Speakers:

• Kathryn Nesbit (University of Rochester, Edward Miner Library) - Mastering Medical Information course; NBME grant on how to evaluate the student's EBM skills.

Dr. Robert Holloway had received a two-year grant from NBME to study how to evaluate student's EBM skills. It will look at their ability to formulate questions, conduct a Medline search on Ovid and critique research articles. I am a co-investigator and will be responsible for evaluating the student's Medline search skills. This work builds on five years worth of work grading student searching assignments. Related to this Jan Glover and I have submitted a half-day course proposal to MLA on "evaluating student's Medline searching ability". (The course was approved for MLA 2001.) Julie Sollenberger and I are giving a paper at MLA about the Mastering Medical Information course which kicks-off the 1st year of medical school at UR. We are focusing on the computer labs sessions that the library staff taught the medical students. It also shows the follow up assignments that were conducted through the first year of medical school.

• Carol Lefebvre (UK Cochrane Center) - Progress made with The Cochrane Controlled Trials Register

Particular interest in finding hard-to-find trials, especially in other languages. Currently, 250,000 trials are available (Medline only had 19,000). Project involves hand searching the literature. Reports found items in Medline that were coded both correctly and incorrectly, as well as items not in Medline. 30,000 new trials were found in EMBase J-RCT Project - identify RCTs in Japanese. Systematic Review report will be presented at ICML. January CDSR - 716 review and 293 updated reviews, 52 new reviews. 170,000 items overlap between Medline and RCT database. Indexing in Medline of RCTs has improved, as has EMBase.

• Cheryl Chisnell (Ovid Technologies) - Introduction to two new resources on OVID: DARE and Clinical Evidence

Clinical Evidenceis available from Ovid electronically, and is under the "Books at Ovid" system (it is a stand alone product, not linked to anything currently, but this will change down the line). It mimics the print resource, and is an exact electronic copy of the paper version. DARE is joining the EBM-R database. The Controlled Clinical Trial database will also be incorporated into the package - no price increase is anticipated.Best Evidence is being rekeyed by Ovid (ACP is no longer providing electronic copy) - it is felt this will make the tables and other information easier to access and read. The list of other studies section will also be included in the database.

• Ann McKibbon (McMaster University) - Discussion of the hedges grant from the NLM, and input from librarians to the research being done.

Putting ebm type reviews in JBJS, and possibly in a neurology and cardiology journal (without buying new journals). Will have an NLM fellow working with them. NLM is funding a hedges project; 160 journals will be surveyed. EmBase, CINAHL and Psyc will also be included in this project. Economic Studies, Qualitative Study, Systematic Reviews and Clinical Prediction Guides. 43 page document of possible terms is available, in return for supplying even more terms. Contact Ann at: mckib@mcmaster.ca McMaster is hiring, and you would have to move to Hamilton.

• Patricia Gallagher (New York Academy of Medicine) - Report on the EBM Resource Center, and the Librarians' Working Group activities.

Hosted the 3^rd "Teaching EBM Course" held Oct 5-8 1999, 8 librarian co-tutors in 10 groups, with 8 librarian students. 80 physicians participants and 27 tutors and co-tutors in Internal Medicine and Emergency Medicine faculty. 4^th course is being held Oct 2-5th, 2000. A clerkship director track and advanced track are planned (subject to interest) 10 librarians have already agreed to participate as co-tutors. Information on the course can be found on the EBM Resource Center home page at: http://www.ebmny.org. The Librarians' Working Group hosted the first in a series of 4 seminars in March on EBM Terminology, led by Dorice Vieira and Richard Fariano of NYU Medical Center. The next one will be held in the summer (June or July) on the Clinical Question, led by Gail Hendler (Memorial Sloan-Kettering) and Roberta Bronson Fitzpatrick (NYU). It is hoped that this will help prepare librarian students better for the course. EBM Committee has formed new subcommittees: Medical School Curricula (which had a program led by Dan Mayer of Albany Medical Center), Research, Geriatrics, Palm Top Computers (which will meet virtually), Web Page, CE/CME Committees; these join the Librarians' Subcommittee which has existed from the beginning.

• Sam Vincent (BMJ Publishing Group) - Report on the publication, Clinical Evidence.

Clinical Evidence published by BMJ Publishing Group is a compendium of the best available evidence of the effects of common clinical interventions. Publication will summarize the best evidence, or tell you that there is no good evidence. Each issue expands and updates the information. Publication is question driven, in collaboration with physician and patient groups, it identifies important clinical questions. It is updated every 6 months (December and June) - new issues supercede older issues. Clinicians assigned to research a specific question that has been identified search work in collaboration with information specialists who Cochrane Library, Medline, EMBase, PsychLit, et al. using validated search strategies, like those designed by Ann McKibbon, for systematic reviews, randomized trials (or cohort studies). Two information specialists appraise the information that is found, based on the criteria devised by David Sackett, et al. The author of the piece is given the information, and (s)he then does another selection process, and must justify and additions/deletions, and summarizes the evidence. This summary is submitted to <Clinical Evidence, where it is reviewed. Issue two had 87 topics, issue three has 123 topics. Aim is to reach 400 key clinical questions. Topics are arranged by disease types, with each type following the same structured format. Clinical Evidence is aimed at general practitioners.

• Carol Scherrer (University of Illinois, Chicago, Library of the Health Sciences) - Report on a new project to provide 24-hour turn-around on clinically answerable questions in pediatrics.

The pediatric who mentors the residents asked the library to participate in a 6 week trial with 24 hour turn around for a clinically answerable question. Questions were submitted by physicians in PICO format. These were picked up at 4pm each day, and the librarians did a clinically filtered search, and articles are clinically filtered (using both the abstract and the actual articles) which were due back to the requestor at 4pm the next day. Many logistical problems occurred (including the time factor, getting copies of articles not held by the library, contacting the physician for more information), but the librarians have found it very rewarding, and it is hoped to eventually have it all done electronically. No charges for this service. Five (out of eight) librarians were assigned to the project (so that there was backup), librarians are going to morning report.

• Peg Spinner &Jim Comes (University of Massachusetts, Soutter Library) - Report on EBM initiative

Web site started as a collaboration between the library and the department of Family and community medicine http://library.umassmed.edu/EBM/ to provide a home on the web for ANY EBM activities at U Mass Med School. It includes interactive Medline tutorials that focuses on prognosis and therapy, links to other EBM sites, a collection of database resources (versions of Medline, Cochrane, Best Evidence and Guidelines collections). Usability testing - five/six tasks were selected and volunteers are observed doing the tasks on the prognosis tutorial. Despite the fact that the site got very good reviews, the usability test showed the tutorials were not being used, or were being ignored. As a result of the test, the second tutorial (on therapy) was devised based on what worked and what did not work. Journal club for family medicine residents (who are geographically spread). Using "Journals at Ovid" and Chat software, will be able to meet virtually.

• Diane Wolf (Christiana Care System)

Declined to subscribe to a newsletter (requested by a physician) called "Evidence Based Practice" on the basis that it decreased the amount of funds she had to spend on new products like Clinical Evidence. She asked if other colleagues are aware of this publication (at the request of the physician). Response: This is the POEMS publication; abstracts are assessed reviews, not just abstracts. The publication has been available for at least two years. Recommendation from the audience was that it be purchased.