USER GUIDE
clinicalevidence.bmj.com
Contents
Introduction … … … … … … … … … … … … … … … … … 3
Getting started with Clinical Evidence … … … … … … 4
Browse and search … … … … … … … … … … … … … … 5
Navigating around a review … … … … … … … … … … … 6
Overview of effectiveness … … … … … … … … … … … 7
Discover more about EBM … … … … … … … … … … … 8
News and alerts … … … … … … … … … … … … … … … 9
Clinical Evidence on the move … … … … … … … … … 10
Contact Clinical Evidence … … … … … … … … … … … 11
clinicalevidence.bmj.com
2
Introduction
Helping you teach, learn
and practise evidence-based
medicine
Clinical Evidence brings you the best available evidence for a wide
range of conditions, and provides you with the necessary evidencebased medicine (EBM) skills and tools to make effective use of
published research, and to improve clinical practice and patient
outcomes.
Following the rigorous, gold-standard Clinical Evidence methodology,
we systematically find, assess and summarise the most relevant
evidence for a wide range of common clinical questions, and display
systematic review findings in a quick- and easy-to-use format.
We continuously develop and improve the Clinical Evidence website,
to ensure that we provide the best possible knowledge resources for
your EBM needs. Based on extensive customer feedback, we have
recently added numerous extra tools designed specifically to enhance
the teaching, learning and practice of EBM – including guidance on
designing literature searches, appraising evidence, calculating and
assessing risk, and explaining EBM to patients.
This user guide introduces you to the essential features of Clinical
Evidence, and will help you get the most out of them.
We very much welcome all your feedback. Please send us your
thoughts and ideas via the ‘Feedback’ button on every page, or by
emailing us at support@bmjgroup.com. We look forward to hearing
from you.
3
Please explore the website at
clinicalevidence.bmj.com.
Below are just some of the key
features that you will discover:
• Systematic reviews of more than
3,200 interventions relating to over
190 common conditions
• At-a-glance overview of the
effectiveness of treatments for over
670 clinical situations
• Access to all the most relevant
research findings
• Simple user interface to minimise
the number of clicks required to
reach information
• GRADE scores ranking the quality
of the evidence presented
• Regular updates and new topics
• Unique resources to help you learn,
teach, and practise evidence-based
medicine
• Available for smartphones and
PDAs to provide answers on the
move
• Patient information leaflets so you
can provide your patients with
plain-English information about
treatment options for their disease
• All of this within a single, evidencebased resource
clinicalevidence.bmj.com
Getting started with Clinical Evidence
Your guide to the Clinical Evidence
home page
8
1. FINDING EVIDENCE
Browse or search the full Clinical Evidence database
2. DISCOVER MORE ABOUT EBM
Additional EBM resources and links are found here
1
3. NEW AND RECENTLY UPDATED REVIEWS
Keep up to date with the latest evidence – these
links highlight recently added and updated reviews
4. LATEST CITATIONS
See the latest evidence discovered through our
ongoing literature horizon scanning
2
5. FIND OUT MORE ABOUT CLINICAL EVIDENCE
Discover how we create our renowned systematic
reviews
6. RECOMMEND CLINICAL EVIDENCE
Click on these links and enter a friend, colleague or
institutional contact’s e-mail address to recommend
Clinical Evidence
7. MANAGE YOUR ACCOUNT
Set up and manage your Clinical Evidence account,
e-mail alerts and RSS feeds
3
7
5
6
8. SITE SETTINGS
Review and modify your bookmarks and BMJ
Portfolio
clinicalevidence.bmj.com
4
4
Browse and search
TEXT SEARCH
BROWSE BY
CLINICAL AREA
ALPHA LISTING
FILTER BY
BROWSE BY CLINICAL AREA
If you are looking for evidence on a particular topic, you
can use the drop-down Conditions browser by clicking on
the ‘Show Conditions’ button at the top of every Clinical
Evidence screen.
Clinical Evidence includes systematic
reviews, guidelines and patient leaflets
for over 190 conditions. There are
several ways to find the information you
need in Clinical Evidence.
FREE-TEXT SEARCH
You can use the ‘Search Clinical Evidence ’ free-text search
box at the top of every page to find a particular word or
phrase from anywhere within Clinical Evidence. Search
results include a selection of text from the relevant article
to help put each result into context.
Choosing a clinical area from the list (e.g. ‘Diabetes’) will
display all articles relevant to that area. You can also filter
articles by Systematic Reviews, Citations, Guidelines or
Patient Information using the buttons above the topic list.
FILTERING SEARCH RESULTS
Results can also be filtered by type – Systematic Reviews,
Citations, Guidelines or Patient Information – using the
buttons above the search results, to help you find the exact
information you are looking for.
ALPHABETICAL LISTING
The ‘Conditions’ browser also allows you to browse the full
contents of Clinical Evidence alphabetically. Click on the ‘All
Conditions’ button to display alphabetical tabs above the
article list.
5
clinicalevidence.bmj.com
Navigating around a review
Once you have located the review that interests you,
Clinical Evidence presents the information with a tabbed
sub-menu. This evidence has been selected by systematic
and rigorous searching to answer clinical questions while
focusing on outcomes that matter most to patients
and clinicians. Each treatment or intervention is then
categorised according to its benefits and harms.
The core evidence is supplemented by links, references, and
additional information.
INTERVENTIONS
A summary of individual
interventions ranked by
effectiveness -– see page
8 for further details
CITATIONS
Links to relevant external articles
relating to this condition that have
been published subsequent to the
systematic review of the literature
GUIDELINES
Links to major guidelines
relevant to the review
KEY POINTS
A one-page summary of the
review
BACKGROUND
Background information
about the condition
REFERENCES
View a full list of the literature
included in the current systematic
review
PATIENT INFORMATION
View and download relevant
patient information leaflets
CREDITS
Information on contributors
and declaration of any
competing interests
clinicalevidence.bmj.com
6
LATEST GUIDELINES
View a list of the most
recently updated major
guidelines relevant to the
current topic.
ADD NOTES
Click here to add notes
to any article. Notes will
appear at the top of the
relevant page, and can
be edited or deleted as
necessary.
BOOKMARK
Add the current page to
your Clinical Evidence
bookmarks for easy
reference – these can be
reviewed and modified
through the ‘site settings’
menu at the top of each
screen
ADD TO PORTFOLIO
Add the page to your
BMJ Portfolio (see
portfolio.bmj.com for
further information)
FEEDBACK
Submit feedback
on the current
page directly to the
Clinical Evidence
team
PRINT
Print a copy of the
current page
PDF
Download the full
multi-page review in
PDF format
LATEST CITATIONS
View the latest articles
for the current topic,
identified in conjunction
with McMaster Plus.
7
clinicalevidence.bmj.com
Unique to Clinical Evidence: overview of effectiveness
The Clinical Evidence team regularly
assess the available evidence for a
range of conditions, with a focus on
clinical questions most frequently
asked by practitioners. Interventions
related to each question are
summarised in a table and categorised
by efficacy for most patients, with
icons for easy reference. Click the
description of each intervention to
access a summary, details of the
associated benefits and harms, and a
commentary.
EFFECTIVENESS CATEGORIES
Beneficial
For which effectiveness has been demonstrated by clear
evidence from systematic reviews, RCTs, or the best alternative
source of information, and for which expectation of harms is
small compared with the benefits.
Likely to be beneficial
For which effectiveness is less well established than those listed
under “beneficial”.
Trade-off between benefits and harms
For which clinicians should weigh up the beneficial and harmful
effects according to individual circumstances and priorities.
Unknown effectiveness
For which there are currently insufficient data or data of
inadequate quality.
Unlikely to be beneficial
For which lack of effectiveness is less well established than
those listed under “likely to be ineffective or harmful”.
Likely to be ineffective or harmful
For which ineffectiveness or associated harm has been
demonstrated by clear evidence.
clinicalevidence.bmj.com
8
Discover more about EBM
Reading the full text
In addition to carefully selected links to other
evidence based materials, publications and
organisations, Clinical Evidence offers a variety
of other resources to help keep you up-to-date
and to help you practise EBM.
LEARN EBM
This section of the site provides a selection of articles that
explain the building blocks of EBM – identifying a clinical
question, designing and conducting a systematic review,
study design search filters, and evidence synthesis and
appraisal.
PRACTISE EBM
Clinical Evidence includes guidance on translating evidence
into improved patient outcomes. This section of the site
features a number of downloadable case studies that show
how systematic reviews from Clinical Evidence can be
applied to patient scenarios, tools for assessing risk, and
ways to explain EBM to patients.
EBM TOOLBOX
The EBM Toolbox section has been designed as an invaluable
reference resource for day-to-day practice of EBM. In this
section of the site, you will find sets of critical appraisal
checklists for assessing trials and systematic reviews, an
interactive statistical calculator, an EBM glossary and list of
common abbreviations.
9
clinicalevidence.bmj.com
News and alerts
Clinical Evidence helps you monitor
what is happening in the world of
EBM, and beyond, with a variety of
tools that alert you to new content,
findings and news.
RSS UPDATES
Subscribe to our RSS feeds and be notified of new
updates as soon as they are published.
EMAIL ALERTS
Receive notification when new reviews or updates
are added to Clinical Evidence.
EVIDENCE UPDATES
In collaboration with McMaster Plus, the
BMJ Evidence Centre publishes regular Evidence
Updates via e-mail. Sign up for this free service at
http://group.bmj.com/products/evidence-centre/
evidence-updates
clinicalevidence.bmj.com
10
Clinical Evidence on the move
Clinical Evidence Cover Jun2012 03/04/2012 12:24 Page 1
Health professionals need to find quick answers to
clinical questions wherever they are. It’s not always
possible to check the evidence on a computer, so
Clinical Evidence is also available in two portable
formats.
Clinical Evidence is the continually updated international source
of the best available evidence on the effects of common clinical
interventions. It provides a succinct account of the current state
of evidence on the prevention and treatment of a wide range of
clinical conditions. It can be used by anyone making decisions
about patient care.
JUNE
2012
The Clinical Evidence Handbook amalgamates the entire
summary information into an easy-to-use format.
Reviews regularly updated and expanded
l
Monthly updates online at clinicalevidence.bmj.com. Refer to
the website for the most up to date content
l
Systematically reviews the evidence from thousands of original
studies, summarising what is known about the benefits and
harms of 3306 interventions, in the context of 675 specified
clinical situations
l
Written by clinicians and peer reviewed by independent experts
l
Uses explicit methodology for selecting which evidence to
summarise
l
Identifies gaps in the evidence
l
Presents the balance between the benefits and harms of
interventions
l
Covers medical, surgical, nursing, and complementary medicine
CLINICAL EVIDENCE HANDBOOK
Published biannually in June and December
Containing summary and background information for each topic
and recently enhanced to be more efficient at the point of care, this
handbook is an essential reference tool for healthcare professionals when
they are away from their computer.
Clinical Evidence Handbook
l
Clinical
Evidence
Handbook
The international source of
the best available evidence
for effective health care
JUNE
2012
ISBN 978-1-905545-62-9
ISSN 1475-9225
CLINICAL EVIDENCE ON SMARTPHONES AND PDAS
The key information from Clinical Evidence online can now also be
delivered to your Android, Blackberry, Apple iOS (iPhone, iPad and iPod
Touch), Windows Mobile or PalmOS device. Access to the latest evidence
– wherever it’s needed – enables healthcare professionals to quickly
make informed and effective treatment decisions for their patients.
See clincalevidence.bmj.com for more information.
11
clinicalevidence.bmj.com
Contact Clinical Evidence
For more information, please contact:
BMJ Group,
Sales department,
BMA House,
Tavistock Square,
London, WC1H 9JR,
UK
Tel: +44 (0) 207 383 6693
Fax: +44 (0) 207 383 6661
Email: consortiasales@bmjgroup.com
US: +1 800 348 6473
clinicalevidence.bmj.com
12