Evidence Based Searches in the Emergency Department

Journal Club – February 25, 2010

Evidence Based Medicine

PART 1

Evidence Based Searches in the Emergency Department

There are several online resources that are ideal for answering Evidence Based questions quickly and accurately while working in the Emergency Department. One resource is:

Trip Database is a Free Online Evidence Based search engine that easily filters search results based on type of evidence. Let’s try it out.

Scenario #1

You are working an overnight shift at the Foothills Hospital and you just finished seeing a 50yr old female with a two-week history of intermittent postprandial RUQ pain. Eager to tryout the department’s new Ultrasound Machine you wonder what the test characteristics of Emergency Department based Biliary Ultrasound are.

Question#1:

Using Tripdatabase find out the sensitivity and specificity of Emergency Department US for the diagnosis of Biliary Colic and Acute Cholecystitis.

Answer:

Biliary Colic

Sensitivity = Specificity =

Acute Cholecystitis

Sensitivity =Specificity =

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Pubmedis a great resource for searching literature. For answering clinical Evidence Based questions Pubmed has a specific search feature that helps you do this in a quick and efficient manner.

Instead of using the general search heading click on the “Clinical Queries” section.

The Clinical Queries section has pre-set research methodology filters designed to access the best available evidence by providing expedient and efficient access to reliable clinical studies. You may search under one of four study categories and two type of retrieval emphasis. Clinical Queries will NOT supply a comprehensive literature search, but rather it provides a quick and easy answer to specific questions.

Scenario # 2

You just saw a 35yo male with recurrent renal colic in the Raz area of the PLC. You are unsure what the evidence is regarding acute pain control in renal colic.

Question #2:

What is the most effective method of pain control in renal colic.Morpine? Ketorolac? Both? Go to and click on the “Clinical Queries” section and perform a search.

Answer:

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Another quick note about Pubmed. Consider using the My NCBI feature in the future. This section allows you to save searches, and articles to an online profile.

This feature is useful when preparing a talk or a paper to keep your searches and articles saved. Additionally after saving one of your searches, you can receive notifications via email when any new articles under that search appear on Pubmed.

PART 2

Staying uptodate

There are many excellent online resources that make it easy to keep uptodate on new Emergency Medicine research.One of the best free evidence based resources is BMJ Evidence Updates.

Through this resource you are notified through email when there are new-high quality publications in your area of choice.

The articles are selected trough a systematic review of over 120 journals and a quarterly review of the Cochrane Library. Each article is screened for explicit quality criteria to be selected. Each article that is selected is then rated for clinical relevance and newsworthiness by at least 3 practitioners from each pertinent specialty. The articles are rated on the McMaster Online Rating of Evidence Scale

If interested, you can fill out your contact information and subscribe for weekly notifications of articles that meet your threshold of clinical relevance and newsworthiness.

Go to and click on register here in the top right hand corner.

After checking out the website for a bit.

Question #3:

Can you find what thehighest rated articlewas in Emergency Medicine in the last 365 days?

Answer:

Question #4:

What was the most readEmergency Medicine article in the past thirty days? (Hint: Go to home and look under Hit parade.)

Answer:

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If you liked this resource consider checking out:

Similar to Evidence Updates. Email notification and ranking review of articles

Excellent clinical resource - $$$ for full access