ACCESSSS is a service to help provide current best evidence for clinical decisions. It conducts literature searches simultaneously in several different evidence-based information services (online evidence-based texts, and pre-appraised journal publications). ACCESSSS also provides email alerts to newly published evidence in the user’s chosen area(s) of training/interest.

Searching ACCESSSS yields content that is hierarchically organized: Always look first at the content available at the highest level of the hierarchy, as it is most likely to be useful for clinical purposes.

The hierarchy is based on principles of evidence-based decision-making:

  • Systems provide patient-specific computerized decision support – “under construction” at present
  • Summaries provide the best summarization of evidence for entire clinical topics (eg asthma, diabetes)
  • Synopses are brief abstracts of high quality original studies and systematic reviews
  • Syntheses are systematic reviews of original studies
  • Studies are original investigations, such as randomized trials

For more details please consult: Explanation of the 6S model

What do the ratings in McMaster PLUS mean?

The current features of PLUS include:

  • systematic review of over 120 journals (including quarterly updates of the Cochrane Library) with selection of articles by expert research staff concerning the cause, course, diagnosis, prediction, prevention, and treatment of health problems, quality improvement and health economics, according to explicit criteria , with high reproducibility and periodic quality assurance checks.*
  • ratings of each eligible article for clinical relevance and newsworthiness by at least 3 practitioners for each discipline for which the article might be pertinent. The McMaster Online Rating of Evidence (MORE) rating panel has >5000 physicians from around the world, all in clinical practice, with about half in primary care, and the rest in internal medicine and its subspecialties, and other major specialties including pediatrics, psychiatry, obstetrics, gynecology, surgery, and anaesthesiology; >3000 nurses in 31 areas of practice specialization; and >1000 rehabilitation specialists and 21 fields of interest.
  • e-mail alerts about new evidence, tailored to the user's interest profile and adjustable for their time demands. Each alert includes MORE clinical ratings and comments, and electronic links to the article's abstract via PubMed (if available).
  • Links to fulltext articles and summaries for free fulltext articles and Clinical Evidence topics (a subscription or fee may be needed for some of these articles and summaries).
  • Hit Parade, the articles most frequently accessed by practitioners with your interests.
  • a cumulative searchable database of the alerts that is continuously updated (from 2003 forward).
  • a user interface allowing each user to register their health care interests, leading to matching of those interests to the appropriate "virtual" subset of the accumulating database.

* Wilczynski NL, McKibbon KA, Haynes RB. Enhancing retrieval of best evidence for health care from bibliographic databases: calibration of the hand search of the literature. Medinfo. 2001;10(Pt 1):390-3.


The information contained in ACCESSSS is intended for health care professionals and is provided on an "as is" basis without warranty of any kind, express or implied.

ACCESSSS provides an educational service for practicing clinicians, designed to alert clinicians to important new research; however, we cannot warrant its accuracy. It is intended to support evidence-based decision making, by providing links to published research reports about the diagnosis, treatment, prediction and prognosis, etiology, and economics of medical conditions. However, "evidence does not make decisions"**, and clinicians making decisions about the care of their patients must take into account the limitations of evidence from research as well as the unique nature of their patients' circumstances and wishes. Readers should also be aware that professionals in the field may have different opinions about the interpretation of evidence from research. Because of this fact and also because of regular advances in medical research, we strongly recommend that readers independently verify any information they chose to rely on. Ultimately it is the readers' responsibility to make their own professional judgements.

ACCESSSS attempts to provide access to the best new research of relevance for clinical practice. It does not report all research but uses explicit criteria to define a subset of published research that is likely to be valid and ready for clinical attention in these disciplines. Practicing physicians then provide their assessments of the relevance and newsworthiness of the reports through an online review process, the McMaster Online Rating of Evidence (MORE). Individual clinicians who then receive these reviews must then apply their own judgment concerning the strength and applicability of this evidence to their own patients.

Description or reference to a product or publication does not imply endorsement of that product or publication.

To the fullest extent permitted by law, McMaster University is not responsible for any losses, injury or damage caused to any person or property (including under contract, by negligence, products liability or otherwise) whether they be direct or indirect, special, incidental or consequential, resulting from the application of the information on ACCESSSS.

**Haynes RB, Devereaux PJ, Guyatt GH. Physicians and patients' choices in evidence-based practice. Evidence does not make decisions, people do [Editorial]. BMJ 2002;324:1350.