The American College of Physicians has provided a new online Evidence-Based Medicine (EBM) tool--ACP's PIER: Physicians' Information & Education Resource. PIER is available on JEFFLINE through Stat!Ref. What makes this tool a little different from the EBM Reviews in OVID is that it follows an online textbook format instead of a topic or article review format. It is also intended as a patient care tool, rather than a tool to determine the validity of the evidence. It has some similarities to the Lange Current… series, also available in Stat!Ref, but specifically evaluates the evidence that supports its recommendations.
Although it is arranged like a printed text, PIER only exists in a computerized format. It is similar other online EBM texts such as Up To Date, BMJ's Clinical Evidence, or ACP Medicine (formerly, Scientific American Medicine). All provide similar information and functionality, with minor differences. One unique feature is that PIER can also be simultaneously searched with every text in Stat!Ref.
PIER is arranged in seven sections: Diseases, Screening & Prevention, Complimentary & Alternative Medicines, Ethical & Legal Issues, Procedures, and Drug Information. Also included is a monthly listing of new modules and an appendix on Evidence Ratings and Criteria.
The Evidence Ratings and Criteria appendix is a quick reference guide used to determine the level of EBM validity of each cited reference. Each reference is also linked to its record in PubMed, providing abstracts and full text links, where available. PIER also provides links to external professional and patient resource websites, including any available clinical practice guidelines.
All of the sections in PIER look at the various aspects of treatment and their effectiveness according to the evidence. These include diagnostic and consultation issues, hospitalization, treatment outcome, and follow-up. Many of the sections also include backgrounds and descriptions of the topic being covered, along with patient education sections and case scenarios. The Screening & Prevention and Disease sections also include a subsection called Alert Triggers. These are lab results or conditions that must be present for a specific diagnosis. The included tables are well organized and easy to follow. The Perioperative Management records, found under the Disease section, are especially detailed, as shown below.
The Drug Information section contains brief drug monographs, similar to those found in the mobileMicromedex and ePocrates PDA tools, although the full Micromedex database in JEFFLINE provides more detailed drug information than PIER. Therefore, PIER would be best used as a quick reference tool for drug information.
PIER is an excellent EBM-based patient care tool. Go ahead a try it for yourself, you won't be disappointed.
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