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Clinical Skills: Clinical & Evidence-Based Resources

Out on rotation? Need quick info? Here's where you'll find it. Quick links to all sorts of skills - basic ones everyone needs to know, and specialty info. And links to the best ebooks too.

What we mean by "clinical information"

In evidenced based medicine clinical information is also referred to as foreground information.   A clinical question is one that asks for specific information in order to make a clinical decision.  Generally clinical questions fall into one of five categories.

  • Harm/Etiology -what are the causes of the condition or state
  • Diagnosis - what is the condition or state
  • Prognosis - what is the likely outcome of the condition or state
  • Therapy - what is the treatment for the condition or state
  • Prevention - how to reduce the risk of the condition or state

What we mean by "evidence-based medicine"

Evidence-Based Medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. (BMJ 1996;312:71-72)

Evidence-based medicine asks questions, finds and appraises the relevant data, and harnesses that information for everyday clinical practice. Evidence-based medicine follows four steps: ƒ

  • formulate a clear clinical question from a patient's problem ƒ
  • search the literature for relevant clinical articles ƒ
  • evaluate (critically appraise) the evidence for its validity and usefulness ƒ
  • implement useful findings in clinical practice

The term "evidence based medicine" (no hyphen) was coined at McMaster Medical School in Canada in the 1980's to label this clinical learning strategy, which people at the school had been developing for over a decade. (BMJ 1995;310:1122).

How to search Pubmed Clinical Queries

PubMed Clinical Queries can be found here.  

On June 16, 2015, PubMed hit a milestone when the 25 millionth journal citation was added to the database.

This is both good and bad.  Good because it means there is so much medical research out there that you should be able to find the answer to your question. Bad because there is so much medical research out there that it could take forever to find the answer to your question.

Recognizing the need to search for clinical evidence the developers at NCBI, who maintain PubMed, created Clinical Queries. (CQ) CQ eliminate everything that isn’t evidence, like editorials or history, and lets you focus in on just the clinical research you are looking for.  It does that by using search hedges, or filters that limit to a specific clinical study category and scope.  Click here for more about the filters themselves 

There are five filters to match 5 clinical questions: etiology, diagnosis, therapy, prognosis and clinical prediction guidelines.  You can choose a narrow, specific search or a broad more sensitive search.  CQ also has a systematic review filter and a filter for articles that focus on medical genetics. The default is all medical genetics topics but you can limit to specific genetics topics.

To search CQ just enter your terms into the search box.  Filtering is automatic.  The top 5 most recent citations show up on the screen with the total count.  Click on “See all” to go to all the citations on the PubMed results page.  Once at the PubMed results page consider re-ordering the results by relevance instead of date. Now you can use all PubMed filters and limits to make you search more precise.  One note of caution, at the article level there is an option to see “Similar articles.”  Once you click on that you have moved away from the evidence filters of PubMed Clinical Queries 

Online resources for quality, evidence-based clinical resources