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Evidence-Based Medicine: In Sherlock Holmes' Footsteps

ISBN: 978-1-4051-5713-1
104 pages
December 2006, Wiley-Blackwell
Evidence-Based Medicine: In Sherlock Holmes
This lively handbook on the fundamentals of Evidence-based Medicine (EBM) leads the reader, step by step, through a process that proceeds from a patient’s medical history, via information searches and critical appraisal of the literature, to recommendations for treatment.

Using a simple four-step approach, the author illustrates how to develop better questions and more effective searches, resulting in objective and clinically relevant information that can be evaluated and implemented in day-to-day practice. Sherlock Holmes and Dr Watson, the famous fictional detectives, assist throughout, drawing parallels between criminal and medical investigation, and simplifying the processes and themes of EBM.

Evidence-Based Medicine in Sherlock Holmes’ Footsteps is a concise, accessible and instructive introduction to EBM for medical students, health care trainees, doctors and allied health professionals, and a valuable resource for anyone wanting to improve their ability to search, access and interpret the wealth of information at the fingertips of today’s medical community.

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FOREWORD.

INTRODUCTION.

STEP 1 FORMULATE AN ANSWERABLE QUESTION.

Information Sources.

Choosing the Appropriate Database.

Systematic Reviews/Meta-Analysis.

Meta-Search Engines.

Clinical Practice Guidelines.

Critically Appraised Topics (CATs).

Primary Information Sources.

Library Resources.

Other EBM Portals.

STEP 2 INFORMATION SEARCH.

Make a Wide Search with High Sensitivity.

Principal Database Search Strategy.

Limit Your Search Results/Increase Your Specificity.

Use a Good Hit for Further Searches.

STEP 3 REVIEW OF INFORMATION AND CRITICAL APPRAISAL.

Quality Assessment of Information.

Evaluation of the Scientific Quality.

Quality of Evidence.

STEP 4 EMPLOY THE RESULTS IN YOUR DAILY PRACTICE.

Applicability.

Balance between Benefit and Harm.

Strength of Recommendation.

Patient’s Perceptions.

Make a Recommendation.

Communicating the Evidence to Your Patient.

DEDUCTION, ANALYSIS AND MEDICINE.

REFERENCES.

SUMMARY OF INFORMATION SOURCES AND SEARCH ENGINES.

INTERNET-BASED SPREADSHEETS.

SHERLOCK HOLMES REFERENCES.

LIST OF ILLUSTRATIONS.

RECOMMENDED EBM LITERATURE.

GLOSSARY.

INDEX

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Jorgen Nordenstrom Karolinska University Hospital, Solna, Stockholm, Sweden
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A unique and user-friendly step-by-step introduction to evidence-based medicine

  • Breaks the evidence-based approach into four steps: formulating an answerable question; information search; reviewing information and critical appraisal; employing the results in daily practice
  • Introduces concepts with the use of easy-to-remember acronyms, clinical examples, tables, illustrations and selective quotes from Sherlock Holmes
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"A useful and introductory book … Small and easy to read. The arrangement and layout of the book are easy on the eye … Some interesting examples used to explain some of the basic concepts." (Evidence Based Medicine, August 2008)

"Small enough to read on the bus to placement but contains enough 'meat' to keep you entertained. It is clearly set out, and using Sherlock Holmes' steps really makes it a novel and interesting read. I think it's the best evidence based decision making book I have read." (The Placebo Effect, HYMS Gazette)

“Based on a solid foundation…concise…handbook that learners and practitioners alike could easily carry around…In this regard, the book is quite a success.” (Canadian Medical Association Journal)

Reviews of the original Swedish publication

”The entertaining analogy between critical appraisal and Sherlock Holmes´detective work, with well-found and appropriate quotations, makes the reading a pure pleasure.” (Läkartidningen 2004; 40:3100-1)

”The book is a little pearl and is warmly recommended.” (Ugeskrift for Laeger 2004; 18 October:43)

”The author has succeeded in creating a comprehensive, relevant and at times witty book. It is a useful and readable introduction [to EBM] that is warmly recommended.” (Tidskrift for den Norske Laegeforening 2005;1:125)

”[The author]has written an ingenious book, a compact EBM textbook in a light format, with a twinkle in his eye. The subject has been packaged for easy digetion – fish liver oil encapsulated in candy.” (Lääkärilehti 2005;3:322)

”This book written by Surgery Professor J.N. is a little pearl! Not only is it tasteful, humorous and well structured; it is also comprehensive, nutritious and – most importantly- understandable in an area where other more voluminous books fail.” (Svensk Bibliotekstjänst 2004:15)

“This is the best book I’ve ever read regarding how to do EBM – it teaches you how to do powerful, effective searches for medical literature and how to review the evidence. All that you know you should be learning about EBM but previously found it difficult to start – they're spelled out clearly in this tiny beautiful book. The book’s layout was very clear, and I found myself looking forward to reading it as I practised the steps myself and found almost immediate improvement in my EBM skills.”
Medical student, Edinburgh University

"I would almost certainly recommend it as a core text for anyone serious about scientific research and study. I would and will be using this book alongside every essay in the future that I have to prepare...A fantastic introduction on how to access the best information available using the forbidding databases and online search engines with a step by step approach to critically appraising original scientific literature...It has completely changed the way I will approach essay writing and literature searches forever. I have often been daunted by critical appraisal and no-one has ever really managed to capture and present such an important skill until now." –Medical student, Glasgow University

“Evidence-Based Medicine in Sherlock Holmes’ Footsteps presents key information within EBM in a highly original format and provides a very good introduction to the main concepts of EBM.; this book helps to further consolidate your understanding of the main concepts. This text provides an original way to focus on scientific integration of wider epidemiology with individual patient requirements. It shows how EBM can be practiced in a variety of clinical settings and gives good practical advice for accessing the best evidence quickly and effectively.”
Medical student, Bristol University

"This is the best book I've ever read regarding how to do EBM. It teaches you how to do powerful, effective searches for medical literature and how to review the evidence. All that you know you should be learning about EBM but previously found it difficult to start - They're spelled out clearly in this tiny beautiful book."
Medical Student, University of Edinburgh

“This small quirky book uses examples from Sherlock Holmes to demonstrate how to get the most from published journals, and how to critically appraise the quality of the information gathered from your detective work. A fascinating read that makes EBM more accessible to the masses. Learn at the hand of the master. This really is a great little book!“
Medical student, University of East Anglia

I'm so happy that I was able to review this book. It has completely changed the way I will approach essay writing and literature searches forever. I have often been daunted by critical appraisal and no one has ever really managed to capture and present such an important skill until now. I hope this book evolves with the search engines and data management systems so that it will always be useful to current and future generations of students. It won't be long until this becomes recommended reading for many science based courses and those monotonous hours spent being shown database searches by librarians become obsolete."
Medical Student, University of Glasgow

"This really is a great little book! Size wise it’s good- not big enough to put you off, and easy to handle and read. The format is very functional. The layout and presentation are easy to follow and the examples are clear and interesting. High quality diagrams and pictures add to the ambiance."
Medical Student, UEA

”It is well written, covers the basics and is delightfully concise.”
Andy Oxman, Norweigian Health Services Research Center

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