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BestBETS (Best Evidence Topic Reports) is a system designed by emergency physicians at Manchester Royal Infirmary, UK. It was conceived as a way of allowing busy clinicians to solve real clinical problems using published evidence. The system is based on the principles of evidence-based medicine as set out by Sackett et al. The web-based system is free to use and free to access via the Internet. It is believed to be the largest repository of emergency medicine short cut reviews in the world.
Although originally developed in Manchester, the system now takes contributions from all over the world. BETs are published in a number of print journals covering a broad range of topics. Initially these were focused on emergency medicine, but in recent years this has diversified to include surgical, rehab, ophthalmological and paediatric questions.
All BETs have the same format:
- Clinical scenario – this describes the problem facing the clinician
- A three- or four-part question – this encapsulates the problem in an answerable form
- An explicit search strategy – typically across several databases (e.g. Medline, Cochrane)
- A tabulated analysis of the papers found
- A discussion of the papers
- A clinical bottom line
Following an initial paper based system for recording BETs at a local level, a web-based repository and development tool was designed. The site at http://www.bestbets.org/ now has over 1700 BETs published in online format. The development tool allows any registered author to use the BET creation engine to develop and e-publish their BET.
BestBETs in print
Selected BETs are published in medical journals, although sometimes under a different name. The Emergency Medicine Journal publishes 3–5 BETs per month. In the paediatric journal, Archives of Disease in Childhood, BETs are published under the name ‘Archimedes’, although the format is the same. Similarly a large number of BETs have been published in the Interactive Cardiovascular and Thoracic surgery.
Many people have contributed to the successful development of the BestBETs system. Major contributions have come from all the Consultants within the emergency department at Manchester Royal Infirmary, ably supported by Katharine Wylie (senior information scientist).