Dear Colleagues

I agree with Bruce about if you want "very digested synthesized evidence you
have to pay for".
 
However there may be exceptions.
As Alison asked about 'Clinicians' I did not specifically write about GPs
(although I am one!).
 
But it is difficult to say that MDCONSULT falls into the category of  "very
digestible evidence". It is a web site that gives many diverse important
resources - it is certainly not a database. 
 
Evidence based information access falls into four categories 
1 -Systems (Computerized Clinical Decision Support Systems) - Ideal /still
mostly theoretical
2 - Synopsis - EB journal abstracts
3 - Synthesis - Cochrane reviews
4 - Studies - original articles
 
I think when we refer to synthesized evidence' we are focusing on (2). 
 
There have been a few Internet sources that tends to provide more than one
source of (2) in one web-interface. 
OVID interface that is provided FREE to NSW medical personal is one such
synthesised resource that provides - Cochrane Library, ACP Journal Club,
Clinical Evidence, the Database of Abstracts of Reviews of Evidence (DARE)
all though a single search interface. You search using just ONE search box.
 
Even MEDSCAPE is FREE from the CIAP <http://www.ciap.health.nsw.gov.au/>
site.  
The same type of resource is now available in the US as SKOLAR
<http://md.skolar.com/index__.jsp?trg=%2Fjsp%2FAuth%2Flogin__.jsp%3Furl%3D%2
6query%3D%26category%3D%26resource%3D&nav=front> 
 
Maybe in Australia you do not have to pay for most of the synthesise
evidence!! - at least in NSW? how about in Victoria?
 
For those of who are in this very informative list from the developing world
and who are generalists (GPs/Internal Medicine) some of the resources are
FREE and excellent although it will give you only a limited amount of
clinical topics to search - e.g. Clinical Evidence (more than 200 topics and
2000 treatments) and PRODIGY <http://www.prodigy.nhs.uk/>   (NHS -UK)
 
With a little bit of training and even with a dial-up connection from the
developing world still PubMed
<http://www.ncbi.nlm.nih.gov/entrez/query/static/clinical.shtml> Clinical
queries are FREE. This is the raw material that most evidence is synthesized
from (4). 
Sometimes we have to pay for the Brand-Name (very similar to drugs) and even
Super Market items from Woolworth!!
 
I agree if you have the funds - UpToDate and DynaMed are still among the top
five -one-stop-shops for the busy clinicians.
 
Watch out for newer community initiatives like MORE
<http://hiru.mcmaster.ca/More/AboutMore.htm>  
 
Would like more information from other parts of Australia and other
countries (both economically developed and developing) 
 
Kumara 

  _____  

From: Bruce Arroll [mailto:[log in to unmask]] 
Sent: Tuesday, 30 May 2006 2:24 AM
To: K Mendis; [log in to unmask]
Subject: RE: 6 searchable electronic databases of synthesised evidence - (in
less than six clicks)


dear all
 
if you want very digested in terms of synthesized then the only valid,
uptodate, and comprehensive (if you go there you will probably get an
answer) are the ones that you have to pay for. These are
www.dynamicmedical.com, www.mdconsult.com and www.uptodate.com. For primary
care physicians you need fairly instant answers for point of care questions.
while i am a cochranite and editor for clinical evidence none of the
databases mentioned below meet "my" three criteria.
 
bruce arroll
Head of General Practice
University of Auckland 
New Zealand 

  _____  

From: Evidence based health (EBH) on behalf of K Mendis
Sent: Mon 5/29/2006 12:10 PM
To: [log in to unmask]
Subject: 6 searchable electronic databases of synthesised evidence - (in
less than six clicks)


Alison,
 
Your question: 
If you were to provide clinicians with electronic access in the clinical
setting to about 6 searchable databases of 'synthesised' evidence, which
databases, in addition to Cochrane, would you recommend?
 
 
Answer:
Depends where you are and what resources you have - If you are looking for a
ONE-STOP-SHOP for clinicians, I haven't seen anything close to CIAP-OVID
Journals 
 
In NSW, Australia you can use CIAP <http://www.ciap.health.nsw.gov.au/>
(free to all health care workers) and get into OVID Journals. You can choose
what databases to search in a few clicks
(I am not sure whether it can be accessed in Victoria...just give it a try!)
 
In a clinical setting I would choose (with two clicks the following
databases)
1) All
<http://gateway.ut.ovid.com/gw2/ovidweb.cgi?New+Database=Single%7C8&S=IDNJHK
KOECDKKM00D> EBM Reviews - Cochrane DSR, ACP Journal Club, DARE, and CCTR
2)
<http://gateway.ut.ovid.com/gw2/ovidweb.cgi?New+Database=Single%7C28&S=IDNJH
KKOECDKKM00D> Clinical Evidence Issue 14, May 2006
 
One database that is not available in CIAP but I would like very much to
search would be UpToDate
 
These are the databases recommended by 3rd edition of EBM- How to Practice
and Teach (Strauss et.al)
 
Is there any particular reason why you wanted six databases?
 
I think clinicians need to have very simple, quick sources to search for
their complex problems. 
 
regards
 
Kumara
 
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Dr. Kumara Mendis
MBBS, MSc (Medical Informatics), MD (Family Medicine), FCGP
Senior Lecturer
School of Rural Health
University of Sydney
Tel: +61  6885 7996
Mob:+61 427 141 112 
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