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Exciting News: Introducing the New Essential Evidence Plus!

We are thrilled to announce that a brand-new version of Essential Evidence Plus is on its way! Mark your calendars for the launch date, September 11th, as we are introducing a modern, mobile-first application that will revolutionize your experience. With this update, accessing our valuable content will be easier and more convenient than ever before.

What to Expect from the New Essential Evidence Plus:

  1. Modern Mobile-First Experience: Our new application has been meticulously designed with a mobile-first approach. No matter what device you're using, whether it's a smartphone, tablet, or desktop, you'll enjoy a seamless and intuitive user experience.
  2. Enhanced Accessibility: We understand the importance of accessing content from anywhere, at any time. The new Essential Evidence Plus will provide you with the flexibility to explore our extensive collection of evidence-based resources on the go, making it easier to stay up to date with the latest medical knowledge and interactive tools.
  3. Improved User Interface: We have revamped our user interface to ensure effortless navigation and a visually appealing experience. Finding the information, you need will be quicker and more intuitive, saving you valuable time and effort.

Essential Evidence Plus will be available to users during this transition. However, please note that ability to create new trial and individual subscriptions will not be available from September 8th to September 11th 7:00 AM EST. During this period, we will be working diligently to transfer our existing system to the upgraded platform, ensuring a seamless transition for all users.

We apologize for any inconvenience caused by this temporary interruption. Rest assured, our team is committed to bringing you a superior user experience, and we appreciate your patience and understanding during this time.

Stay Tuned for the New Essential Evidence Plus!

We are counting down the days until September 11th when the new Essential Evidence Plus will be available for you to explore. Get ready to unlock a wealth of evidence-based resources that empower you in your medical decision-making process.

Thank you for your continued support, and we look forward to delivering an exceptional experience with the all-new Essential Evidence Plus!

Essential Evidence Plus

Daily POEMs Alerts

Delivered directly to you by e-mail every Monday through Friday, Daily POEMs identify the most valid, relevant research that may change the way you practice. Monthly, the complete set is compiled and sent for additional summary review. Each Daily POEM is also added to the Daily POEMs database in Essential Evidence Plus, for easy future reference.

Ongoing since 1996, our editors now review more than 1,200 studies monthly from more than 100 medical journals, presenting only the best and most relevant as POEMs.

The acclaimed POEMs process applies specific criteria for validity and relevance to clinical practice. About 1 in 40 studies qualifies.

Manage POEMs

For Individuals

To manage your Daily POEMs email subscription go to “My Account” and choose the preference that is best for you: daily, monthly, or none at all.

For Institutional Users

To get Daily POEMs email alerts you can sign-up or make changes through your “Personal Profile” or you can contact your librarian.

Read these instructions for creating a personal profile, then register online.

Sample Daily POEMs Email Alert

Sample Daily POEMs Email Alert View Full Size

A Sample Daily POEMs Email Alert

Vitamin E not helpful, perhaps harmful

Clinical question

In patients with or without heart disease, does vitamin E supplementation decrease mortality?

Bottom line

Vitamin E supplementation does not decrease all-cause mortality in patients with or without pre-existing heart disease. At higher doses it can actually be harmful, although the deleterious effect is small (number needed to treat to harm = 250). (LOE = 1b)


Miller ER 3rd, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med 2005; 142:37-46.

Study design

Meta-analysis (randomized controlled trials)


Outpatient (any)


The antioxidant property of vitamin E has led many to use it to prevent cardiovascular or cancer-related mortality. However, several studies and several previous meta-analyses have shown either no benefit or a slight increase in mortality with its use. The authors of this study performed a literature search in the usual way, searching MEDLINE, the Cochrane Clinical Trials Database, and reference lists and files. They included 19 randomized studies of almost 136,000 patients comparing vitamin E with a control or placebo group for at least 1 year and with at least 10 deaths in the trial. Study subjects varied and included elderly patients, healthy adults, and patient with cardiovascular disease. Study results were analyzed by intention to treat. The method of data extraction was not explained and studies were not graded or selected on the basis of quality. In the studies the baseline death rate was approximately 10%. Overall, there was no difference in all-cause mortality between the control group and placebo group. However, when comparing low-dose versus high-dose vitamin E (less than 400 IU/day vs 400 IU/day or more), differences were found. In the studies of lower doses, there was no benefit or detriment to vitamin E supplementation (relative risk = 0.98; 95% CI, 0.96-1.01). When high dose supplementation was studied separately, the risk was slightly but significantly higher in the supplemented group, with a number needed to treat to harm of 250 (143 - 998). The effect of vitamin E supplementation was not different when the results were evaluated by patient's sex or average age, or by the length of follow-up.