Evidenced-based medicine (EBM) is a process of developing skills and knowledge for better patient management and to ensure that the information used to handle the patient clinically is based on sound findings and research studies. The process of EBM includes clinical problems, development of the clinical question, selection of the appropriate resources, use of the evidence in clinical practice, application of the evidence-based knowledge and evaluating the performance. The issues of LOE and SOR especially develop when assessing the validity of the information.
LOE is usually utilized for one study, whereas SOR is utilized for many studies. The highest level of evidence is Systematic reviews (meta-analysis), cohort studies, case-control studies, case-series, and expert opinions. The various SOR’s include A, B, C, & X, based on the strength of the medical research conducted to support the recommendations. X would suggest potential or direct harm from the intervention. Besides Cochrane, CEBM and DynaMED, there are several other EBM databases which can effectively be utilized as tools for obtaining evidenced-based information.
These include Clinical Evidence, DARE, ACP, National Guidelines Clearinghouse, US Preventive Services Task Force and InfoPoems. ACP contains more than 100 journals on internal medicine that have been examined carefully throughout the world. To encourage review from others, structured abstracts containing valid information are available on the database. THE ACP Journal provides summaries of helath information. DARE or ‘Database of Abstracts of Reviews of Effects is service provided by the NHS UK that includes information on Abstracts, Cochrane Reviews, Health News, EPSS, etc.
InfoPOEMS is information that exists for the sake of providing evidenced-based care for the patient. It includes several journals of family medicine and various specialties. The database gives huge concerns for the patient issues such as morbidity rates, mortality rates, patient satisfaction levels, etc. The National Guidelines Clearinghouse has provided evidenced-based practice guidelines to be utilized in various clinical situations. These guidelines are not only based on evidenced-based literature, but also on expert consensus.
This would ensure greater amount of importance to answering the practical problems when using EBM. To help physicians and other healthcare providers on the move or at the bedside of the patient, a new tool known as EPSS (Electronic Performance Support Systems) is provided. The physician can it use on a PDA or on a computer having internet. Along with information of the disease, the physician has to include gender and age of the patient to obtain various levels of recommendation (Durme, 2008).