Framework
for Making Systems Changes
 Sources of Evidence-Based Decision-Making
Please
note: Some
links on this page take you outside the Better Diabetes Care website. The NDEP
does not endorse or otherwise guarantee the accuracy of links that take you out
of this website.
- Agency for Healthcare Research and Quality (AHRQ), formerly known as the Agency for Health Care Policy and Research (AHCPR): Clinical Guidelines and Evidence Reports
www.ahrq.gov/clinic
The AHRQ website includes links to the National Guideline Clearinghouse, Evidence Reports from the AHRQ's 13 Evidence-based Practice Centers (EPC), and Preventive Services. The AHCPR released 19 Clinical Practice Guidelines between 1992 and1996 that were not subsequently updated.
AHRQ's Evidence-Based Practice Reports
Closing the Quality Gap: Diabetes Care Strategies, Fact Sheet
HTML www.ahrq.gov/qual/diabetesgap.htm
PDF www.ahrq.gov/qual/diabetesgap.pdf
Diabetes Mellitus, Islet Transplantation
www.ahrq.gov/clinic/tp/islettp.htm
Diabetes Mellitus, Use of Glycated Hemoglobin and Microalbuminuria
www.ahrq.gov/clinic/tp/glycatp.htm
Ayurvedic Treatments for Diabetes Mellitus: A Systematic Review
www.ahrq.gov/clinic/tp/ayurvtp.htm
Diabetes: Quality Improvement
www.ahrq.gov/clinic/tp/dbgap2tp.htm
AHRQ's Synthesis - Research in Action
Improving Care for Diabetes Patients Through Intensive Therapy and a Team Approach
HTML www.ahrq.gov/research/diabria/diabetes.htm
PDF www.ahrq.gov/research/diabria/diabria.pdf
AHRQ's Health Technology Assessment
Health and Behavior Assessment/Intervention for the Management of Physical Health Problems-Impact on Management of Patients with Diabetes Mellitus (2004)
Not available electronically
- American College of Physicians
www.acponline.org/journals/ecp/primers.htm
Numeric Presentation of Results
The following primers are some of several available:
- Primer on 95% Confidence Intervals for the Number Needed To Treat
- Primer on Absolute vs. Relative Differences
- Primer on Cost-Effectiveness Analysis
- Primer on Statistical Significance and P Values
- Primer on 95% Confidence Intervals
Glossary of terms used in therapeutics, definitions relating to data presentation in therapeutics, and terms used in diagnosis
www.acpjc.org/shared/glossary.htm
American College of Physicians Journal Club (ACPJC)
www.acponline.org/journals/acpjc/jcmenu.htm
ACPJC evaluates evidence in individual articles. Commentary by ACP author offers clinical recommendations. Access to the online version of ACPJC is a benefit for members of the ACP.
- American Diabetes Association: Clinical Practice Recommendations
www.diabetes.org/for-health-professionals-and-scientists/cpr.jsp
This compilation contains all the current ADA positions statements, technical reviews, and consensus statements related to clinical practice, as well as the evidence grading system used. Updated yearly in January.
- American Heart Association
Resources for professionals including Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update www.americanheart.org/presenter.jhtml?identifier=529
www.circ.ahajournals.org/cgi/content/full/106/3/388
Cardiovascular Health in Childhood: A Statement for Health Professionals from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young
www.circ.ahajournals.org/cgi/content/full/106/1/143
- Bandolier
www.jr2.ox.ac.uk/bandolier/
Features short evaluations and discussions of individual articles dealing with evidence-based clinical practice.
- Clinical Evidence, BMJ Publishing Group
www.clinicalevidence.com
Searches BMJ's Clinical Evidence compendium for up-to-date evidence regarding effective health care. Lists available topics and describes the supporting body of evidence to date (e.g., number of relevant randomized controlled trials published to date). Concludes with interventions "likely to be beneficial" versus those with "unknown effectiveness." Individuals who have received a free copy of Clinical Evidence Issue 5 from the United Health Foundation are also entitled to free access to the full online content.
- Cochrane Database of Systematic Reviews
www.cochrane.org
Systematic evidence reviews that are updated periodically by the Cochrane Group. Reviewers discuss whether adequate data are available for the development of evidence-based guidelines for diagnosis or management.
- Effective Health Care
www.york.ac.uk/inst/crd/ehcb.htm
Bi-monthly, peer-reviewed bulletin for medical decision-makers from the Centre for Reviews and Dissemination. Based on systematic reviews and synthesis of research on the clinical effectiveness, cost-effectiveness and acceptability of health service interventions.
- Evidence-Based Diabetes Care
Hertzel C. Gerstein, R. Brian Haynes (Editors), BC Decker Inc., Hamilton, 2001
This textbook provides a broad evidenced-based review of the topic of diabetes medicine. The hardbound text is accompanied by a CD-ROM compilation of abstracts and patient information material.
- Evidence-Based Medicine
www.evidence-basedmedicine.com
Bimonthly publication launched in 1995 by the BMJ Publishing Group. Article summaries include commentaries by clinical experts. Subscription is required.
- Evidence-Based Practice Newsletter (including JFP Patient-Oriented Evidence that Matters [POEM])
www.ebponline.net
This JFP newsletter features up-to-date POEM, Disease-Oriented Evidence (DOE), and tests approved for Category 1 CME credit. Subscription required.
- Grading of Recommendations Assessments, Development and Evaluations (GRADE) Workgroup.
www.gradeworkinggroup.org/index.htm
The WHO, UpToDate, and The Endocrine Society are among those using this approach. The website details the process by which recommendations can be made which incorporates a strength of the recommendation that is based on the quality of the evidence as well as the balance between benefits and harms. It features an excellent FAQ section.
- Guide to Community Preventative Services
www.thecommunityguide.org/diabetes
The Guide to Community Preventive Services is developed through systematic reviews of available evidence of effectiveness for population-based interventions addressing diabetes focused on strategies within two areas: health-care system level interventions promoting disease and case management; and diabetes self-management education in various settings.
- Institute for Clinical Systems Improvement (ICSI)
www.ICSI.org
ICSI is an independent, nonprofit collaboration of health care organizations, including the Mayo Clinic, Rochester, Minn. Web site includes the ICSI guidelines for preventive services and disease management.
- National Guideline Clearinghouse (NGC)
www.guidelines.gov
Comprehensive database of evidence-based clinical practice guidelines from government agencies and health care organizations. Describes and compares guideline statements with respect to objectives, methods, outcomes, evidence rating scheme, and major recommendations.
- National Health Service (NHS) Centre for Reviews and Dissemination (CRD)
www.york.ac.uk/inst/crd/
Searches CRD Databases (includes DARE, NHS Economic Evaluation Database, Health Technology Assessment Database) for EBM reviews. More limited than TRIP Database.
www.york.ac.uk/inst/crd/crddatabases.htm
Structured abstracts written by University of York CRD reviewers (see NHS CRD). Abstract summaries review articles on diagnostic or treatment interventions and discuss clinical implications.
- North Carolina Center for Evidence-Based Medicine Education Center of Excellence
www.library.ncahec.net/ebm/pages/index.htm
This website provides a collection of resources that support teaching and learning in evidence-based medicine for faculty, librarians, students, and other health care professionals. It includes links to international evidence-based journals, and EBM-related teaching materials including the University of Oxford CATbank (Critically Appraised Topics).
- Primary Care Clinical Practice Guidelines
www.medicine.ucsf.edu/resources/guidelines
University of California, San Francisco website that includes links to NGC, CEBM, AHRQ, individual articles, and organizations.
- Risk Assessment Tools from Better Diabetes Care Toolbox
betterdiabetescare.nih.gov/TOOLBOXrisk.htm
Risk assessment tools can help health care providers and people with diabetes to identify specific risk factors that can be changed to reduce the overall risk for diabetes and cardiovascular disease.
- Translating Research Into Action for Diabetes (TRIAD)
www.triadstudy.org
TRIAD stands for Translating Research Into Action for Diabetes. It is a national study that aims to improve the quality of care and quality of life for people with diabetes. TRIAD is made up of six research centers that have been looking at the care received by people with diabetes. The goals of TRIAD are to assess the level of care provided to people with diabetes, identify the barriers that get in the way of people receiving care, and find new ways to provide better care to people with diabetes
- TRIP Database
www.tripdatabase.com/index.html
The AHRQ began the Translating Research into Practice (TRIP) initiative in 1990 to implement evidence-based tools and information. The TRIP Database features hyperlinks to the largest collection of EBM materials on the internet, including NGC, POEM, DARE, Cochrane Library, CATbank, and individual articles. A good starting place for an EBM literature search.
- U.S. Preventive Services Task Force (USPSTF)
www.ahrq.gov/clinic/uspstfix.htm
This website features updated recommendations for clinical preventive services based on systematic evidence reviews by the U.S. Preventive Services Task Force.
- Weighing Treatment Pros and Cons
www.breastcancer.org/treatment_stats.html
This online non-profit organization brings consumers information about breast cancer and provides simple, graphic examples of relative vs. absolute risk -- helpful for both health care providers and patients.
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