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Indian Journal of Pharmacology
Medknow Publications on behalf of Indian Pharmacological Society
ISSN: 0253-7613 EISSN: 1998-3751
Vol. 36, Num. 3, 2004, pp. 190-191

Indian Journal of Pharmacology, Vol. 36, No. 3, June, 2004, pp. 190-191

Web-Wise

Netting the evidence

Website Editor, IJP, JIPMER, Pondicherry - 605006.
Correspondence Address:Website Editor, IJP, JIPMER, Pondicherry - 605006. jatindersingh@vsnl.com

Code Number: ph04069

Figure

The information explosion in health sciences has made medical decision-making an extremely complex undertaking with an integration of health economics, operational research, management sciences, epidemiology, statistics, and information sciences amongst others. Rapid access to and dissemination of information are essential components of the health sciences sector where researchers must have access to the most recently published information.

Health professionals also need to be able to critically evaluate scientific methodology and conclusions of information in order to sort the "wheat from the chaff". This is where evidence-based medicine steps in. Less than a decade ago the concept of ′evidence-based practice′ did not exist and since its introduction, originally in the domain of medicine, it has quickly migrated to fields as diverse as pathology, mental health, pharmacotherapy and in disciplines such as social work, education and human resource management. Thus, regardless of the role of an individual in an organization, evidence-based practice helps in deciding if a particular intervention is better than the alternative when faced with an uncertain situation. The process of intelligently identifying the superior option based on previous published research forms the essence of evidence-based practice. It is best illustrated by the definition, "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."

The School of Health and Related Research of the University of Sheffield, United Kingdom (ScHARR) works in conjunction with the National Health Service (NHS) to conduct applied and methodological health services research, consultancy and teaching programs for health services staff. One of the services that the School provides is a very comprehensive website with an annotated list of links to over 100 evidence-based medicine sites, prepared by Andrew Booth (a.booth@sheffield.ac.uk). The website very appropriately christened www.nettingtheevidence.org.uk has a simple interface and professes to, "facilitate evidence-based healthcare by providing support and access to helpful organizations and useful learning resources, such as an evidence-based virtual library, software and journals".

The "Library" tab further links to various resources, from the Oxford Center for Evidence-Based Medicine (www.cebm.net) to others. These library resources collectively tend to introduce evidence-based medicine, its limitations and the coverage of its applicability in practice. A collection of articles from the Journal of American Medical Association (JAMA), Annals of Internal Medicine, British Medical Journal (BMJ), British Journal of Clinical Practice and the American College of Physicians deals with diverse topics, namely systematic reviews, meta-analysis, controlled clinical trials, research methods in primary care in addition to others. Of particular interest in this section is the exhaustive BMJ collection on "How to read a paper?"

The "Searching" link lists certain external sites that supplement retrieval of specific information. Various electronic databases, clinical trial sites, websites that focus on protocol design and development are also included. The "Appraisal" link focuses on evaluation methodologies followed by various centers in different countries http://www.shef.ac.uk/~scharr/ir/adept/. Standardized checklists for appraisal in different settings form the backbone of this page. The "Implementing" page seeks to put evidence-based medicine into practice; this is done through relevant links on standardized clinical methods, diagnostic methodologies, practice guidelines, reporting guidelines and certain training modules.

The "Software" link essentially has two programs on statistics, one on producing reviews and the other on clinical decision-making. These software programs are free or have downloadable trial versions. The "Journals" link lists a number of journals that are dedicated to evidence-based medicine. The "Databases" link goes on to list various electronic resources, which could form the basis for implementing evidence-based medicine. The "Organizations" listed under this link are surprisingly many which goes on to prove that evidence-based practice is of immense applicability in all disciplines. A noteworthy link in this category is WISDOM (www.wisdomnet.co.uk) which lists various tutorials related to evidence-based practice. The website is a commendable attempt at bringing together a number of scattered resources on evidence-based practice. The contents are a valuable source of ready information for healthcare providers, researchers, administrators, academicians and everyone interested in the judicious use of information in the provision of health care.

Copyright 2004 - Indian Journal of Pharmacology


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