Evidence-based information may be in the form of Clinical Guidelines, Technology Assessments, Best Practices, Standards, etc. Such tools are created to help healthcare systems reduce errors and provide an improved standard of patient care. Guidelines also are used for accountability and facilitate the learning process. The following resources were chosen based on currency, clarity, authority, and access availability to the information. Any additional sites can be recommended to the library staff.
Government Initiatives
Access to information is unrestricted, topic coverage is usually broader and deeper, and most sites provide several links to other related resources.
U.S. Government sites
- Agency for Healthcare Research and Quality (AHRQ)
Charged with improving the quality, safety, efficiency and effectiveness of healthcare for all Americans, it is the lead federal agency in this endeavor. 'Evidence-based Guidelines and Reports' are developed by contracted Evidence Based Practice (EBP) Centers. The site's vast amount of information is well-organized. Most useful EBP tools are found under the 'Clinical Information' section.
- Centers for Disease Control and Prevention (CDC)
The federal agency charged with overseeing public health. Its efforts aim to prevent and control infectious and chronic diseases, injuries, workplace hazards, disabilities, and environmental health threats. This site compiles an interesting variety of documents on an exhaustive list of topics. A separate publication, MMWR, is featured below.
- Health Services Technology/Assessment Text
One of many e-biomedical texts available from the National Library of Medicine, it contains AHRQ reports, Surgeon General Reports, Guidelines for Community Preventive Services, and more.
- Morbidity & Mortality Weekly Report (MMWR)
Contains in-depth articles that relay policy statements for prevention and treatment on all areas in CDC's scope of responsibility. Recommendations and Reports are located in the sidebar under 'MMWR Publications'. Current and past volumes are listed by date, but keyword searchable.
- National Guideline Clearinghouse
A public resource for evidence-based clinical practice guidelines, it is an initiative of AHRQ. Extremely well-organized, the 'Browse' sidebar section lists guidelines by organization and by disease/topic. Site is also keyword searchable.
- National Heart, Lung, and Blood Institute (NHLBI)
This agency supports, organizes and publishes a variety of information on topics related to the causes, prevention, diagnosis, and treatment of heart, blood vessel, lung, blood diseases and sleep disorders.
- Veterans Administration
Clinical Practice Guidelines for select topics. They are clearly presented with downloads available for 'pocket cards', key points, algorithms, etc. Publication dates of the guidelines are found at bottom of the page or on the title page.
International Government sites
- Cancer Care Ontario
"An umbrella organization that steers and coordinates Ontario's cancer services and prevention efforts " Easy to navigate and updated monthly, the 'Standards and Guidelines' section has drug monographs and dosing regimens, and evidence-based guidelines (searchable by topic).
- NHS Evidence Health Information Resources
Sponsored by National Health Service, UK, this site offers a vast amount of information. Restricted areas will be encountered but the Specialist Library section contains evidence based information by subject and is accessible. Many links to other sites also.
- New Zealand Guidelines Group
Click 'GO' on home page. Evidence Guidelines are available under Publications in navigation menu. The Links navigation tab is a gem; international in scope, it is one of the best for a list of comprehensive, quality evidence-based medical sites.
Professional/Proprietary/Organizational Initiatives
Access to portions of information on these sites may be subscriber restricted, but each site does allow free access to valuable sections. A few may ask for registration at no charge.
General Resources
- Bandolier
From Oxford University, this free Internet version of an independent evidence-based healthcare journal is accessible because, "The internet version of the Bandolier appears several months after the print version." The Knowledge Library, Oxford Pain Site, and Healthy Living Zone (for patients) are key sections.
- Best Bets (Best Evidence Topics)
Initiated by a UK hospital, it started with an emergency medicine focus, but has since expanded coverage. Databases (sometimes slow to load) contain a standardized 3-part question answered with a structured approach. Designed for busy clinicians, the database is growing with color-codes representing completion.
- Cochrane Library
Considered a cornerstone in EB information, the 'Library' contains a variety of databases, but the core one is 'Systematic Reviews'.
- Institute for Healthcare Improvement
A 'not-for-profit' based in Cambridge, MA. Unique interactive site with broadcasts, email discussions, recommended books, white papers, related links, etc. Valuable if your interest is a 'Topic'. All 'Topics' are in a collapsible sidebar. Click to expand for refined search. Note: free registration is required for full access.
- Institute for Clinical Systems Improvement (ICSI)
A non-profit started in 1993 in Minnesota, the Mayo Clinic is one of three founding partners. Nicely presents EB information on a limited number of topics. The 'Patient Education Resources' lists quality links.
- Virginia Henderson International Nursing Library
Sponsored by Sigma Theta Tau International Honor Society of Nursing this is a portal to many nursing EB resources plus more. Nicely organized.
Resources by Specialty Practice
These sites, mostly professional, may have value added features. Many 'Patient' sections are very informative. Access to some areas is restricted by membership.
Critical Care
- American Association of Critical Care Nurses (AACN)
Most information is member restricted. Abstracts from American Journal of Critical Care accessible under 'Publications' on the main page.
- Society of Critical Care Medicine
Look for free access to 'Guidelines' under 'Professional Resources' in the sidebar.
Emergency
- American College of Emergency Physicians
Go to 'Practice Resources' for 'Clinical Policies' and more.
- Best Bets
Initiated by a UK hospital, it started with an emergency medicine focus, but has since expanded coverage. Databases (sometimes slow to load) contain a standardized 3-part question answered with a structured approach. Designed for busy clinicians, the database is growing with color-codes representing completion.
Geriatrics
The American Geriatrics Society
- University of Iowa Gerontological Nursing Interventions Research Center (GNIRC)
Note: these EB Guidelines are available in the Mount Carmel Health Sciences Library.
Heart
- Heart Failure Society of America
Under 'Education' section are free Guidelines and Educational Modules plus more.
Infectious Diseases
- Infectious Diseases Society of America
Easy navigation, lots of free access.
Oncology
- Cancer Care Ontario
"An umbrella organization that steers and coordinates Ontario's cancer services and prevention efforts " Easy to navigate and updated monthly, the 'Standards and Guidelines' section has drug monographs and dosing regimens, and evidence-based guidelines (searchable by topic).
- Imaginis, the breast cancer resource
An independent site sponsored by several key healthcare partners, it is well-organized and informative. Many of the bullet lists are actually links, although not visually indicated. Unfortunately, the Practice Guidelines under 'Professional Resources' because the links have not been kept up to date. However Imaginis still offers much.
- Oncology Nursing Society
The EBP area is linked from here as are additional resources. The Topic Reviews give citations with links to abstracts.
Orthopaedics
- American Academy (Association) of Orthopaedic Surgeons
The 'Research' section freely offers Guidelines, Statistics and Summary Documents plus more.
Pain
- The Oxford Pain Internet Site (via Bandolier)
Well organized with links to other pain sites.
Pharmacy
- Institute for Safe Medical Practices
A Philadelphia-based non-profit, it is alone in its mission "…devoted entirely to medication error prevention and safe medication use". Has excellent resources for error-prone meds, black-box warnings, etc.
Physiotherapy
- PEDro (Physiotherapy Evidence Database)
From the University of Sydney, this database is not well-structured, but comprehensive. Search is by keyword, with no topic list visible to user. Gives citation to document and link to full-text or abstract if available.
Primary Care
- American College of Physicians
Look under 'Clinical Info' for free access to Guidelines and more.
Respiratory Care
- American Thoracic Society
Look under 'Clinical Information' and 'Education' sections for free access to many resources.
- National Heart, Lung, and Blood Institute (NHLBI)
This agency supports, organizes and publishes a variety of information on topics related to the causes, prevention, diagnosis, and treatment of heart, blood vessel, lung, blood diseases and sleep disorders.
Women's Health
- Association of Women's Health, Obstetric and Neonatal Nurses
Membership restriction for most information or it can be purchased. The 'Site Map' provides easy view of site content.
Evidence Based Tools & Methods
Many sites previously listed explain how they create their EB information. Some institutes have more comprehensive EB programs and therefore offer in-depth looks at their procedures. Two are listed below. In addition, most of the EBP Centers contracted by AHRQ provide similar looks at their endeavors.
- Centre for Health Evidence
A not-for-profit organization based at the University of Alberta.
- Evidence-based Medicine Resource Center
Created by New York Academy of Medicine in partnership with the New York Chapter of the American College of Physicians, it has links to many sites regarding standards used in creating EB information. Easy to use.