USER GUIDE（English） CE user guide

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USER GUIDE

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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.

Helping you teach, learn

and practise evidence-based

medicine

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 lealets so you can provide your patients with plain-English information about treatment options for their disease

• All of this within a single, evidence- based resource

Introduction

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Getting started with Clinical Evidence

Your guide to the Clinical Evidence

home page

1. FINDING EVIDENCE

Browse or search the full Clinical Evidence database 2. DISCOVER MORE ABOUT EBM

Additional EBM resources and links are found here 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

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

8. SITE SETTINGS

Review and modify your bookmarks and BMJ Portfolio

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Browse and search

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.

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. 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.

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.

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.

Clinical Evidence includes systematic

reviews, guidelines and patient lealets

for over 190 conditions. There are

several ways to find the information you

need in Clinical Evidence.

BROWSE BY CLINICAL AREA

TEXT SEARCH

ALPHA LISTING FILTER BY

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INTERVENTIONS A summary of individual

interventions ranked by effectiveness -– see page 8 for further details

GUIDELINES Links to major guidelines

relevant to the review BACKGROUND Background information

about the condition PATIENT INFORMATION View and download relevant

patient information lealets

CITATIONS

Links to relevant external articles relating to this condition that have been published subsequent to the systematic review of the literature

KEY POINTS

A one-page summary of the review

REFERENCES

View a full list of the literature included in the current systematic review

CREDITS

Information on contributors and declaration of any competing interests

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.

Navigating around a review

LATEST GUIDELINES View a list of the most recently updated major guidelines relevant to the current topic.

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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

PDF

Download the full multi-page review in PDF format

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

PRINT

Print a copy of the current page

LATEST CITATIONS View the latest articles for the current topic, identified in conjunction with McMaster Plus.

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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

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 beneicial 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.

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Reading the full text

Discover more about EBM

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.

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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

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Clinical Evidence on the move

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 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 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.

Clinical

Evidence

Handbook

The international source of the best available evidence for effective health care

JUNE 2012

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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