Nonetheless, the step-by-step guide on searching specific databas

Nonetheless, the step-by-step guide on searching specific databases and selecting and combining search terms is useful and specific to each domain. HDAC inhibitor The third feature within each domain is a ‘worksheet’ which is an excellent template (downloadable as a word or pdf document) for summarising the evidence. Such structured, concise summaries would be a valuable resource to share with colleagues during journal clubs or to facilitate implementation of evidence-based practice amongst colleagues in a clinic or hospital department. From my experience, these worksheets are more user-friendly

than the EBM tool CATmaker (CAT = Critically Appraised Topic) that are available on the University of Oxford Centre For Evidence Based Medicine website (http://www.cebm.net/index.aspx?o=1157). Finally, each domain has relevant tools to assist with calculations (eg, likelihood ratios for diagnosis), including a link to the online (Canadian) CEBM Statistics Calculator. The Practice Guidelines

and the Systematic Reviews sections have a similar structure to the Domains section, including appraisal guides, search strategies and worksheets. The information on how to find good quality practice guidelines is particularly good and has links to excellent sites such as The National Guideline Clearing House and Clinical Knowledge Summaries (although the hyperlink to a third site ‘CMA Infobase’ was not functional check details at the time of this review but can be found at: http://www.cma.ca/cpgs/). The Systematic Reviews section would benefit from some small improvements. First, the appraisal guide has an item asking ‘was the validity of the included

studies appraised’ which links to a generic definition in the Glossary about the definition of validity. Because the methodological quality of studies included in a systematic review can have a substantial impact on estimates of treatment effect, careful appraisal of the risk of bias (also referred to as the quality or internal validity) of studies is important. Therefore it would be more fitting with contemporary terminology to ask ‘was very the risk of bias of the included studies appraised’ and more useful to have a link to a brief summary of currently accepted tools for this purpose. Second, it would be useful to broaden the ‘what are the results’ section, to include continuous outcomes for reviews on treatments, and to add appropriate outcomes for reviews of diagnosis (eg, likelihood ratios) The final two sections of the EBM Toolkit include links to other excellent web-based EBM resources as well as a useful glossary of terms for reference. Overall, this is a user-friendly resource that provides tools and strategies for formulating clinical questions, searching and critically appraising the evidence, and applying the evidence to patients. I recommend it to physiotherapy students and practitioners.

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