Resources for Evidence-Based Decision-Making
In participatory decision-making, physicians actively engage patients in treatment and other care decisions. Such patient participation appears to be associated with better understanding of care.  Participation in decision-making can play a key role in patient understanding of diabetes self-management and subsequent self-care practices.  People with diabetes with limited education benefit from specific instruction in foot care, food choices, and monitoring hemoglobin A1c.  Involving patients in treatment decision-making alone, however, does not appear to be sufficient to improve biomedical outcomes.  
Diabetes-Specific Recommendations and Guidelines
American Academy of Family Physicians
- Diabetes: Clinical Preventive Services Recommendations
- Diabetes Mellitus: Diagnosis and Screening (2010)
American Association of Clinical Endocrinologists
- Guidelines for the Management of Dyslipidemia and Prevention of Atherosclerosis (2012)
- Guidelines for Clinical Practice for Developing a Diabetes Mellitus Comprehensive Care Plan (2011)
American College of Physicians
- Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus: A Clinical Practice Guideline From the American College of Physicians (2012)
- Use of Intensive Insulin Therapy for the Management of Glycemic Control in Hospitalized Patients: A Clinical Practice Guideline From the American College of Physicians (2011)
American Diabetes Association
American Geriatrics Society
- Expert Panel on the Care of Older Adults with Multimorbidity Patient-Centered Care for Older Adults with Multiple Chronic Conditions: A Stepwise Approach from the American Geriatrics Society (2012)
American Heart Association
- Scientific Statement New and Emerging Weight Management Strategies for Busy Ambulatory Settings: A Scientific Statement From the American Heart Association (2011)
Indian Health Service
The Endocrine Society
- Evaluation and Treatment of Hypertriglyceridemia (2012)
- Management of Hyperglycemia in Hospitalized Patients in Non-critical Care Setting (2012)
- Continuous Glucose Monitoring (2011)
- Endocrine & Nutritional Management of the Post-Bariatric Surgery Patient (2010)
- Primary Prevention of Cardiovascular Disease & Type 2 Diabetes in Patients at Metabolic Risk (2008)
U.S. Preventive Services Task Force
Veterans Affairs/Department of Defense
Agency for Healthcare Research and Quality (AHRQ)
Clinical Guidelines and Recommendations
The AHRQ website includes links to the National Guideline Clearinghouse, Evidence Reports from the AHRQ's 13 Evidence-based Practice Centers (EPC), and Preventive Services. The AHCPR released 19 Clinical Practice Guidelines between 1992 and1996 that were not subsequently updated.
Evidence-Based Practice Reports
Diabetes: Quality Improvement
- National Guideline Clearinghouse is a comprehensive database of evidence-based clinical practice guidelines from government agencies and health care organizations. It describes and compares guideline statements with respect to objectives, methods, outcomes, evidence rating scheme, and major recommendations.
American College of Physicians
Numeric Presentation of Results
The following primers are some of several available:
- Primer on 95% Confidence Intervals for the Number Needed To Treat
- Primer on Absolute vs. Relative Differences
- Primer on Cost-Effectiveness Analysis
- Primer on Statistical Significance and P Values
- Primer on 95% Confidence Intervals
- American College of Physicians Journal Club Plus ACPJC evaluates evidence in individual articles. Commentary by ACP author offers clinical recommendations. Access to the online version of ACPJC is a benefit for members of the ACP.
American Diabetes Association: Clinical Practice Recommendations
This compilation contains all the current ADA positions statements, technical reviews, and consensus statements related to clinical practice, as well as the evidence grading system used. Updated yearly in January.
Features short evaluations and discussions of individual articles dealing with evidence-based clinical practice.
Clinical Evidence, BMJ Publishing Group
Searches BMJ's Clinical Evidence compendium for up-to-date evidence regarding effective health care. Lists available topics and describes the supporting body of evidence to date (e.g., number of relevant randomized controlled trials published to date). Concludes with interventions "likely to be beneficial" versus those with "unknown effectiveness." Individuals who have received a free copy of Clinical Evidence Issue 5 from the United Health Foundation are also entitled to free access to the full online content.
Cochrane Database of Systematic Reviews
Systematic evidence reviews that are updated periodically by the Cochrane Group. Reviewers discuss whether adequate data are available for the development of evidence-based guidelines for diagnosis or management.
Bimonthly publication launched in 1995 by the BMJ Publishing Group. Article summaries include commentaries by clinical experts. Subscription is required.
Grading of Recommendations Assessments, Development and Evaluations (GRADE) Workgroup
The WHO, UpToDate, and The Endocrine Society use this approach. The website details the process by which recommendations can be made which incorporates a strength of the recommendation that is based on the quality of the evidence as well as the balance between benefits and harms. It features anFAQ section.
Guide to Community Preventative Services
The Guide to Community Preventive Services is developed through systematic reviews of available evidence of effectiveness for population-based interventions addressing diabetes focused on strategies within two areas: health-care system level interventions promoting disease and case management; and diabetes self-management education in various settings.
Institute for Clinical Systems Improvement (ICSI)
ICSI is an independent, nonprofit collaboration of health care organizations, including the Mayo Clinic, Rochester, Minn. Web site includes the ICSI guidelines for preventive services and disease management.
National Health Service (NHS) Centre for Reviews and Dissemination (CRD)
Searches CRD Databases (includes DARE, NHS Economic Evaluation Database, Health Technology Assessment Database) for evidence-based reviews. More limited than TRIP Database.
- Public Health Information and Data Tutorial This site reviews the types of statistics and data sets that are available on the Internet.
Translating Research Into Action for Diabetes (TRIAD)
TRIAD is a national study in six research centers to improve the quality of care and quality of life for people with diabetes. The goals are to assess the level of care provided to people with diabetes, identify the barriers that get in the way of people receiving care, and find new ways to provide better care to people with diabetes.
The TRIP Database features hyperlinks to the largest collection of evidence-based tools materials on the internet, including NGC, POEM, DARE, Cochrane Library, CATbank, and individual articles.
U.S. Preventive Services Task Force
This website features updated recommendations for clinical preventive services based on systematic evidence reviews by the U.S. Preventive Services Task Force.