User Guide For Acp Pier
User Guide for ACP PIER
t h e e v i d e n c e - b a s e d, p o i n t - o f - c a r e t o o l
1. Enter search term(s) and click Search. Or browse the
1.
Disease modules in the left hand Table of Contents.
1.
2. Choose a relevant result from the applicable disease
module. (For Example, in the asthma search image on the left, we see
several results related to asthma.)
3. View a module’s section by scrolling or directly clicking
on the blue link in the left-hand Table of Contents
navigation bar.
4. Find the Specific Recommendation within the section.
Each Specific recommendation includes Rationale,
Evidence and Comments.
5. Click on the footnote to find the Evidence Rating and
Criteria
See reverse side for description of ACP PIER Reference
Citations, Guidance Statements, content details and updates.
The “5S” Levels of Organization of Evidence From Health Care Research
EXAMPLES
System
Computerized decision support
1.
Summaries
ACP PIER and evidence-based text-
books
Synopses
Evidence-based journal abstracts
Syntheses
Systematic reviews
3.
Studies
2.
Original journal articles
5.
“... we add a layer to the model, namely clinical topic summaries of
4.
evidence about all pertinent management options for a health condition,
such as those included in Clinical Evidence and PIER. If a current topic
summary exists, it would summarize the relevant synopses, syntheses, or
studies about several aspects of a health condition. Thus, a current
summary ‘trumps’ an individual synopsis, synthesis, or study or a collection
of these.”
R. Brian Haynes, MD, PhD
McMaster University
STAT!Ref • Electronic Resources For Healthcare Professionals • www.statref.com • 307-733-5494 • 800-901-5494
Evidence-Based Clinical Content in ACP PIER
The Physicians' Information and Education Resource (PIER) provides evidence-based clinical guidance for
primary care physicians. In an effort to ensure the breadth and quality of this evidence, PIER has contracted with
McMaster University to conduct continual literature searches on topics contained in PIER. McMaster University
is known and respected for establishing the most strident methodology for evidence based medicine. PIER
authors are required to base the recommendations in their modules on citations from the medical literature
which are ranked by McMaster. This process provides PIER authors with vetted, reliable, evidence-based
references which they can review as they produce and update modules and guidance statements.
Reference citations in PIER modules are rated by the type and quality of the study. A general guide to this
rating system is as follows:
1 - level reference: randomized controlled trial, meta-analysis, or systematic review
2 - level reference: any experimental study designs other than randomized controlled trials or meta-analyses
(e.g., case series, or cohort, case-control, or observational studies)
3 - level reference: expert opinion or consensus statements
The guidance statements in PIER are rated A, B, or C.
Explanations for each of these ratings include:
A - level statement: The recommendation is supported by at least one good randomized controlled trial, or the
preponderance of evidence supports the recommendation.
B - level statement: The recommendation is based on research data that are less compelling than a randomized
controlled trial (e.g., cohort, case-control, observational studies, or case series).
C - level statement: The recommendation is based on expert opinion or consensus, or on historically, generally
accepted standards of clinical practice not based on evidence.
Every PIER module is reviewed by expert peer reviewers who are selected for both their clinical knowledge
and strong familiarity with the medical literature for the topic they are reviewing.
In addition to regular updating by PIER's editorial consultants, the contents of at least six major medical
journals are reviewed each week by PIER's editorial staff. Relevant citations are added to the “What's New”
section of module home pages to keep readers abreast of the latest relevant studies and to add to the depth
and currency of knowledge contained on the site.
