Source

ACP Journal Club (also known as Evidence-Based Medicine - The Journal)

http://www.acpjc.org/

Agency for Healthcare Research and Quality (and Evidence-base Practice Center reports)
Includes the National Guidelines Clearinghouse, plus US Services Preventive Task Force has helpful information you can access through here.

http://www.ahrq.gov

Ambulatory Quality Alliance
Founded by AAFP, ACP, AHIP and AHRQ. Endorsed 26 performance measures as starter set. Goal is to focus on agreed-to measures accepted by health plans to eliminate tracking different measures for different initiatives.

http://www.aqaalliance.org/

Quality Measures
http://www.aqaalliance.org/performancewg.htm

Individual practice internal improvement demo flow sheets:
http://www.ama-assn.org/ama/pub/category/4837.html

Registry
http://www.aafp.org/fpm/20060400/diabetesregistry.xls

Performance Measures & Tools

American Academy of Family Physicians (AAFP)
AAFP Guidelines and Performance Measurement

• For Guidelines (referred to as "Policy Statements")

http://www.aafp.org/x6595.xml

For Performance Measures

http://www.aafp.org/x18919.xml

Guidelines
Performance Measures

American College of Physicians

http://www.acponline.org/sci-policy/guidelines/

American College of Preventive Medicine

http://www.acpm.org

Bandolier

http://www.jr2.ox.ac.uk/bandolier/

BMJ BestTreatments
Also, they now have yet another most fabulous resource for patients and clinicians. You can read more about it at our newsletter: On the Same Page™

https://www.besttreatments.org/Unified/CDA/HP/tmpl/HPIndex/

As peer reviewers and guest editors, Delfini works closely with Craig Stern, CPhA Chair, Editorial Review Committee, and Cathi Lord, California Pharmacist Journal Managing Editor, to provide tools and just-in-time training along with reviewing and editing content.

With permission, we are happy to be able to share these reviews with Delfini readers:
http://www.delfini.org/Showcase_Publication_CPhA.htm

The Canadian Agency for Drugs and Technologies in Health (CADTH)
A good resource for evidence-based assessments of drugs, health technologies and health systems. Frequently uses Cochrane methodology for quality assessment of trials (based heavily on concealment of allocation).

http://www.cadth.ca/

Cancer Guide
Selected basic statistics from Steve Dunn.

http://cancerguide.org/index.html

Centre for Clinical Effectiveness

http://www.med.monash.edu.au/healthservices/cce/

Centre for Evidence-based Medicine

http://www.cebm.net/

Clinical Evidence
A reasonable starting source for systematic reviews from the BMJ. Evidence syntheses of varying quality are available here so auditing of studies and updating is advised.

http://www.clinicalevidence.org

You may be able to get a copy free by going to http://www.unitedhealthfoundation.org. Click on "Resources."

Clinical Drug Trial Information
An industry sponsored effort. Read about the site below.

http://www.ifpma.org/clinicaltrials

Cochrane Library
A terrific resource. You can get many high quality evidence syntheses here as well. Mike makes this his first stop.

http://www3.interscience.wiley.com/cgi-bin/mrwhome/106568753/HOME?CRETRY=1&SRETRY=0

Confidence Interval Calculations

GraphPad QuickCalcs
http://www.graphpad.com/quickcalcs/NNT1.cfm

Dr. Shakespeare's Confidence Calculator
http://www.theshakespeares.com/Free_statistical_software.html

The Consort Statement: Consolidated Standards of Reporting Trials —CONSORT
"The CONSORT statement is an important research tool that takes an evidence-based approach to improve the quality of reports of randomized trials. The statement is available in six languages and has been endorsed by prominent medical journals such as The Lancet, Annals of Internal Medicine, and the Journal of the American Medical Association. Its critical value to researchers, health care providers, peer reviewers, and journal editors, and health policy makers is the guarantee of integrity in the reported results of research.

CONSORT comprises a checklist and flow diagram to help improve the quality of reports of randomized controlled trials. It offers a standard way for researchers to report trials. The checklist includes items, based on evidence, that need to be addressed in the report; the flow diagram provides readers with a clear picture of the progress of all participants in the trial, from the time they are randomized until the end of their involvement. The intent is to make the experimental process more clear, flawed or not, so that users of the data can more appropriately evaluate its validity for their purposes. "

http://www.consort-statement.org/

And glossary: http://www.consort-statement.org/explanation/newene.htm#glosstop

And STARD for Standards in Reporting of Diagnostic Accuracy

Consumer Reports Best Buy Drugs

The mission of the Consumer Reports Best Buy Drugs project is to provide consumers and their doctors with information to help guide prescription drug choices–based on effectiveness, a drug's track record, safety and price.

This appears to be a good source of information since it is based on the work of the Oregon Health & Science University Evidence-based Practice Center which uses a rigorous approach to evaluating science.

http://www.bestbuydrugs.org

Database of Abstracts of Reviews of Effects (DARE)
This site identifies potential systematic reviews and assesses for methodological quality against a set of inclusion criteria and summarizes the results.

http://www.york.ac.uk/inst/crd/crddatabases.htm

Diagnostic Test Calculators (See also STARD for Standards in Reporting of Diagnostic Accuracy)

Delfini Diagnostic Testing Calculator
Features:
—» Natural language explanations for results. Can use with patients.
—» Provides information in percents, probabilities and odds.
—» Likelihood ratio results computed for you so you don't have to guess what is “insignificant” and what is “large.” The calculator does the interpretive work for you.
—» Bandolier number-needed-to-diagnose (NND) calculated as well.
Calculates on the basis of —
• pre-test likelihood, sensitivity and specificity
• raw data from a 2x2 table
Links to confidence interval calculator
Download Excel file here

University of British Columbia, Department of Health Care and Epidemiology
Features:
Confidence intervals calculated
Calculates on the basis of —
• pre-test likelihood, sensitivity and specificity
• pre-test likelihood and the likelihood ratios
• raw data from a 2x2 table
Online and interactive

http://www.healthcare.ubc.ca/calc/bayes.html

DIPEx
Illness information for patients, including patients talking about their experiences with illness, can be found at this site. Many of the modules are produced by professionals involved with the Cochrane Collaboration. The site provides patients with information by condition, but also through interviews with patients that you can hear directly online. It also provides information about other resources available to patients.

http://www.dipex.org

Dynamed
A meticulously and frequently updated source of information for clinical questions. We do have some issues with the SORT system upon which it is based. See our letter here. However, much of this work is evidence-based and many statements are graded for validity.

http://www.dynamicmedical.com/

Effective Health Care Bulletins

http://www.york.ac.uk/inst/crd/ehcb.htm

Evidence-based Practice Newsletter (includes JFP POEMS)
Requires a subscription.

http://www.ebponline.net/

US Food and Drug Administration (FDA)
The site is huge and complex to navigate. It requires patience and persistence to find relevant information. However, for those interested in detailed information from the FDA for drugs or medical devices, the search function on the home page and the search functions on the drug and medical device pages can provide — at times — useful information.

http://www.fda.gov

FDA Advisory Committee Site: Searchable site at FDA for information from the committee.

http://www.fdaadvisorycommittee.com/FDC/AdvisoryCommittee/TOC.htm

Especially useful sections are Drugs@FDA (http://www.fda.gov/search/databases.html) and the Center for Drug and Evaluation and Research (CDER; http://www.fda.gov/cder). CDER is an up-to-date source for new drug applications (NDAs) and useful background information on new drugs. The medical reviews and statistician reviews can be of great value. It is worthwhile to do a search using the generic name of the agents of interest at both of these sections, as well as the brand name.

Free Medical Journals
This site contains a database of 940 online medical journals, all of which offer some degree of free access. This site's affiliate web site (http://www.freebooks4doctors.com) provides links to more than 550 free medical books online.

http://www.freemedicaljournals.com

Global Family Doctor — World Family Doctors Caring for People — WONCA Online
Wonca is an unusual, yet convenient acronym comprising the first five initials of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians. Wonca's short name is World Organization of Family Doctors. They offer a free journal alert service.

http://www.globalfamilydoctor.com

Medical News

Free Journal Alert Service

Graph Pad Statistical Software: QuickCalcs
There is probably a host of wonders here (for free), but we use the 2x2 table calculator to verify p=values.

http://www.graphpad.com/quickcalcs/contingency1.cfm

This one calculates confidence intervals and more.
http://www.graphpad.com/quickcalcs/NNT1.cfm

Health Services/Technology Assessment Text (HSTAT)

http://hstat.nlm.nih.gov/

Health Technology Assessment Text (HTA)
The HTA programme is part of the National Institute for Health Research (NIHR). It produces independent research information about the effectiveness, costs and broader impact of healthcare treatments and tests for those who plan, provide or receive care in the NHS.

http://www.hta.ac.uk/

Highwire Press

HighWire Press, of Stanford University, maintains the online content of 332 medical journals, including the New England Journal of Medicine and Canadian Medical Association Journal.

HighWire's alerting service will notify users of new content that matches their specific interests in any HighWire-affiliated publisher's full text, or in the Medline database.

http://highwire.stanford.edu/

IBS — The Delfini Irritable Bowel Syndrome (IBS) Guideline Resource Kit:
"Explicit" Evidence-based Clinical Practice Guidance

IBS Resource Center

ICSI: Institute for Clinical Systems Improvement

ICSI is an independent collaborative that helps its members provide evidence-based health care services to patients. Comprised of 58 medical groups and sponsored by six Minnesota health plans, ICSI unites diverse stakeholders to deliver patient-centered and value-driven care, established in 1993 by HealthPartners, Mayo Clinic and Park Nicollet Health Services, and sponsored by HealthPartners.

http://www.icsi.org/

Guidelines
Evidence-based recommendations

Informed Health Online
Evidence-based information for patients, clinicians and others — summarizes systematic reviews from Cochrane (abstracts of Cochrane Reviews are available without charge).

http://www.informedhealthonline.org/index.2.en.html

Institute of Medicine Reports
The Institute provides a vital service by working outside the framework of government to ensure scientifically informed analysis and independent guidance. The IOM’s mission is to serve as adviser to the nation to improve health. The Institute provides unbiased, evidence-based, and authoritative information and advice concerning health and science policy to policy-makers, professionals, leaders in every sector of society, and the public at large.

http://www.iom.edu/reports.asp

JCAHO — Joint Commission on Accreditation of Healthcare Organizations

http://www.jcaho.org/pms/index.htm

Medicare

http://www.medicare.gov/

MEDLINEplus for Patients

Medline Plus provides extensive, “authoritative” information from National Library of Medicine, the National Institutes of Health and other trusted sources on over 650 diseases and conditions. Included are a medical encyclopedia and a medical dictionary, extensive information on prescription and nonprescription drugs, health information from the media, and links to thousands of clinical trials. There is no advertising on the site, nor does MEDLINEplus endorse any company or product.

Caution: Although the site uses criteria, there is no critical appraisal of the information for validity.

Key criteria for information and links include:

• Quality, authority and accuracy of content (again, caution because there is no critical appraisal of the information for validity).
  • The source of the content is established, respected and dependable. A list of advisory board members or consultants is published on the site.
  • The information provided is appropriate to the audience level, well-organized and easy to use.
  • Information is from primary resources (i.e., textual material, abstracts, web pages).
  • Lists of links are evaluated/reviewed/quality-filtered.
• The primary purpose of the web page is educational.
• Information is current or an update date is included.
• Registration is not required to view the information on the site.

http://www.medlineplus.gov

National Cancer Institute

http://www.nci.nih.gov

Cancer Information

National Committee for Quality Assurance (NCQA) HEDIS Effectiveness of Care Measures

http://www.ncqa.org/Programs/HEDIS/

http://www.ncqa.org/Communications/State%20Of%20Managed%20Care/SOHCREPORT2003.pdf

National Guidelines Clearinghouse

http://www.guideline.gov

Guidelines
Performance Measures

National Institute for Health and Clinical Excellence (NICE)
A nice (no pun intended) British site for technology assessments.

http://www.nice.org.uk/page.aspx?o=appraisals.completed

National Quality Forum

Endorsement of consensus-based national standards for measurement and public reporting of healthcare performance data. “Seed” performance measures for hospital care, safe practices, children’s health care, diabetes care and other practices are available from NQF.

http://www.qualityforum.org/home.htm

National Quality Measures Clearinghouse

http://www.qualitymeasures.ahrq.gov/

Netting the Evidence

http://www.nettingtheevidence.org.uk/

New Zealand Guidelines Group
This is a great first stop for guidelines. They know and use the "explicit" guideline development method.

Caution: Some guidelines are developed using consensus and, therefore, may be biased.

http://www.nzgg.org.nz/index.cfm?screensize=1024&ScreenResSet=yes

Oregon State Drug Formulary Reviews – Oregon Health Services University
Nicely done drug reviews. It also includes reviews from other states as part of a consortium.

http://www.ohsu.edu/drugeffectiveness/index.htm

Patient information =
http://www.oregonrx.org

Oregon State Health Resources Commission Evidence-based Reports Database:

http://www.oregon.gov/OHPPR/HRC/Evidence_Based_Reports.shtml

Physician Consortium for Performance Improvement

http://www.ama-assn.org/ama/pub/category/2946.html

PubCrawler — an Update Alerting Service for PubMed and GenBank

"It goes to the library. You to go the pub." ™

http://pubcrawler.gen.tcd.ie/

Pub Med for Clinical Staff
We love! It just gets better and better, and easier and easier. A continual stop!

Caution: You must critically appraise this information for validity and usability.

http://www.PubMed.gov

Primary and Secondary Studies
Evidence Syntheses
Guidelines
Performance Measures

RegenceRx®: Pharmacy Benefit Management
We know of no group that does a better job of critical appraisal and applying evidence-based medicine principles. Plus they make summaries of their drug reviews freely available online.

For clinicians:
RxNews
http://www.regencerx.com/meet/physicianNews/index.html
Drug Review Summaries
http://www.regencerx.com/learn/physicianRx/index.html

For consumers:
http://www.regencerx.com/prescriptions/physicianTools/consumer/index.html

Read more about our work with them here »

The STARD Initiative — Standards for Reporting of Diagnostic Accuracy
Towards Complete and Accurate Reporting of Studies on Diagnostic Accuracy
"To improve the accuracy and completeness of reporting of studies of diagnostic accuracy in order to allow readers to assess the potential for bias in a study and to evaluate the generalisability of its results....Evaluation of research depends on complete and accurate reporting. If medical journals adopt the checklist and the flow diagram, the quality of reporting of studies of diagnostic accuracy should improve to the advantage of clinicians, researchers, reviewers, journals, and the public."

You can read the article here: http://bmj.bmjjournals.com/cgi/content/full/326/7379/41

And about the statement here: http://www.consort-statement.org/stardstatement.htm

See also Consort Statement: Consolidated Standards of Reporting Trials

STATS: STeve's Attempts to Teach Statistics
Children's Mercy Hospitals and Clinics, Kansas City, MO
We think this is wonderfully clear and beautifully written information on a number of important EBM issues, thanks to and courtesy of Steve Simon, PhD.

http://www.childrens-mercy.org/stats/ (Don't know why, but sometimes you will get a "page cannot be displayed" notice. Hit the back button, and click the link again. This usually works.)

SUMSearch
Searches numerous sources for clinical guidelines, narrative and systematic reviews, articles in NLM (PubMed).

http://sumsearch.uthscsa.edu/

Turning Research into Practice (TRIP)

http://www.tripdatabase.com

University of California, San Francisco Primary Care Clinical Practice Guidelines

http://medicine.ucsf.edu/resources/guidelines/index.html

US Preventive Services Task Force (USPSTF)
An independent panel of primary care systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services.

http://www.ahcpr.gov/clinic/uspstfix.htm

Guidelines & Clinical Recommendations on Prevention & Screening

User's Guide to the Medical Literature

http://www.cche.net/principles/content_all.asp

Veterans Administration
Another site for guidelines from some really terrific people. We understand that a lot of their work has been applauded by the IOM.

The PBM's documents are available publicly at: http://www.vapbm.org and the VA/DoD CPGs are at: http://www.oqp.med.va.gov/cpg/cpg.htm

World Family Doctors Caring for People — WONCA Online
Wonca is an unusual, yet convenient acronym comprising the first five initials of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians. Wonca's short name is World Organization of Family Doctors. They offer a free journal alert service.

http://www.globalfamilydoctor.com

Medical News

Free Journal Alert Service

University of Alberta — Really nice.

http://www.library.ualberta.ca/subject/evidence/guide/index.cfm#ebsites

University of California San Diego BioMedical Library

http://scilib.ucsd.edu/bml/

UCSD Online Clinical Library (although we believe Scientific American and Up-to-Date are not evidence-based to our standards and should be considered textbooks)

http://gort.ucsd.edu/clinlib/

University of Washington Health Links

http://healthlinks.washington.edu/hsl/