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Evidence Based Medicine (EBM) Resources

Connect with CMS

This page is a resource for use by faculty:
  • To understand the purpose and definition of EBM
  • To learn how to design EBM experiences or questions 
  • To provide some resources that can help in EBM assessment

What is EBM?

Definition of EBM

“Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.” (Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ. 1996;312(7023):71-2.)

EBM Training Modules

, a free online resource, offers an introduction to health evidence and how to use it to make informed health choices. Modules include:
  • Module 1: Evidence-based medicine
  • Module 2: Randomized controlled trials
  • Module 3: Introduction to systematic reviews
  • Module 4: Understanding and using systematic reviews

Glossary of EBM Terms

Components of EBM

Podcast

Recommended Reading

Publications with further discussion of EBM:

  • Albarqouni L, Hoffmann T, Straus S, Olsen NR, Young T, Ilic D, Shaneyfelt T, Haynes RB, Guyatt G, Glasziou P. . JAMA Netw Open. 2018 Jun 1;1(2):e180281. doi: 10.1001/jamanetworkopen.2018.0281. PMID: 30646073.
  • Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. . BMJ. 1996 Jan 13;312(7023):71-2. doi: 10.1136/bmj.312.7023.71. PMID: 8555924; PMCID: PMC2349778.
  • Dowie J. . BMJ. 1996 Jul 20;313(7050):170; author reply 170-1. doi: 10.1136/bmj.313.7050.170a. PMID: 8688793; PMCID: PMC2351544.
  • Maynard A. . BMJ. 1996 Jul 20;313(7050):170-1. doi: 10.1136/bmj.313.7050.170b. PMID: 8688794; PMCID: PMC2351563.
  • Melnyk BM, Fineout-Overholt E, Stillwell SB, Williamson KM. . Am J Nurs. 2009 Nov;109(11):49-52. doi: 10.1097/01.NAJ.0000363354.53883.58. PMID: 19858857.

Key Elements of EBM Skills

The following are skills needed to practice evidence-based medicine. For each skill, websites, publications, and other resources will be provided.

Asking the Question

Websites

Publications

  • Kendall S, Ryu M, Walsh C. . Can Fam Physician. 2017 Jun;63(6):490-492. PMID: 28615402; PMCID: PMC5471090.
  • Richardson WS, Wilson MC, Nishikawa J, Hayward RS. . ACP J Club. 1995 Nov-Dec;123(3):A12-3. PMID: 7582737.
  • Geddes, J. (1999). . Evidence Based Mental Health, 2, 35-36 doi: http://dx.doi.org/10.1136/ebmh.2.2.35

The Search

Websites

Publications

  • Vogel EW, Block KR, Wallingford KT. . J Med Libr Assoc. 2002 Jul;90(3):327-30. PMID: 12113519; PMCID: PMC116407.
  • Bramer WM, de Jonge GB, Rethlefsen ML, Mast F, Kleijnen J. . J Med Libr Assoc. 2018 Oct;106(4):531-541. doi: 10.5195/jmla.2018.283. Epub 2018 Oct 1. PMID: 30271302; PMCID: PMC6148622.
  • Vandenbroucke JP, Pearce N. . Clin Epidemiol. 2018 Mar 6;10:253-264. doi: 10.2147/CLEP.S142940. PMID: 29563838; PMCID: PMC5846748.
  • Borges Migliavaca C, Stein C, Colpani V, Barker TH, Munn Z, Falavigna M; Prevalence Estimates Reviews – Systematic Review Methodology Group (PERSyst). . BMC Med Res Methodol. 2020 Apr 26;20(1):96. doi: 10.1186/s12874-020-00975-3. PMID: 32336279; PMCID: PMC7184711.
  • Swanberg SM, Dennison CC, Farrell A, Machel V, Marton C, O'Brien KK, Pannabecker V, Thuna M, Holyoke AN. . J Med Libr Assoc. 2016 Jul;104(3):197-208. doi: 10.3163/1536-5050.104.3.004. PMID: 27366120; PMCID: PMC4915637.
  • Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. . Int J Evid Based Healthc. 2015 Sep;13(3):147-53. doi: 10.1097/XEB.0000000000000054. PMID: 26317388.

Levels of Evidence

Websites

Publications

  • Jeremy Howick, Iain Chalmers, Paul Glasziou, Trish Greenhalgh, Carl Heneghan, Alessandro Liberati, Ivan Moschetti, Bob Phillips, and Hazel Thornton. “”. Oxford Centre for Evidence-Based Medicine.
  • Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008 Apr 26;336(7650):924-6
  • Jonas WB, Crawford C, Hilton L, Elfenbaum P. . J Altern Complement Med. 2017 Jan;23(1):18-25. doi: 10.1089/acm.2016.0291. Epub 2016 Dec 27. PMID: 28026968; PMCID: PMC5248545.

Understanding Summary Statistics in Clinical Studies

Websites

Critical Appraisal & Harm-Benefit (concept and in numbers)

Useful Resources

  • Tips for learning and teaching evidence-based medicine:
  • Tips for teachers of evidence-based medicine: Relative risk reduction, absolute risk reduction and number needed to treat
  • Tips for learners of evidence-based medicine: 2. Measures of precision (confidence intervals)
  • Critical appraisal checklists:
  • Weighing up risks and benefits:

Publications

  • Montori VM, Jaeschke R, Schünemann HJ, Bhandari M, Brozek JL, Devereaux PJ, Guyatt GH. . BMJ. 2004 Nov 6;329(7474):1093-6. doi: 10.1136/bmj.329.7474.1093. PMID: 15528623; PMCID: PMC526126.
  • Boutron I, Ravaud P. . Proc Natl Acad Sci U S A. 2018 Mar 13;115(11):2613-2619. doi: 10.1073/pnas.1710755115. PMID: 29531025; PMCID: PMC5856510.
  • Horsley T, Hyde C, Santesso N, Parkes J, Milne R, Stewart R. . Cochrane Database Syst Rev. 2011 Nov 9;2011(11):CD001270. doi: 10.1002/14651858.CD001270.pub2. PMID: 22071800; PMCID: PMC7389530.
  • McGee S. . J Gen Intern Med. 2002 Aug;17(8):646-9. doi: 10.1046/j.1525-1497.2002.10750.x. PMID: 12213147; PMCID: PMC1495095.
  • Greenhalgh T, Kostopoulou O, Harries C. . BMJ. 2004 Jul 3;329(7456):47-50. doi: 10.1136/bmj.329.7456.47. PMID: 15231628; PMCID: PMC443458.
  • Aronson Jeff, . BMJ 2016; 352 :i537

Online Calculators

Short Articles that Explain Clinical Stat Concepts

Applying the Evidence

Websites

Publications

  • McAlister FA, Straus SE, Guyatt GH, Haynes RB. . Evidence-Based Medicine Working Group. JAMA. 2000 Jun 7;283(21):2829-36. doi: 10.1001/jama.283.21.2829. PMID: 10838653.
  • McGinn TG, Guyatt GH, Wyer PC, Naylor CD, Stiell IG, Richardson WS. . Evidence-Based Medicine Working Group. JAMA. 2000 Jul 5;284(1):79-84. doi: 10.1001/jama.284.1.79. PMID: 10872017.

Evaluation

How to Build Brief EBM Exercises for the Classroom or Small Groups

Online Resources

External Examples of EBM Work-Throughs

  • :
    Guyatt GH, Haynes RB, Jaeschke RZ, Cook DJ, Green L, Naylor CD, Wilson MC, Richardson WS. Users' Guides to the Medical Literature: XXV. Evidence-based medicine: principles for applying the Users' Guides to patient care. Evidence-Based Medicine Working Group. JAMA. 2000 Sep 13;284(10):1290-6. doi: 10.1001/jama.284.10.1290. PMID: 10979117.

Publications with Cases, Exercises or Multiple Choice Questions

  • Al Achkar M, Davies MK. . Adv Med Educ Pract. 2016 Oct 25;7:611-615. doi: 10.2147/AMEP.S117672. PMID: 27822132; PMCID: PMC5087589.
  • Patell R, Raska P, Lee N, Luciano G, DiNardo DJ, Baduashvili A, Anderson ML, Merritt F, Rothberg MB. . J Gen Intern Med. 2020 May;35(5):1530-1536. doi: 10.1007/s11606-019-05595-2. Epub 2019 Dec 17. PMID: 31848856; PMCID: PMC7210361.
  • Leung WC. . Postgrad Med J. 2000 Sep;76(899):594-5. doi: 10.1136/pmj.76.899.594. PMID: 10964140; PMCID: PMC1741721.
  • Hift RJ. BMC Med Educ. 2014 Nov 28;14:249. doi: 10.1186/s12909-014-0249-2. PMID: 25431359; PMCID: PMC4275935.

General Discussion about Available Tools to Assess EBM Skill (with some examples):

  • Ilic D, Nordin RB, Glasziou P, Tilson JK, Villanueva E. . BMC Med Educ. 2014 Jun 9;14:114. doi: 10.1186/1472-6920-14-114. PMID: 24909434; PMCID: PMC4062508.
  • Ilic D. . BMC Med Educ. 2009 Aug 6;9:53. doi: 10.1186/1472-6920-9-53. PMID: 19656412; PMCID: PMC2728711.
  • Shaneyfelt T, Baum KD, Bell D, Feldstein D, Houston TK, Kaatz S, Whelan C, Green M. . JAMA. 2006 Sep 6;296(9):1116-27. doi: 10.1001/jama.296.9.1116. PMID: 16954491.
  • Albarqouni L, Hoffmann T, Glasziou P. . BMC Med Educ. 2018 Aug 1;18(1):177. doi: 10.1186/s12909-018-1284-1. PMID: 30068343; PMCID: PMC6090869.
  • Kumaravel B, Jenkins H, Chepkin S, Kirisnathas S, Hearn J, Stocker CJ, Petersen S. . BMC Med Educ. 2020 Aug 24;20(1):278. doi: 10.1186/s12909-020-02140-2. PMID: 32838775; PMCID: PMC7445898.
  • Bird JB, Olvet DM, Willey JM, Brenner J. . Med Educ Online. 2019 Dec;24(1):1649959. doi: 10.1080/10872981.2019.1649959. PMID: 31438809; PMCID: PMC6720218.
  • Ramos KD, Schafer S, Tracz SM. . BMJ. 2003 Feb 8;326(7384):319-21. doi: 10.1136/bmj.326.7384.319. PMID: 12574047; PMCID: PMC143529.

Models and Benefit of Longitudinal Integration of EBM into Curriculum

  • Kumaravel B, Jenkins H, Chepkin S, Kirisnathas S, Hearn J, Stocker CJ, Petersen S. . BMC Med Educ. 2020 Aug 24;20(1):278. doi: 10.1186/s12909-020-02140-2. PMID: 32838775; PMCID: PMC7445898.
  • West CP, Jaeger TM, McDonald FS. . J Gen Intern Med. 2011 Jun;26(6):611-5. doi: 10.1007/s11606-011-1642-8. PMID: 21286836; PMCID: PMC3101983.
  • Young T, Rohwer A, Volmink J, Clarke M. . PLoS One. 2014 Jan 28;9(1):e86706. doi: 10.1371/journal.pone.0086706. PMID: 24489771; PMCID: PMC3904944.
  • Menard L, Blevins AE, Trujillo DJ, Lazarus KH. . BMJ Evid Based Med. 2020 Oct 22:bmjebm-2020-111391. doi: 10.1136/bmjebm-2020-111391. Epub ahead of print. PMID: 33093190.
  • Martin BA, Kraus CK, Kim SY. . Am J Pharm Educ. 2012 Dec 12;76(10):197. doi: 10.5688/ajpe7610197. PMID: 23275662; PMCID: PMC3530059.
  • Lupi C, Lefevre F, Ward-Peterson M, 2017, '', MedEdPublish, 6, [4], 52.

Additional Resources

    • Xia AD, Schaefer CP, Szende A, Jahn E, Hirst MJ. . Drugs Real World Outcomes. 2019 Dec;6(4):193-203. doi: 10.1007/s40801-019-00167-6. PMID: 31741199; PMCID: PMC6879703.Real-World Evidence (RWE) Tools
  • E-book: Evidence-Based Medicine: How to Practice and Teach EBM
    Straus, Sharon E. author.; Glasziou, Paul, 1954- author.; Richardson, W. Scott (Warren Scott), author.; Haynes, R. Brian, author.; Pattani, Reena, contributor.; Veroniki, Areti Angeliki, contributor. Edinburgh : Elsevier, 2019