Clinical Evidence

TitleClinical Evidence
Publication TypeDatabase
Year of Publication1999
Date Accessed2012-06-04
PublisherBMJ Publishing Group
KeywordsEvidence-Based Medicine, Databases, Factual
AbstractWelcome to Clinical Evidence, a database showcasing the best available evidence on common clinical interventions. When we started, Clinical Evidence set out specifically not to make recommendations: we felt it was difficult, maybe impossible, to give advice for every situation, because differences in patients' risks and preferences, and in the local availability of interventions, mean that those situations vary hugely. So, we said, we'll supply the evidence, you make the decisions. Increasingly, though, we have been rethinking this position (as we constantly re-examine everything we do - we've never stopped changing). It's still true, for example, that Clinical Evidence should point out where evidence is lacking. But it's also true that just saying, sorry, there's no information, may not much help. So we're addressing this issue with ongoing initiatives, such as encouraging authors to use their expert knowledge and the current consensus positions in our Clinical Guide sections where evidence is weak - while keeping as close as feasible to what reliable evidence there is. Like other EBM resources, such as producers of guidelines, we look to answer the 'what' questions that doctors and patients ask. But what Clinical Evidence also looks at are the 'whys'; because, without those answers, patients can only be treated in the kind of authoritarian manner that was out of date two decades ago. The 'why' questions describe the difficulty of achieving the complexity demanded of best clinical practice - where patient-centeredness and evidence-based practice intersect. Our challenge is to determine which 'why' questions matter most. Clinical Evidence (CE to its friends) was created in 1999, and it has been evolving ever since - both in response to clinicians' changing needs and the latest EBM innovations. Standing still has never been an option. We have convened an international advisory board, held focus groups of clinicians and patients, and adopted countless great ideas from our contributors. However, throughout all this development, we have kept in mind a crucially pertinent equation set out by Slawson et al. (J Fam Pract 1994;38:505-513.) "The usefulness of any source of information is equal to its relevance, multiplied by its validity, divided by the work required to extract the information." With this always in mind, we aimed for high relevance, high validity, and low work for our readers. We also stuck to basic principles of transparency and explicitness: readers needed to understand where our information came from and how it was assembled.