Purpose and procedure ===================== 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 * ■. o 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 * ■. he economic question must compare alternative courses of action in real or hypothetical patients * ■. he 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. ## 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 horax Western Journal of Nursing Research