Current issues of ACP Journal Club are published in Annals of Internal Medicine

Resource Corner

EBM Guidelines: Evidence Based Medicine


ACP J Club. 2004 Mar-Apr;140:A15. doi:10.7326/ACPJC-2004-140-2-A15

This electronic resource aims to provide physicians with fast and easy access to practical guidelines linked to the best available research evidence. It covers a wide range of medical conditions and is aimed at general practitioners and outpatient departments.

The first electronic version was published in 1989 as a joint venture of The Finnish Medical Society Duodecim and Duodecim Medical Publications Ltd. and is updated regularly. The editorial team is made up of experienced physicians, who work in cooperation with about 20 specialist coordinators and 300 authors. The editors review the contents of the most important English-language general medical journals, with systematic criteria for searching for evidence. The main sources of evidence are Cochrane reviews and Database of Reviews of Effectiveness (DARE) abstracts, which are evaluated as they are published. If they bear relevance to topics in EBM Guidelines, they are abstracted as evidence summaries.

EBM Guidelines currently contains 927 guidelines and 1906 evidence summaries. The interface is simple to use and information is found quickly, navigating from the guideline to an evidence summary. When a relevant Cochrane review exists, a link is made from the summary to the abstract, and the full-text review is added to the CD-ROM and the Internet databases (currently 759 full-text Cochrane reviews). The evidence summaries are updated whenever the linked Cochrane reviews are updated, ensuring that the evidence summaries are always in accordance with recent updates of the Cochrane Library. The resource also contains 772 dermatologic and ophthalmologic images and 77 audio samples.

This resource provides clinically useful answers when appropriate systematic reviews are available, but it is slightly frustrating when no pointer to the evidence is available. This occurs because it relies largely on evidence from Cochrane and DARE, so the problem will diminish as the number of Cochrane reviews increases. Furthermore, using Cochrane permits tracking of the updates, which are handily marked in the text and are visible in red. Future developments include reviewing the contents of Clinical Evidence and producing evidence summaries that are not produced by Cochrane reviews and linking to them.

The guidelines themselves although quickly viewable are quite extensive; this is the time-limiting factor in using this product. Where evidence is not available it can be difficult to gauge how valid the information is—it then feels as though you are reading a textbook. I think this is a resource worth using; clinically useful answers are available some of the time and are easily accessible and readable. Information is available within minutes and provides a useful link to the Cochrane database.

Future developments include making the evidence summaries available as a separate database. The authoring and updating of EBM Guidelines will become more international, using coordinators of Cochrane reviewers groups. Radiologic images will be incorporated. The publishers of EBM Guidelines are seemingly well equipped to maintain this resource for the future.

Carl Heneghan, BM, BCh, BA
Centre for Evidence-Based Medicine
Oxford, England, UK


Methods/Quality of Information: 5 of 5 stars

Clinical Usefulness: 4 of 5 stars

EBM Guidelines is available at for €99 (Internet, CD-ROM, or mobile handheld), €130 (Internet and CD-ROM), or €150 (Internet, CD-ROM, and handheld). Institutional pricing is available on request. A free 14-day trial is also available.