Every 2 months, a brand new issue of Evidence-Based Medicine containing 20 abstracts is published. The compact appearance belies the mounds of sifting required to arrive at the finished journal. Readers should know, though, that the process for winnowing these select articles from the published literature is systematic and thorough. This article describes the 2-stage process of validity checks followed by a rating by clinicians for relevance that is used to selected articles.

Journal staff hand search 140 journals and examine each original study or review. This hand searching amounts to 60 000 articles that are annually assessed. The 140 journals include the highly rated general medical journals (Lancet, N Eng J Med, JAMA, BMJ, CMAJ, Ann Int Med, and Cochrane reviews), plus various speciality journals that are selected on the basis of article yield—we …