Evidence Based Medicine (Journal)
The purpose of Evidence-Based Medicine is to alert clinicians to important advances in internal medicine, general and family practice, surgery, psychiatry, paediatrics, and obstetrics and gynaecology by selecting from the biomedical literature those original and review articles whose resulsts are most likely to be both true and useful. These articles are summzarised in value-added abstracts and commented on by clinical esperts. The author of the original is given an opportunity to review the abstract and commentary before publication.
The procedures we follow as we attempt to achieve this purpose are:
The BMJ Publishing Group publish Evidence-Based Medicine bimonthly, under the editorship of Professor R Brian Haynes at McMaster University and Professor Paul Glasziou at the University of Oxford.
Acta Obstet Gynecol Scand |
Arch Pediatr Adolesc Med |
Gut |
J Vas Surg Lancet Med Care Med J Aust N Engl J Med Neurology Obstet Gynecol Pain Pediatrics Rheumatology Spine Stroke Surgery Thorax |
* Approximately 60 additional journals are reviewed. This list is available upon request at ebmed@mcmaster.ca |
All English-language original and review articles in an issue of a candidate journal are consdiered for abstracting if they concern topics improtant to the clinical practice of internal medicine, general and family practice, surgery, psychiatry, paediatrics, or obstetrics and gynaecology. Access to foreign-language journals is provided through the systematic reviews we abstract, especially those in the Cochrane Library, which summarises articles taken from over 800 journals in several languages.
Prevention or treatment; quality improvementPrognosis
• An inception cohort of persons, all initially free of the outcome of
interest
• Follow-up of ³ 80% of patients
until the occurrence of either a major study end point or the end of the study.
Causation
• Observations concerning the relation between exposures and putative clinical
outcome
• Prospective data collection with clearly identified comparison group(s)
for those at risk for the outcome of interest (in descending order of preference
from randomised controlled trials, quasi-randomised controlled trials, nonrandomised
controlled trials, cohort studies with case by case matching or statistical
adjustment to create comparable groups, to nested case control studies)
• Masking of observers of outcomes to exposures (this criterion is assumed
to be met if the outcome is objective).
Economics of health care programmes or intervention
• The economic question must compare alternative courses of action
in real or hypothetical patients
• The alternative diagnostic or therapeutic services or quality improvement
strategies must be compared on the basis of both the outcomes they produce (effectiveness)
and the resources they consume (costs)
• Evidence of effectiveness must come from a study (or studies) that meets
criteria for diagnosis, treatment, quality assurance, or review articles
• Results should be presented in terms of the incremental or additional
costs and outcomes incurred and a sensitivity analysis should be done.
Clinical prediction guides
• The guide must be generated in 1 set of patients (training set) and validated
in an independent set of real not hypothetical patients (test set), and must
pertain to treatment, diagnosis, prognosis, or causation.
Differential diagnosis
• A cohort of patients who present with a similar, initially undiagnosed
but reproducibly defined clinical problem
• Clinical setting is explicitly described
• Ascertainment of diagnosis for 80% of patients using a reproducible diagnostic
workup strategy and follow up until patients are diagnosed or follow up of 1
month for acute disorders or• ³1
year for chronic or relapsing disorders.
Systematic reviews
• The clinical topic being reviewed must be clearly stated; there must
be a description of how the evidence on this topic was tracked down, from what
sources, and with what inclusion and exclusion criteria
• ³1 article included in the review
must meet the above-noted criteria for treatment, diagnosis, prognosis, causation,
quality improvement, or the economics of health care programmes.
Evidence-Based Medicine has a related journal, ACP Journal Club. It is generated using procedures identical to those used for Evidence-Based Medicine and is published by the American College of Physicians. Approximately one third of the abstracts in ACP Journal Club are published in Evidence-Based Medicine, and the abstracts not published are listed, by their declarative titles, in the section titled Additional Articles Abstracted in ACP Journal Club.