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Evidence Based Medicine

Additional EBM Teaching Materials

This page provides links to additional readings and resources that provide a more in-depth exploration and understanding of EBM.

Asking the Clinical Question

Focusing Clinical Questions
From the Oxford Centre for Evidence-Based Medicine
Study Designs
From the Oxford Centre for Evidence-Based Medicine
Understanding Research Study Designs
From the University of Minnesota Libraries Bio-Medical Library

Critical Appraisal: Assessing Risk of Bias

Methodology (Validity)

Intention-to-treat principle
Montori, V.M. and Guyatt, G.H. CMAJ, 2001.
Intention-to-treat concept: A review
Gupta, S.K. Perspectives in Clinical Research, 2011.

Interpreting Results and Statistics

CONSORT 2010 Explanation and Elaboration: Updated guidelines for reporting parallel group randomised trials
Moher, D. et al. Journal of Clinical Epidemiology, 2010.
Explaining Odds Ratios
Szumilas, M. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 2010.
Intention to treat analysis versus per protocol analysis of trial data
Sedgwick P. BMJ, 2015.
Know Your Changes: Understanding Health Statistics
Woloshin, S., Schwartz, K.M., and Welch, H.G. 2008.
NNT/NNH Calculator
From Alan Schwartz at the University of Illinois Chicago
Stating the Meaning of Effect Size Measures in Plain English
From the Duke Program on Teaching Evidence-Based Practice
Statistical Significance Versus Clinical Importance of Observed Effect Sizes: What Do P Values and Confidence Intervals Really Represent?
Schober, P., Bossers, S.M., and Schwarte L.A. Anesthesia and Analgesia, 2018.
Tips for learners of evidence-based medicine: 1. Relative risk reduction, absolute risk reduction and number needed to treat
Barratt, A. et al. CMAJ, 2004.
Understanding statistical significance
Hayat, MJ, Nursing Research, 2010.

Appraising the Evidence: Diagnosis

Diagnostic Test Calculator
From Alan Schwartz at the University of Illinois Chicago
EBM Calculators
RCT, Case Control Study, Prospective Study, Diagnostic Text, and Odds Ratio to NNT calculators. From the Knowledge Translation Program.
Evidence-based medicine: Answering questions of diagnosis
Zakowski, L., Seibert, C., and VanEyck, W.S. Clinical Medicine & Research, 2004.
An introduction to critical appraisal of articles on diagnosis
The Journal of the American Osteopathic Association, 2007
Nomogram for interpreting diagnostic text results (Likelihood ratio)

Appraising the Evidence: Systematic Reviews/Guidelines

Appraisal of Guidelines for Research and Evaluation II
Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews
Shea, B.J. et al. BMC Medical Research Methodology, 2007.
Interpreting meta-analysis in systematic reviews
Perera, R. and Heneghan, C. BMJ Evidence-Based Medicine, 2008
Understanding systematic reviews: the meta-analysis graph (also called ‘forest plot’)
Moja, L. et al, Internal and Emergency Medicine, 2007.

Evidence of Bias in Results

Influence of reported study design characteristics on intervention effect estimates from randomised controlled trials: combined analysis of meta-epidemiological studies
Savović J et al. Health Technol Assess. 2012 Sep;16(35):1-82.
Nocebo vs. Placebo: The Challenges of Trial Design in Analgesia Research
Vase L, Amanzio M, Price DD. Clin Pharmacol Ther. 2015 Feb;97(2):143-50.
Use of relative and absolute effect measures in reporting health inequalities: structured review
King NB, Harper S, Young ME.BMJ. 2012 Sep 3;345:e5774.
Why all randomised controlled trials produce biased results
Krauss A. Ann Med. 2018 Jun;50(4):312-322. doi: 10.1080/07853890.2018.1453233. Epub 2018 Apr 4.