Evidence-Based Medicine Guidelines (EBMG) is a handbook on the wide range of diseases and conditions encountered by the physician in everyday practice. The guidelines have two approaches: problem-based and disease-specific, and are linked to the best available evidence including Cochrane Reviews and DARE Abstracts. Other sources of evidence include clinical evidence, original articles and systematic reviews in clinical journals, abstracts in the Health Technology Assessment Database and the NHS Economic Evaluation Database, and clinical guidelines that describe evidence systematically. Where recommendations are given in the absence of high-quality evidence, they are based on textbooks, review articles, and expert opinion agreed upon by independent referees. Pulled together by hundreds of experts and compiled by the team of editors, EBMG also seeks to include guidelines where clinical evidence is incomplete or unavailable.
A specific feature of this textbook is the use of evidence codes (A, B, C, D) that appear in connection with many of the guideline recommendations. The coding corresponds to that proposed by the GRADE Working Group for grading the quality of evidence – they do not indicate the strength of the recommendations.
- A (high): Further research is very unlikely to change our confidence in the estimate of effect.
- B (moderate): Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
- C (low): Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
- D (very low): Any estimate of effect is very uncertain.
(Adapted from the GRADE Working Group (BMJ 2004;328:1490–8))
The result is a concise and easy-to-use book intended for GPs and other primary care physicians as a practical tool for clinical decisions. It is also of practical use by specialists, not in their own field, but as a reference to other specialities.
Originally created in Finland and associated with the Finnish Medical Society Duodecim, Evidenced-Based Medicine Guidelines was first published as an electronic version but it has become apparent that a print version is highly desirable for busy practitioners who need a quick and handy reference when not at their keyboards.
