A link to the course outline with speaker notes can be found at http://www.healthsystem.virginia.edu/internet/familymed/information_mastery/information_mastery_course.cfm
Mike started out with introductory information. He makes an interesting point that when he did a search in PubMed on EBM he got far fewer hits than when he searched "Evidence Based Medicine". Apparently, PubMed does NOT map EBM to evidence based medicine. We need to keep in mind the terminology that the physicians use.
"Incorporating the best evidence into the real world of the busy practitioner requires the applied science of information management."
What is our role in this? Apparently not as much as we'd like to think. The number one influence of physicians in the United States is drug reps. Whether or not they push a drug or stop pushing a drug has more influence than the medical literature. On average, it can take up to 13 years for a change to occur in medical practice strictly on the literature alone. People don't change unless they have a reason to change.
Limitations to the practice of high-quality medicine at the bedside:
1. Shortage of coherent, consistent scientific evidence.
2. Difficulties in finding what evidence does exist due to searching and access limitations.
3. Difficulties in applying evidence to the care of individual patients.
There will never be information to answer all of the questions all of the time.
EBM has taken medical practice from inductive to deductive. Doctors don't have time to read the literature - we need to come up with secondary sources.
Usefulness of any source = relevance x validity / work.
Doctors won't look for something if it takes them more than a minute to find. They won't look if they don't know it's going to be there.