Best Evidence 2: Linking Medical Research to Practice

CMAJ 1998;158:1649

© 1998 Canadian Medical Association

Strengths:

• Excellence in quality of content
• Uses an interface that is intuitive to those familiar with navigating Windows and the World Wide Web
• Effective index and text-word search strategies
• Excellent glossary on analytical terms
• Thought-provoking and insightful editorials on harnessing MEDLINE to practise evidence-based medicine

Weaknesses:

• No hypertext linkages of references in the body of review articles
• No access to the complete articles that were reviewed
• Cannot chronologically access articles
• Does not fully exploit the CD-ROM medium (e.g., graphics, sounds, videos)

Audience:

• Family practice, internal medicine, obstetrics and gynecology, surgery, psychiatry and pediatrics; physicians interested in health economics and organizing medical educational programs

This CD-ROM offers several outstanding features for a modest price. Navigation with button bars and hypertext linkages is relatively effortless and intuitive for those comfortable with computers and the Internet. Conducting an index or text-word search among the 1000 citations is easy and effective. The glossary, which succinctly defines and discusses terms frequently used in statistical analysis of clinical papers, is a handy and effective reference. Examples include relative risk (RR), absolute reduction rate (ARR), numbers needed to treat (NNT), confidence intervals (CI) and odds ratios (OR). Also impressive is a series of well written and thoughtful editorials — "Beyond ACP Journal Club" — which discusses the use of MEDLINE to deal with problems in diagnosis, therapy, etiology and prognosis. Another series of editorials, "Transferring evidence from research into practice," is equally insightful and well worth reading.

Best Evidence 2 does have several weaknesses, although they do not significantly diminish its value or hamper its effectiveness. The ACP Journal Club and Evidence-Based Medicine issues cannot be accessed chronologically; readers cannot select an issue or article by date. Pertaining to the review articles, references cited in the text are not hyperlinked to the reference section. Furthermore, the full text of the articles reviewed is not available. Since the full text of both Annals of Internal Medicine and British Medical Journal articles is now accessible via the Internet, a connection from the CD-ROM to the Internet for access to cited articles in these 2 journals would be a good start. There is a conspicuous absence of radiographs, educational videos, graphs or other visual aides; these would add clarity and dynamism to the text. Reviewing and abstracting articles from multimedia journals would bring out the full potential of the CD-ROM medium.

Ultimately, the editors deliver what they promise: Best Evidence 2 summarizes the best of the literature and puts the evidence into clinical context. For those without a subscription to ACP Journal Club or Evidence-Based Medicine, this CD-ROM is a valuable investment that provides quality information for a reasonable price. For those who do, it should still be considered for its searching and indexing capability and its excellent glossary.

Kendall Ho, MD, FRCPC
Associate Dean and Director
Division of Continuing Medical
  Education
Faculty of Medicine
University of British Columbia
Vancouver, BC