Evidence-Based Medicine (EBM) Resources

The resources and tools below can help with the learning, teaching and application of evdience based practice. Materials and worksheets are to be used with proper attribution to their creators.

On this page

What is Evidence-Based Practice?

Asking the Clinical Question

Acquiring the Evidence (Searching EBM LIterature)

"Filtered Information" - EBM Information Sources

"Unfiltered Information" - Primary Research Studies Databases and Background

Meta-Search Engine (TRIP)

Appraising the Evidence

Other Useful EBM Resources

1. What is Evidence - Based Practice?

Evidence Based Medicine (EBM),Evidence-based practice (EBP) and evidence-based health care (EBHC) refer to similar processes of (patient centered) inquiries seeking to increase effectiveness and efficiency in health care based on answers from unbiased scientifc literature. EBM is defined as “theintegration of best research evidence with clinical expertise and patientvalues.” -- Sackett, D. L. (1997).

Evidence-Based Practice: a five-step process

  1. ASK: Converting information needs into focused questions.
  2. ACQUIRE: Efficiently tracking down the best evidence with which to answer the question.
  3. APPRAISE: Critically appraising the evidence for validity and clinical usefulness.
  4. APPLY: Applying the results in clinical practice
  5. ASSESS AND ADJUST: Evaluating performance of the evidence in clinical application.

Read more:

 What is EBM? Centre for Evidence-based Medicine (CEBM) at the University of Oxford.

JAMA's  Users' Guides to the Medical Literature : A Manual for Evidence-Based Clinical Practice (2nd Edition)

Top / Haut

2. Asking the Clinical Question

Clinical questions should be directly relevant to the problem at hand, focused, and phrased to facilitate searching for a precise answer

PICO offers a structure for formulating clinical questions.

P= Patient, population, or problem

I = Intervention, prognostic factor or exposure

C = Comparison (baseline or placebo)

O = Outcomes to measure or be achieved

 Template for Formulating the Question - PICO (pdf) - Dartmouth Biomedical Library

 Understanding Research Study Designs - University of Minnesota Libraries

 Types of Questions and Types of Research Study Designs (pdf) – Yale and Dartmouth

 Best evidence by type of Question (pdf) - McGill University Library

 Levels of Evidence (2011) - Oxford Centre for Evidence-Based Medicine

 Levels of Evidence - Is All Evidence Created Equal? - University of Illinois at Chicago Library

Top / Haut

3. Acquiring the evidence (Searching the EBM Literature)

Hierarchy of evidence: the EBM evidence pyramid

(Source: http://hlwiki.slais.ubc.ca/index.php/File:EBMpyramid.gif#filehistory )

 EBM Pyramid handout (levels of evidence/study type/Resources) (pdf) - Dartmouth EBM Institute

 EBM Resources Summary Psychiatry 2013 (doc) - JGH and McGill Libraries

 Bryan Haynes 6S model (pdf) - (McGill University Library adaptation)

Systems, Summaries, Synopsis of synthesis, Synthesis, Synopsis of studies, Studies

Top / Haut

3a. "Filtered Information"

Synthesis of Information: Systematic Reviews/Meta-Analysis

 Cochrane Library

An electronic library of independent, high quality evidence for healthcare decision making. It includes seven databases, most importantly the Cochrane Database of Systematic Reviews (CDSR) which contains over 7000 reviews of which more than 400 are on topics in Mental Health.

 The Database of Abstracts of Reviews of Effectiveness (DARE)

Contains over 18,000 structured abstracts of systematic reviews from a variety of journals.

Summaries: Critically Appraised Topics

 Clinical Evidence (BMJ Group)

"A frequently updated compendium of evidence on the effects of common clinical interventions based on thorough searches of the literature. It provides a concise account of the current state of knowledge, ignorance, and uncertainty." Includes patient information.


"UpToDate allows clinicians to search by disease, symptom, lab abnormality, procedure, or drug, and find information based on the latest evidence". It includes information for patients.

Summaries: Guidelines

 American Association of Child and Adolescent Psychiatry (AACAP) Practice Parameters

 American Psychiatric Association Practice Guidelines

 Canadian Psychiatric Association guidelines

 CMA Infobase: clinical practice guidelines -- Canadian Medical Association

 National Institute for Health and Clincial Evidence (NICE-UK)

 National Guidelines Clearinghouse (US)

Synopsis of Studies (Critically Appraised Individual Articles)

 Evidence-Based Mental Health Journal

Evidence-Based Mental Health alerts clinicians to important advances in treatment, diagnosis, aetiology, prognosis, continuing education, economic evaluation and qualitative research in mental health. It surveys over 100 international journals and summarises studies of high relevance and methodological quality. Published quarterly by the BMJ group.

 Evidence Updates (McMaster Plus and BMJ)

Complements the BMJ Clinical Evidence for current research. Research articles are selected from over 110 clinical journals covering all medical specialties and rated for clinical interest and relevance. Sign up to receive regular alerts by e-mail.

Clinical Queries Filters

These are pre-set filters for selecting methodologically sound studies. Available when searching MEDLINE, PsycInfo, EMBASE, CINAHL as Limits on different search platforms (OVID, EBSCO).

 PubMed Clinical Queries

Filtered retrieval of clinically sound studies from MEDLINE for therapy, diagnosis, etiology, prognosis and clinical prediction guides (tests, validation).

Top / Haut

3b. "Unfiltered Information" Primary Research Studies databases


MEDLINE is the premier biomedical database containing over 20 million indexed citations. It covers over 5500 international journals in medicine, dentistry, veterinary medicine, healthcare, preclincial sciences and more.Medline is freely-searchable at PubMed  http://pubmed.gov, and available by subscription via OvidSP.

 PubMed with LinkOut (McGill links)

PubMed comprises more than 22 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central ('NIH repository for peer-reviewed primary research reports in the life sciences.') and publisher web sites. It includes not yet indexed literature (PubMed in process) as well as out of scope citations.

FAQ: *  What is the difference between PubMed and MEDLINE?


Major biomedical and pharmaceutical database covering drug research, pharmacology, pharmaceutics, toxicology, clinical and experimental human medicine, health policy and management, public health, occupational health, environmental health, drug dependence and abuse, psychiatry, forensic medicine, and biomedical engineering/instrumentation. Produced by Excerpta Medica and updated weekly. Indexing of over 3,500 international journals.

 PsycINFO (OvidSP)

International coverage of the professional and academic literature in psychology, medicine, psychiatry, nursing, sociology, education, pharmacology, physiology, linguistics, and other areas.


Cumulative Index to Nursing and Allied Health Literature.

To limit your CINAHL search to the best evidence-producing studies: Click on the "Limits" icon to use "Clinical Queries" or limit to "Research" or other "publication" types (i.e., systematic review).

Background Information

 PsychiatryOnline: includes the DSM-IV-TR®, Handbooks, Textbooks but also Guidelines and Journals published by the American Psychiatric Association.

Top / Haut

3c. Meta-Search Engines

 TRIP Database (Turning Research into Practice):

A meta-search engine that searches simultaneously evidence-based sources of systematic reviews, practice guidelines, critically-appraised topics and articles -- including most of those listed above -- individual studies, patient information and more. Also searches MEDLINE's Clinical Queries, medical image databases, e-textbooks, and patient information leaflets.

Top / Haut

4. Appraising the Evidence

Filtered information has already been put through a critical appraisal process. When the best evidence for your question is unfiltered, before you put the evidence into practice, you will need to critically appraise it to ensure that it is both useful and valid.

 How to Critically Appraise an Article

doi: 10.1038/ncpgasthep1331 (if links don't work  copy and paste doi here)

 Critical Appraisal tools - Centre for Evidence-Based Medicine

 Critical Appraisal tools - JAMA Evidence

 Critical Appraisal tools- Dartmouth College

 Risk Reduction calculator- from Alan Schwartz at the University of Illinois, Chicago.

 Diagnostic Test Calculator - from Alan Schwartz at the University of Illinois, Chicago.

 Number Needed to Treat (NNT)

 The three-minute appraisal of a prospective cohort study

 Tips for teachers of evidence-based medicine: 2. Confidence intervals and p values

 Tips for learners of evidence-based medicine: 2. Measures of precision (confidence intervals)

Top / Haut

5. Other Useful EBM Resources

More EBM information sources

 Where's the best evidence? 2011

from  Dean Giustini

 Evidence-based Answers to Clinical Questions for Busy Clinicians (2011) (pdf)
Centre for Clinical Effectiveness (CCE), Monash Medical Centre, Australia: A free, user-friendly EBM workbook

 Evidence at Becker Library Subject Guide
Washington School of Medicine, St Louis Missouri. How To: Search the Literature, Appraise the Literature, EBM Calculators and Tutorials.

 Research and Subject Guides. Evidence Based Medicine
University of Illinois at Chicago UIC Library. Practical guide designed to assist health care professionals and students become effective and efficient users of the medical literature. Includes Clinical Search filters, useful terms for MEDLINE EBM searching and Library Tutorials (What is EBM, PICO).

 Glossary of EBM Terms – from the Centre for Evidence Based Medicine – Toronto

Library Video Tutorials

 Find It Fast! - Yale University

Top / Haut

Page last updated on 

We always seek feedback to make our site better.