HealthGate Evidence-Based Medicine (EBM) Clinical Guidelines (formerly, EBM Solutions) is a collection of evidence-based guidelines on more than 100 health topics. Each guideline is well researched, and levels of evidence, using the evidence grading of the American College of Chest Physicians, are noted throughout. Each guideline has separate sections for providers and patients. Creators of the guidelines come from various institutions, including Duke University Medical School, Emory University Medical School, Oregon Health & Science University, and Vanderbilt University Medical School.
Each provider guideline is arranged in fourteen sections (as noted in the help section):
Key Points: summary of the most important information and conclusions in the guideline
EBM Highlights: links to tables and figures, Websites, and clinical indicators
Decision Tree: algorithms used to assist clinicians in making evidence-based care decisions
Definition: general overviews of the condition
Significance: information about the relevance of the condition to individuals and the community's health
Causes: known and potential causes of the condition
Symptoms and Signs: most common clinical signs and symptoms of the condition
Screening and Diagnosis: most common procedures for screening and diagnosis
Prevention and Treatment: most common prevention and treatment strategies
Complementary/Alternative Medicine: risks and potential benefits of alternative therapies
Prognosis: likely outcome after being diagnosed with the condition and potential treatment outcomes
Research Frontiers: overview of current studies and new therapies that may affect future treatment and prevention strategies
References: references with links to PubMed abstracts
About the Author: information regarding the background, education, and expertise of the primary author(s) of the guideline
Patient guidelines have the same sections, though some of the sections use different terminology, for example, “description” rather than “definition” and “importance” rather than “significance.” The patient guidelines are written at a tenth- to eleventh-grade reading level. Some sections of the patient guidelines are identical to the provider guidelines, with fewer references in the References section, some of which may not be in the provider guideline.
The topics are listed under twenty categories: Cancer; Cardiology; Ear, Nose, and Throat; Endocrine/Metabolic; Gastrointestinal; Hematology; Infectious Diseases; Mental/Behavioral Health; Neurology; Ophthalmology; Orthopedics; Pediatrics; Prevention; Pulmonology; Renal; Reproductive Health; Special Topics; Symptoms; Urology; and Women's Health.
Each guideline has links to other pertinent topics in HealthGate, as well as links to other resources, including clinical trials and reports. Decision trees include links to appropriate diagnosis and treatment information. The References section links to abstracts in PubMed. Diagrams and illustrations are used when appropriate.
Each guideline section is brief and well written. However, it is not possible to see a guideline as a whole or print out an entire guideline. Each section must be read, downloaded, or printed individually. Although the guidelines have current references, no information is available about when the guideline was written or updated. In the References section, it is not possible to see which reference refers to which part of the guideline.
Keywords can be searched through a simple search feature throughout all the guidelines, in a particular guideline, or in a particular section of the guidelines. Each result links to the section of the guideline where the keyword is mentioned. However, the limits are not cleared out after each search, so a searcher must remember to clear search limits before beginning another search.
Accessibility issues include the inability to use the browser back button to move around in the guideline. Each section must be accessed by using the lefthand menu. Another possible complication is that the pop-up feature is used liberally, and, those who routinely have pop-ups blocked need to make some modifications to their computer set-up.
A number of user aids for this product are available, including a help page, a frequently asked questions (FAQ) page, and a thirty-six-page manual. It is also easy to contact the company through email or a feedback link.
These guidelines cover some of the most often diagnosed conditions and diseases, so they are very handy for quickly finding the best evidence. However, the fact that no dates are attached to the guidelines impedes knowing how recent the information is. The guidelines are much more concise than the Cochrane Database of Systematic Reviews or UpToDate, and the information is more easily accessible. Its major drawbacks are its limited scope and the architecture of the guidelines.