Web site sheds new light on evidence-based radiology

Radiologists can now visit a Web site dedicated to evidence-based medicine. An online resource ( http://www.evidencebasedradiology.net ) developed at St. Vincent's University Hospital in Dublin aims to demystify the principles behind evidence-based radiology (EBR) and guide users step-by-step through the process.

"The site is primarily designed to be a platform of support materials for teaching evidence-based healthcare skills and putting these in the context of problem-based learning," said Dr. Dermot Malone, a radiologist at St. Vincent's and lead author of an electronic poster describing the project presented at this year's European Congress of Radiology.

While the theory of EBR might sound attractive, putting it into practice is often difficult. Clinical radiologists with scant experience of academic research methods may not know where to find the relevant information or how to assess the strength of statistical evidence from alternative sources.

Malone initially set up the Web site to support a practice-based learning group that had been active in the St. Vincent's radiology department since 1999. The group had been using a folder of hard-copy documents, and maintaining an online resource appeared to be easier than continually updating the paper-based file.

The Web site is divided into three main sections, each with active links to further Web-based resources or software tools. An introductory "EBR Overview" outlines the background theory of evidence-based medicine and technology assessment, showing how radiology research fits into this context. Discussion of problem-based learning and continuous professional development is also included.

"EBR Process" highlights the five basic steps to evidence-based practice: ask, search, appraise, apply, evaluate. It offers guidance on how to plan literature searches, where to look on the Web, the type of evidence to seek out (e.g., original studies versus literature reviews), how to appraise reports, and how to apply results to daily practice. Users can also follow links to sites that discuss self-evaluation in terms of evidence-based practice.

"EBR in Practice" links to a series of case studies that illustrate how EBR concepts can be incorporated into daily workflow. The studies are subdivided in order of complexity into single searches, critically appraised topics, evidence-based radiology reviews, and systematic reviews.

Radiology registrars at St. Vincent's now get the chance to work through EBR concepts as part of their standard training and to present these studies at congresses, Malone said.

Radiologists will often be able to find the evidence they need in just 10 to 15 minutes, once they have mastered the searching and appraisal skills. Time spent checking online for a second opinion is generally time well spent, even if the search proves fruitless, according to Malone.

"EBR is a constructive approach to problem solving. You can establish with a reasonable degree of certainty what is out there on a particular topic, how strong that evidence is, and then decide how you want to use it locally," Malone said.

For more information from the Diagnostic Imaging archives:

E-learning initiatives require standardization
http://www.dimag.com/db_area/archives/europe/2003/0304.imagingnews5.die.shtml

Radiologists learn the power of presentations
http://www.dimag.com/db_area/archives/europe/2003/0306.imagingnews3.die.shtml