principles can be daunting, and include the time it takes to search out the “best,” wading through irrelevant retrieval, lack of easy access to resources, and cost.
The College helps busy clinicians overcome these obstacles by maintaining access to high-quality EBM resources through its website. Point-of-care tools such as ACP PIER and BMJ Point of Care are easily accessible through the Library’s section of www.cpsbc.ca. These tools provide evidence-based recommendations for diagnosis and treatment and are specially designed to provide quick and authoritative answers. A search of Ovid Medline under “Search Medline, etc” gives the user access to a number of full-text EBM resources, including the Cochrane Collection. Filters known as “clinical queries” in Medline, along with the subject subset “systematic reviews,” helps narrow down a broad search to those articles that provide the “best” evidence.
To reduce the hurdles of access further, the Library also subscribes to over 2000 electronic journals, with free access for College registrants. If time is of concern, the Library offers accredited courses in evidence-based medicine searching to help clinicians develop expertise in search techniques and filtering evidence. And if time for learning is also short, the College librarians are available to provide evidence-based bibliographies on request.
—Karen MacDonell
—Robert Melrose
—Judy Neill
Library Co-Managers
This article is the opinion of the Library of the College of Physicians and Surgeons of BC and has not been peer reviewed by the BCMJ Editorial Board.