Over the years, the art of practicing medicine has given way to a science of establishing guidelines for treatment of disease. Practitioners have mixed feelings on what some term "cookbook medicine." Defenders of evidence-based medicine, or EBM, call it an explicit approach to problem solving when making medical decisions for individual patients. But even EBM advocates point out that guidelines vary between organizations and are not a substitute for a practitioner's own experience.
Whether you believe more in the art or the science, guidelines on the Web are as close as a mouse-click to physicians needing best-practices information. Here are three starting points:
National Guideline Clearinghouse
The National Guideline Clearinghouse has a Web site sponsored by the Agency for Healthcare Research and Quality. Resources for clinicians include AHRQ evidence reports and technology assessments, a complete list of all guideline summaries, links to National Library of Medicine resources such as PubMed and HSTAT, and annotated bibliographies. In addition, evidence reports are available in either summary or full-text form. Comparisons between guidelines are available, and there is also information about submitting guidelines.
Evidence-based Medicine Resource Center
The Evidence-based Medicine Resource Center, operated by the New York Academy of Medicine and the Evidence-based Medicine Committee of the American College of Physicians, New York Chapter, offers information on how to learn more about EBM and how to teach it. Featuring references, bibliographies, tutorials, glossaries, and online databases, the site supports finding best practices evidence, critical appraisal of the studies obtained and access to aids--including links to EBM toolkits, worksheets and calculators--needed for finding and appraising evidence reports.
Personal surfing takes up valuable time. That's where a site like EBMSolutions comes in. It is representative of those commercial sites whose missions are to provide clinical guidelines from a variety of sources--in this case, a consortium of six medical schools--and keep them updated. EBMSolutions' guidelines are based on the company's proprietary, peer-reviewed evidence reporting process based on research done by the medical schools. Such companies charge their clients a fee based on the number of users. Other sites of this nature include www.zynx.com and www.medicalinforetriever.com.