Transcript of Clinical Information Resources Sandra A. Martin, M.L.I.S. Health Sciences Resource Coordinator...
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- Clinical Information Resources Sandra A. Martin, M.L.I.S.
Health Sciences Resource Coordinator Instructor of Library Services
John Vaughan Library Room 305B marti004@nsuok.edu 918-444-3263
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- Learning Objectives To familiarize students with the
information retrieval process for evidence-based patient care To
enable students to use synthesized/filtered/pre- appraised
resources to answer clinical questions To enable students to use
the 6S hierarchy of organization of evidence to plan search
strategies of the clinical literature
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- Information Retrieval for Evidence Based Patient Care Using
research findings versus conducting research Retrieving and
evaluating information that has direct application to specific
patient care problems Selecting resources that are current, valid
and available at point-of-care Developing search strategies that
are feasible within time constraints of clinical practice
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- Integrating the EBM Process into Information Retrieval &
Application Convert information needs into focused questions.
Efficiently track down the best evidence with which to answer the
questions. Consult pre-appraised evidence resources for answers
that are directly useful for clinical practice decisions, or
Critically appraise the evidence found in other clinical
information resources for validity and clinical usefulness Apply
the results in clinical decision making. Evaluate usefulness of the
evidence in clinical application.
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- Answers to Clinical Questions Require: precise information
about complex issues trustworthy clinical research data with direct
application to patient problems Fill gaps in clinical knowledge
pertinent to: Therapy/prevention Diagnosis Prognosis Etiology
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- Search Strategy for EBM Retrieval Derive search terms from
clinical question Match best study design to type of question Begin
search at highest level of evidence 7
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- Extract search terms from question Therapy/Prevention Question
In patients with primary open angle glaucoma or ocular hypertension
[Patient/Population], do topical medications to reduce intraocular
pressure [Intervention] versus no treatment [Comparison
Intervention], delay visual field defect progression
[Outcome]?
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- 1. Search Terms Primary open angle glaucoma, POAG Ocular
hypertension, OHT Intraocular pressure, IOP Visual fields, VF Limit
search results to therapy studies
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- 2. Best Study Design for Type of Question Type of QuestionStudy
Design Therapy/preventionRandomized controlled trials
DiagnosisProspective cohort, blind comparison to a gold standard
PrognosisCohort, Case Control, Case Series Etiology/HarmCohort,
Case Control, Case Series
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- 3. Highest Level of Evidence 6S Hierarchy
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- Search First at Top Levels of 6S MEDLINE - major source of
primary literature Process of searching, selecting, evaluating
original research is time consuming Requires critical appraisal
skills Filtered/Synthesized/Evaluated resources - secondary
literature Speed application of evidence at point-of-care Grade
strength of treatment recommendations Rate quality of research
evidence
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- Summaries UptoDate Evidence based summaries of over 9,500
topics in over 22 specialties 8,500 Treatment Recommendations GRADE
System used to score recommendations and strength of evidence
Practice changing updates; Updated continuously Drug database;
Patient education materials The Gold Standard of summaries
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- Clinical Question Therapy/Prevention In patients with primary
open angle glaucoma or ocular hypertension [Patient/Population], do
topical medications to reduce intraocular pressure [Intervention]
versus no treatment [Comparison Intervention], delay visual field
defect progression [Outcome]?
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- Simple UTD Search Answers Clinical Question in Seconds
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- Summaries FirstConsult Search online in Clinical Key App
available through NSU subscription to Clinical Key for iPhone or
iPad only Create a personal account in Clinical Key Download the
app from the Apple app store Login with your CK username and
password Concise summaries; sections on differential diagnosis;
quality of evidence graded Not updated as rapidly as UTD
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- Critical Assessment of Systematic Review cited in UTD and
FC
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- Syntheses Cochrane Database of Systematic Reviews (DSR) Part of
the Cochrane Library (1996) Over 900 completed reviews, 1900
protocols Among the highest level of evidence upon which to base
treatment decisions Includes Dx since 2008 Eyes & Vision
Research Group Contains over 200 reviews Full Text Available in
Ovid
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- ACPJC Primary Care Focus
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- Databases MEDLINE Premiere biomedical database from the NLM
(National Library of Medicine) Covers 1946-present Indexes >5000
international biomedical journals Full text available for many
articles Access through Ovid and Clinical Key
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- Search of Current MEDLINE files yields 49 studies to scan and
appraise
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- Clinical Key Full text access to 1,000 books and 500 journals
in every medical and surgical specialty Ophthalmology Over 60 full
text books Includes 12 Content Types Access to information at all
levels from topic overview to evidence-based data in one search
Smart search engine matches first few letters of search word/words
to relevant clinical content No complicated search strategies or
Boolean connectors
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- CK MEDLINE Yields 89 RCTS in last 5 Years to Scan and
Appraise
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- CK Topic Overview Page from Current Textbook is not Evidence
Based
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- Take Home Points Focused clinical question (PICO) reveals your
search terms and best type of studies Start your search at top of
6S hierarchy and work down (UpToDate, First Consult) Be aware of
the filters: levels of evidence, graded recommendations, speed of
updating Look at more than one resource in the hierarchy. Findings
may differ Apply in clinical settings; assess your progress
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