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Consensus abstracts for evidence-based medicine

2011; BMJ; Volume: 16; Issue: 2 Linguagem: Inglês

10.1136/ebm20003

1473-6810

Paul Fontelo,

Clinical practice guidelines implementation

Consensus abstracts for evidence-based medicine Paul FonteloThe worldwide dissemination of mobile phones, now reaching more than 5 billion connections, 1 enables healthcare providers to reach medical information resources on the internet.This is particularly signifi cant because most doctors now believe that the internet is essential to the practice of medicine. 2An abundance of clinical practice resources previously unavailable to clinicians in remote locations -journal citations and abstracts from the MEDLINE/PubMed at the National Library of Medicine among them -are now accessible at the point where care is given.4][5] The reasons are obvious -they are easy to read and readily accessible, and they give the reader a quick summary of the article.The IMRAD (Introduction, Methods, Results and Discussion) format which provided the logical structure to the abstract mirrored the full-text article and made them more informative. 6 7Recent innovations, like BMJ's pico 8 format, offer even more detailed information although they are not critically appraised, unless they are derived from systematic research.For clinicians and academicians who want to practice evidence-based medicine (EBM) in an environment with unfettered access to full-text articles, the classical approach of deriving evidence through critical appraisal of the full-text article is still the ideal.However, it is not for everyone.It is diffi cult to practice and is disruptive and challenging to integrate into the daily workfl ow especially in a non-academic environment.It also requires expertise acquired through years of practice.Even the teachers of EBM at McMaster University acknowledge after years of experience with residents in their training programmes that high-level complex appraisal is not suited for everyone. 9owever, clinicians who have some appraisal skills will benefi t most from preappraised resources.Clinicians who want to practice EBM but are neither confi dent of their appraisal skills nor having the time to do their own search and appraisal can obtain on the internet many summaries, reviews and preappraised resources either for free (TRIP Database, ACP Journal Club, Cochrane Library, etc) or through paid subscription (UpToDate, 5-Minute Clinical Consult, etc).Pointers to these resources can be found on many EBM web portals.Many of these websites are very useful references for clinicians although some of their user interface may be more suitable for desktop computers and not for the small screen on mobile devices.Some features, although free, require registration to access content.For clinical practitioners in remote locations with limited access to preappraised resources, unreliable or slow or metered connections to the internet or insuffi cient computer resources, MEDLINE citations accessed through smartphones and other internet capable portable devices may be useful.