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  • Editors choice: an annotated bibliography of EBM articles selected by the Clinical Evidence editorial team
    to refresh their memories It uses practical examples to illustrate how to analyse and critically appraise all kinds of evidence This includes what the statistics are how to calculate and interpret them and finally how to apply the findings to everyday practice Straus SE What s the E for in EBM BMJ 2004 328 535 536 http www ncbi nlm nih gov pubmed 15001480 This short editorial identified the complex issues around getting evidence into practice and evaluating any effect It pre dated further papers in the BMJ which examined the evidence on whether EBM changes care Hart JT The inverse care law Lancet 1971 1 405 412 http www ncbi nlm nih gov pubmed 4100731 This paper stated the availability of good medical care tends to vary inversely with the need for the population served This outlines the challenge to EBM Even when the best practice is identified it needs to be delivered to those most at need Concato J Shah N Horwitz RI Randomised controlled trials observational studies and the hierarchy of research designs N Eng J Med 2000 342 1887 1892 http www ncbi nlm nih gov pubmed 10861325 What evidence do we use This paper examines issues around the hierarchy of research designs It discusses the effects of methodological quality in RCTs and observational studies and how results from both may be similar or differ Shojania KG Sampson M Ansari MT et al How quickly do systematic reviews go out of date A survival analysis Ann Intern Med 2007 147 224 233 http www ncbi nlm nih gov pubmed 17638714 This paper addresses the thorny issue of speed of update of systematic reviews providing a quantitative analysis of signals for change for reviews where new evidence would potentially change conclusions and adds fuel to an ongoing debate when does new data really make a clinical difference Shrier I Boivin JF Platt RW et al The interpretation of systematic reviews with meta analyses an objective or subjective process BMC Med Inform Decis Mak 2008 8 19 http www ncbi nlm nih gov pubmed 18495019 This paper questions the power of data as a tool for decision making in its own right suggesting that no matter how well you collate data it cannot be enough to guide decision making clinical interpretation has a strong role to play evidence is essential but it is not sufficient Glasziou P Chalmers I Rawlins M et al When are randomised trials unnecessary Picking signal from noise BMJ 2007 334 349 351 http www ncbi nlm nih gov pubmed 17303884 This paper convincingly demonstrates the following EBM anecdote about the reliance on randomised trials You realise that the efficacy of parachutes in preventing injury or death has never been put to randomised double blind placebo controlled trials Clearly the efficacy is questionable and at best variable Clearly the policy of the mass issuing of parachutes to paratroopers and coercion of skydivers to use them is questionable Donald A Balancing the benefits and harms

    Original URL path: http://www.clinicalevidence.org/x/set/static/cms/editors-choice.html (2016-02-01)
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  • Citations within Clinical Evidence
    nofollow Add to Portfolio Add new note View notes Feedback Please complete the form below First Name Surname Occupation Email Phone Company BMJ Clinical Evidence Message Please wait Notes Remove Edit Notes Please do not record person identifiable clinical or staff information and other sensitive information in this field Update Cancel Remove Notes Please do not record person identifiable clinical or staff information and other sensitive information in this field Save Cancel Citations within Clinical Evidence Citations are brought to you by the BMJ Evidence Centre and incorporates the McMaster PLUS email surveillance system to collect and review the best evidence from the medical literature published since the last Clinical Evidence systematic search for a given review Users of citations with interests in a specific clinical problem or treatment are also invited to use Evidence Updates www bmjupdates com an openly accessible service to look up topics covered in the McMaster PLUS database published as far back as 2002 Updates based on the following processes conducted by McMaster PLUS systematic review of over 120 journals including quarterly updates of the Cochrane Library with selection of articles by expert research staff concerning the cause course diagnosis prediction prevention and treatment of health problems quality improvement and health economics according to explicit criteria with high reproducibility and periodic quality assurance checks 1 ratings of each eligible article for clinical relevance and newsworthiness made by at least 3 practitioners for each discipline for which the article might be pertinent The McMaster Online Rating of Evidence MORE rating panel has over 3000 participants from around the world all in clinical practice with about half in primary care and the rest in internal medicine and its specialties pediatrics psychiatry obstetrics gynecology and surgery e mail alerts about new evidence Each alert includes MORE clinical ratings

    Original URL path: http://www.clinicalevidence.org/x/set/static/cms/citations-updates.html (2016-02-01)
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  • Citations disclaimer
    clinical or staff information and other sensitive information in this field Update Cancel Remove Notes Please do not record person identifiable clinical or staff information and other sensitive information in this field Save Cancel Citations disclaimer The information contained in Latest citations within Clinical Evidence is intended for medical professionals and is provided on an as is basis without warranty of any kind express or implied Latest citations provides a literature surveillance service for practicing clinicians designed to alert clinicians to important new research however we cannot warrant its accuracy It is intended to support evidence based decision making by providing links to published research reports about the diagnosis treatment prediction and prognosis aetiology and economics of medical conditions However clinicians making decisions about the care of their patients must take into account the limitations of evidence from research as well as the unique nature of their patients circumstances and wishes Readers should also be aware that professionals in the field may have different opinions about the interpretation of evidence from research Because of this fact and also because of regular advances in medical research we strongly recommend that readers independently verify any information they chose to rely on Ultimately it is the readers responsibility to make their own professional judgments Latest citations attempts to provide access to the best new research of relevance for healthcare practice It does not report all research but uses explicit criteria to define a subset of published research that is likely to be valid and ready for clinical attention in these disciplines Practising physicians then provide their assessments of the relevance and newsworthiness of the reports through an online review process the McMaster Premium Literature Service McMaster PLUS including the McMaster Online Rating of Evidence MORE system Individual clinicians who receive these reviews must

    Original URL path: http://www.clinicalevidence.org/x/set/static/cms/citations-disclaimer.html (2016-02-01)
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  • Institutional access enquiries
    access Search tips General FAQ NHS and student Print Online Mobile Info for advertisers Subscribe to Clinical Evidence CE online On demand Institutional access and trial Email and RSS Contact us Print Bookmarked Bookmark class portfolio target blank onclick return prtflo click id addtoplanlink rel nofollow Add to Portfolio Add new note View notes Feedback Please complete the form below First Name Surname Occupation Email Phone Company BMJ Clinical Evidence Message Please wait Notes Remove Edit Notes Please do not record person identifiable clinical or staff information and other sensitive information in this field Update Cancel Remove Notes Please do not record person identifiable clinical or staff information and other sensitive information in this field Save Cancel Institutional access enquiries Access codes If an institution has been set up with access via an access code the user will need to follow the 5 steps below to set up a personal account 1 Click on Redeem Access Code within the sign in box at the top right side of the page 2 Follow the 5 step registration process 3 Fill in your professional details 4 In step 4 enter your access code and submit 5 You account is created and you can use your email address and password to enter the site IP range If an institution has been set up via IP range simply visit clinicalevidence bmj com from within your institution to access the content If you register for your own account within the IP range of your institution you can then access from an external location Athens Shibboleth If an institution has been set up via Athens Shibboleth users can access Clinical Evidence via Athens Shibboleth authentication name password through the sign in box in the top right of the page Username and password If the user has

    Original URL path: http://www.clinicalevidence.org/x/set/static/cms/institutional-access-help.html (2016-02-01)
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  • Searching Clinical Evidence
    Clinical Evidence Message Please wait Notes Remove Edit Notes Please do not record person identifiable clinical or staff information and other sensitive information in this field Update Cancel Remove Notes Please do not record person identifiable clinical or staff information and other sensitive information in this field Save Cancel Searching Clinical Evidence Clinical Evidence includes systematic reviews guidelines and patient leaflets for over 250 topics There are several ways to find the information you need in Clinical Evidence Browsing by section If you are looking for information on a particular topic you can use the drop down Conditions menu at the top of every Clinical Evidence screen Choosing a section from the list e g diabetes will display all the relevant articles including systematic reviews guidelines and patient information or you can filter results using the buttons above the topic list Alphabetical listing The Conditions menu also allows you to browse the full contents of Clinical Evidence alphabetically Click on the drop down Conditions menu and select All conditions button alphabetical tabs will appear above the article list Free text search You can use the free text search box at the top of every page to find a particular word or phrase from anywhere within Clinical Evidence Search results are sorted by how frequently your search terms appear on that page and include a selection of text from the article to help put your search results into context Results can also be filtered by type systematic reviews guidelines patient information to help you find the exact information you re looking for Free text search tips If you want to search for an exact phrase put double quotation marks around the phrase So you might search for side effects of antidepressants If you want to look for several similar words use

    Original URL path: http://www.clinicalevidence.org/x/set/static/cms/search-tips.html (2016-02-01)
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  • NHS and student
    receive my complimentary copy of Clinical Evidence handbook How can I provide my feedback on Clinical Evidence What should I do with previous editions of Clinical Evidence Who should I contact to discuss subscription options or to re subscribe Student Will I receive a student discount How can I join the BMA as a student member What is the handbook distribution policy If I join after this date will I still receive a copy How can I access Clinical Evidence content Free access to Clinical Evidence has been made available for healthcare professionals by HOWIS in Wales You can browse the content freely if you are accessing it from the HOWIS website in Wales Users with Athens accounts provided by Scottish or Welsh institutions can log in with their Athens account Institutions from outside of Wales including England and Scotland where free access through the NHS has now ceased may provide online access to staff through an FTE usage model Email our sales team for details Why do I have to register my details to access clinicalevidence com Within Wales Open access has been provided for you by your NHS with no requirement to register your details If you are presented with a registration option it may be because you are accessing from an NHS institution If this is the case simply log in with your Athens account I am experiencing difficulties in accessing the website Within England and Scotland You may have previously been able to access the full text of Clinical Evidence online free of charge via an agreement with the NHS The BMJ Group regrets that this agreement has now ceased In order to access Clinical Evidence you will need to subscribe click here for more information Within Wales Access is unrestricted provided that your Internet Service Provider ISP is based in Wales If you are accessing the site from Wales but are prompted for a user name and password please check that your ISP server is based in Scotland or Wales or contact us Users with Athens accounts provided by Welsh institutions can log in with an Athens account Will I still receive my complimentary copy of the Clinical Evidence handbook From Issue 16 December 2006 there will no longer be a free distribution of the Clinical Evidence handbook to GPs nurse practitioners and pharmaceutical prescribing advisors If you would like to subscribe to Clinical Evidence handbook then please click here for more information How can I provide my feedback on Clinical Evidence We welcome feedback and work closely with user groups in our continuous development of Clinical Evidence Contact us via this website What should I do with previous editions of Clinical Evidence Previous copies should be recycled Clinical Evidence is regularly revised and updated to include the latest research evidence Who should I contact to discuss subscription options or to re subscribe To subscribe to the Clinical Evidence handbook app or online access please see our products page Will I receive a student discount

    Original URL path: http://www.clinicalevidence.org/x/set/static/cms/nhs-student.html (2016-02-01)
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  • Print
    towards more flexible digital content It is easier for users to search and access the latest evidence at the point of care and the digital platform has no space constraints The full version of Clinical Evidence will now only be available online When was the last issue The last issue of Clinical Evidence full print was issue 15 published June 2006 What options are available to me as an alternative to the full edition Clinical Evidence online All the content that has previously been available to you in the full print edition and more is still available to you online A personal subscription includes individual password access and institutions may provide online access to staff through an FTE usage model For further information please email our sales team A subscription to Clinical Evidence online includes 12 months access to Full text reviews that include the benefits harms and a comment for each option and additional background information and references Monthly updates and new reviews References that link PubMed and Cochrane abstracts Drug safety alerts One page summaries of key points for conditions and treatment options Emerging research information Links to practice guidelines Email alerts RSS feeds useful site tools and EBM resources Clinical Evidence handbook previously called Concise The print handbook edition provides a useful summary of key information from the full online edition updated and published in a handbook format approx 720 pages every 6 months The Clinical Evidence handbook edition contains the summary and background information for each review with full content including evidence detail figures tables and appendices available online along with quantified referenced and up to date information about each condition Clinical Evidence online and handbook print edition A special package price is available for subscribers who want to combine access to the full content of

    Original URL path: http://www.clinicalevidence.org/x/set/static/cms/print.html (2016-02-01)
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  • Online
    twice a month The continuous production process means that reviews go online as soon as they are updated I am a personal student nurse subscriber to the Clinical Evidence handbook Am I entitled to online access Online access can be added to your print handbook subscription for a small additional charge Please see our products page for more information We are an institutional subscriber to the Clinical Evidence handbook How can we get online access Online access for the entire site can be added to your print subscription The price is based in your number of FTEs Please contact our sales team for a quote I have a personal student nurse Clinical Evidence subscription How do I activate my online access If you purchased your Clinical Evidence subscription on this website your account is already activated To enter the site click here to submit the username and password you created at the time of purchase Where can I find my customer number If you subscribe to the Clinical Evidence handbook print edition you will find your customer number is printed on the packaging of your book delivery It is a six digit number on the top left hand corner of the address label If you have subscribed separately to Clinical Evidence online you will have been notified of your customer number upon subscribing What do I do if I can t find or have forgotten my customer number Call customer service on 44 0 20 7383 6270 Fax 44 0 20 7383 6402 Email support bmjgroup com North and South America Tel 1 800 358 6473 toll free Fax 1 205 995 1588 Email bmj clinicalevidence ebsco com I am an NHS professional doctor nurse pharmacist librarian manager or other Can I get online access Online access is free to NHS professionals in Wales Wales Health of Wales information service We regret that free online access through the NHS in England and NHS Education in Scotland is no longer available Any individual or institution can subscribe to Clinical Evidence See our products page for more information As a subscriber how long does my online access last Your online access lasts for 12 months You will be notified when you need to renew your subscription Can I have a free trial before subscribing You can register for a free trial to try Clinical Evidence for 7 days Once your trial ends you have the choice of purchasing a subscription to Clinical Evidence online Alternatively you can purchase access to the online content with pay per view or the season ticket As an institution can we purchase a limited number of online accesses for concurrent users We regret that this option is no longer available Can I make orders online You can make online payments for the following Clinical Evidence handbook online mobile pay per view and season ticket How do I get pay per view or season ticket access You can purchase access to pay per view and season ticket on

    Original URL path: http://www.clinicalevidence.org/x/set/static/cms/online.html (2016-02-01)
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