Article Text

PDF

Purpose and procedure

Statistics from Altmetric.com

The general purpose of Evidence-Based Medicine is to select from the health-related literature* those articles reporting important advances in internal medicine, general and family practice, surgery, psychiatry, paediatrics, and obstetrics and gynaecology, and whose results are most likely to be both true and useful. These articles are described, critiqued and commented on by clinical experts. The specific purposes of Evidence-Based Medicine are:

  • to identify, using predefined criteria, the best original and review articles on the cause, course, diagnosis, prevention, treatment, quality of care, or economics of disorders in the foregoing fields

  • to provide a description and expert commentary on the context of each article, its methods, and the clinical applications that its findings warrant

  • to disseminate the summaries in a timely fashion

The BMJ Publishing Group publishes Evidence-Based Medicine.

Criteria for selection and review of articles

All articles in a journal issue are considered for inclusion if, based on their abstracts, they meet the following basic and category-specific criteria:

Basic criteria

All English-language original and review articles in an issue of a candidate journal are considered for abstracting if they concern topics important to the clinical practice of internal medicine, general and family practice, surgery, psychiatry, paediatrics, or obstetrics and gynaecology

Prevention of treatment, quality improvement

  • Random allocation of participants to interventions

  • Outcome measures of known or probable clinical importance

Diagnosis

  • Inclusion of a spectrum of participants, some (but not all) of whom have the disorder or derangement of interest

  • Each participant must receive the new test and the diagnostic standard test

  • Either an objective diagnostic standard or a contemporary clinical diagnostic standard with demonstrably reproducible criteria for any subjectively interpreted component

Prognosis

  • An inception cohort of persons, all initially free of the outcome of interest

  • Follow-up of >80% of patients until the occurrence of either a major study end point or the end of the study

Causation

  • Observations concerning the relation between exposures and putative clinical outcomes

  • Clearly identified comparison group(s) for those at risk for the outcome of interest (in descending order of preference from randomised controlled trials, quasi-randomised controlled trials, nonrandomised controlled trials, cohort studies with case by case matching or statistical adjustment to create comparable groups, to nested case-control studies), preferably with prospective data collection

Economics of healthcare programmes or interventions

  • The economic question must compare alternative courses of action in real or hypothetical patients

  • The alternative diagnostic or therapeutic services or quality improvement strategies must be compared on the basis of both the outcomes they produce (effectiveness) and the resources they consume (costs)

  • Evidence of effectiveness must come from a study (or studies) that meets criteria for diagnosis, treatment, quality assurance, or review articles

  • Results should be presented in terms of the incremental or additional costs and outcomes incurred and a sensitivity analysis should be done

Clinical prediction guides

  • The guide must be generated in 1 set of patients (training set) and validated in an independent set of real not hypothetical patients (test set), and must pertain to treatment, diagnosis, prognosis, or causation

Differential diagnosis

  • A cohort of patients who present with a similar, initially undiagnosed but reproducibly defined clinical problem

  • Clinical setting is explicitly described

Systematic reviews

  • The clinical topic being reviewed must be clearly stated; there must be a description of how the evidence on this topic was tracked down, from what sources, and with what inclusion and exclusion criteria

  • >1 article included in the review must meet the above-noted criteria for treatment, diagnosis, prognosis, causation, quality improvement, or the economics of healthcare programmes

Articles meeting the criteria set out above and chosen for coverage in Evidence-Based Medicine are described and reviewed by an expert in the content area covered by the article. This expert writes a commentary in which she or he describes the article and compares the study findings to previous research findings, identifies any important methodological problems that affect interpretation of the study results, and offers recommendations for clinical application.

View Abstract

Footnotes

  • * Journals currently reviewed

    Acta Psychiatrica Scandinavica

    Addiction

    Age and Ageing

    American Journal of Gastroenterology

    American Journal of Medicine

    American Journal of Psychiatry

    Annals of Emergency Medicine

    Annals of Internal Medicine

    Annals of the Rheumatic Diseases

    Annals of Surgery

    ANS Advances in Nursing Sciences

    Applied Nursing Research

    Archives of Disease in Childhood Neonatal and Fetal

    Archives of General Psychiatry

    Archives of Internal Medicine

    Archives of Neurology

    Archives of Pediatric and Adolescent Medicine

    Arthritis and Rheumatism

    Australian and New Zealand Journal of Psychiatry

    Behaviour Research and Therapy

    Birth

    BJOG

    BMC Psychiatry

    BMJ

    British Journal of Clinical Psychology

    British Journal of General Practice

    British Journal of Psychiatry

    British Journal of Surgery

    Canadian Journal of Gastroenterology

    Canadian Journal of Infection Control

    Canadian Journal of Psychiatry

    Canadian Respiratory Journal

    Circulation

    CMAJ

    Cochrane Database of Systematic Review

    Critical Care Medicine

    Developmental Medicine and Child Neurology

    Diabetes Care

    Diabetic Medicine

    Eur Child Adolesc Psychiatry

    Evid Rep Technol Assess (Full Rep)

    Gastroenterology

    Gut

    Health Education and Behavior

    Health Psychology

    Health technology assessment reports

    Heart

    Journal of Nursing Scholarship

    International Journal of Geriatric Psychiatry

    JAMA

    Journal of Abnormal Child Psychology

    Journal of Advanced Nursing

    Journal of Affective Disorders

    Journal of Anxiety Disorders

    Journal of Child Psychology and Psychiatry and Allied Disciplines

    Journal of Clinical Epidemiology

    Journal of Clinical Nursing

    Journal of Clinical Psychiatry

    Journal of Clinical Psychopharmacology

    Journal of Consulting and Clinical Psychology

    Journal of Family Practice

    Journal of Infectious Disease

    Journal of Manipulative and Physical Therapy

    Journal of Neurology, Neurosurgery, and Psychiatry

    Journal of Pediatrics

    Journal of Psychosomatic Research

    Journal of the American Academy of Child and Adolescent Psychiatry

    Journal of the American Geriatrics Society

    Journal of Vascular Surgery

    Lancet

    Medical Care

    Medical Journal of Australia

    Medicine

    Midwifery

    Molecular Psychiatry

    Neurology

    New England Journal of Medicine

    Pain

    Pediatrics

    PLOS Medicine

    Psychiatric Services

    Psychological Medicine

    Psychosomatic Medicine

    Qualitative Health Research

    Rheumatology

    Schizophrenia Bulletin

    Schizophrenia Research

    Social Science and Medicine

    Spine

    Stroke

    Thorax

    Western Journal of Nursing Research

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.