Review of Boston University Medicine’s great evidence based medicine app

Information Mastery is a concept coined by evidence based medicine (EBM) experts in the US, Canada and the UK. In the US, Information Mastery was championed by Slawson and Shaughnessy who described the vast medical literature as a “jungle” and used the metaphors of “foraging” and “hunting” to navigate that environment.

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If you wanted to find an answer to a specific question, you needed a “hunting” tool such as UpToDate, Dynamed or Essential Evidence Plus. If you wanted to just wander thru the jungle and see what was new you would use a “foraging” tool such as the DailyPOEM, Prescriber’s Letter or Journal Watch. In short, hunting tools help you answer clinical questions at the point of care and foraging tools alert you to new information.

In the internet age, another skill is also badly needed by medical professionals: information management. How do we manage this information that amounts to thousands of articles per month indexed on Medline? The authors of a new app may have found the answer. Boston University School of Medicine Evidence-Based Medicine Vertical Integration Group created an app for medical students and practicing clinicians to practice both information mastery and information management.

The BUSM FIF prompts providers to ask themselves if their question is a background or foreground question. I first came across this concept while reading the Straus book, “Evidence Based Medicine: How to Practice and Teach It“. This book has become the primary textbook for evidence based medicine over the years. Background questions ask for general knowledge about a disorder and contain a question root (who, what, where, when, how, why) about a disorder or an aspect of a disorder. Foreground questions ask for specific knowledge about managing patients with a disorder. The foreground question is often referred to as the PICO question structure (Patient/Problem, Intervention, Comparison, Outcome).

The BUSM FIF app first asks you which type of question you are asking – background or foreground. It gives you hints if you are not sure. If you select background, it next asks you if you are asking a basic science or clinical question. If you select foreground, it next asks you if you are asking a rare/academic, point of care, or resource/services question. At each step of the algorithm, the app gives you hints if you are not sure what to choose. Based on what type of question you select, the app “answers” with the recommended evidence-based resources to answer your question. The app links to the resource’s website or through the BUSM medical library. There is no way to put in your own institution’s login information.

Evidence based medicine

BUSM FIF is an outstanding EBM app for those new to the concept. The app uses a well-accepted approach to EBM via the use of background and foreground questions and prompts the user to use highly regarded EBM resources.

What providers would benefit from this App?

Students, residents, mid-levels, any staff provider who is new to evidence based medicine.

Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.