Physician Associate Studies: EBP: Searching for the Evidence

ACCESSSS Federated Search

Developed by McMaster University, ACCESSSS is an open access EBM search engine. Reviews over 120 journals; searchable database; provides ratings for each article; can set up email alerts; full-text is available through Pacific’s library only. Access notes: Free account is required.

DARE (Database of Abstracts of Reviews of Effects)

Is produced by the NHS (National Health Service) Centre for Reviews and Dissemination (CRD) from the United Kingdom. It provides reviews of selected systematic reviews and includes discussion of the interventions and outcomes studied; the conclusions drawn; strengths and weaknesses of the review; and implications for practice.

PubMed Clinical Queries

Pre-set search filters to focus your search in 3 areas. (1) Clinical Study Categories: Select a Category (Etiology, Diagnosis, Therapy, Prognosis, or Clinical prediction guide) and a Scope (Broad or Narrow) to filter your search results. These options are available after you enter your search. (2) Systematic Reviews: Filters the search to include systematic reviews, meta-analyses, reviews of clinical trials, evidence-based medicine, consensus development conferences, and guidelines on your topic. (3) Medical Genetics: Filters a disease search for articles about genetic diagnosis, clinical description, management, counseling, molecular genetics, and genetic testing.

TRIP - Turning Research into Practice (free site) This link opens in a new window

• Is made to quickly provide evidence for clinical decision making
• Pulls information from Cochrane, National Guideline Clearinghouse, and Medline
• Allows you to search evidence based resources together, and very quickly.
• Includes a PICO search tool to help you in quickly searching the literature.
• Trip has been online since 1997
• Also searches across other content types including images, videos, patient information leaflets, educational courses and news.

Studies can be descriptive (or observational), such as:

• Case Reports [MeSH Publication Type] - "Clinical presentations that may be followed by evaluative studies that eventually lead to a diagnosis."
• Case Series - Descriptions of groups of patients with a disease.
• Case-Control Studies [MeSH Term] - "Comparisons that start with the identification of persons with the disease or outcome of interest and a control (comparison, referent) group without the disease or outcome of interest. The relationship of an attribute is examined by comparing both groups with regard to the frequency or levels of outcome over time."
• Cohort Studies [MeSH Term] - "Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics."

Or evaluative (interventional), such as a:

• Clinical Trial [MeSH Publication Type] - "A work that reports on the results of a clinical study in which participants are assigned to receive one or more interventions so that researchers can evaluate the interventions on biomedical or health-related outcomes. The assignments are determined by the study protocol. Participants may receive diagnostic, therapeutic, or other types of interventions."
• Controlled Clinical Trial [MeSH Publication Type] - "A work that reports on a clinical trial involving one or more test treatments, at least one control treatment, specified outcome measures for evaluating the studied intervention, and a bias-free method for assigning patients to the test treatment. The treatment may be drugs, devices, or procedures studied for diagnostic, therapeutic, or prophylactic effectiveness. Control measures include placebos, active medicine, no-treatment, dosage forms and regimens, historical comparisons, etc. When randomization using mathematical techniques, such as the use of a random numbers table, is employed to assign patients to test or control treatments, the trial is characterized as a RANDOMIZED CONTROLLED TRIAL."
• Randomized Controlled Trial [MeSH Publication Type] - "A work that reports on a clinical trial that involves at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table."

Studies can also be time-based:

• Follow-up Studies [MeSH Term] - "Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease."
• Longitudinal Studies [MeSH Term] - "Studies in which variables relating to an individual or group of individuals are assessed over a period of time."

• Free Ones
  • Medscape (must register)
  • BMJ Best Practice

Search a database or Google your topic AND ("clinical care guidelines" OR "clinical guidelines")

Check organizations websites. For example, here is the American Family Physician's Clinical Guidelines & Recommendation

MedlinePlus from NLM