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

Resource Corner

Evidence-based Medicine Toolkit (2nd edition)


ACP J Club. 2006 Sep-Oct;145:A11. doi:10.7326/ACPJC-2006-145-2-A11

Evidence-based Medicine Toolkit (2nd Edition) serves the need for an evidence-based medicine (EBM) book that is both reliable yet does not intimidate the reader by its voluminous size. Ideally, a toolkit is neatly compartmentalized, contains all the tools required to carry out the job, and can be used by both basic and advanced students. Evidence-based Medicine Toolkit fully serves these ideals. It is a highly portable book of 105 pages (which could easily fit into a student's coat pocket) immensely readable, and complete. Developed from materials created at the Centre for Evidence-based Medicine, Oxford University, UK, the book is designed to provide the reader with all the essential elements of EBM.

The book comprises 11 chapters and supplementary materials and is well organized. The layout of the book is excellent with prominent displays of key tables containing relevant information, making these tools readily usable. The first page of each chapter displays a checklist summarizing the key points for rapid perusal. Sections within each chapter provide background information and address each point in adequate detail. The chapters are usually brief and can be read in less than 30 minutes. Key points in the appraisal process are highlighted by a “dustbin” icon. If the paper under review does not address these points the reader is advised to discard the paper and not waste precious time. Each chapter ends with selected key references for additional reading.

Several chapters merit special mention. The chapter on Finding the Evidence urges the readers to look for evidence in the TRIP Database, EBM Online, Clinical Evidence, or Cochrane Library before looking at other derivative sources (CATs, Health Technology assessment reviews) or primary sources (MEDLINE, EMBASE) of evidence or the Internet. Guidelines are provided to assess the quality of generic Internet search engines, such as Google, and assess credibility of Web-based sources of information. Searching MEDLINE using textwords, thesaurus search terms, and search filters is highlighted. Searching the MEDLINE or PubMed using the PICO format (Patient, Intervention, Comparison, Outcome) by a new service called AskMedline is encouraged.

In addition to routine chapters on critical appraisal of studies of diagnosis, therapy, prognosis, and systematic reviews, the book also includes a chapter dedicated to appraising qualitative studies and economic evaluations. A chapter on applying the evidence to patients provides a checklist of items to help the practitioner.

Sections at the end of the book provide an EBM glossary, selected important EBM Web sites (both English and non-English), levels of evidence, and notes on study designs. Several new Web sites on statistical calculators and the GATE tool (EPIQ: Effective Practice, Informatics and Quality Improvement) provide the reader with new and innovative information on EBM.

Perhaps the only drawback of the book is the section on levels of evidence, as there is currently no consensus on the use of these levels.

In summary, the text is handy, well organized, and offers comprehensive information on EBM for both the medical student and the busy practitioner conversant with the basic principles of EBM.

Amit K. Ghosh, MD
Mayo Clinic College of Medicine
Rochester, Minnesota, USA


Methods/Quality of Information: 4 of 5 stars

Clinical Usefulness: 5 of 5 stars

Evidence-based Medicine Toolkit is available from for U.S. $24.95.