DynaMed for the Rest of Us

Michelle Henley, MLSInstruction & Consultation Services

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Class outline

• Describe Dynamed

• Locate evidence-based condition summaries

• Get evidence-based treatment guidelines

• Access information for patients

• Review clinical case scenarios

• Access Dynamed via desktop or mobile

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What is Dynamed?

• A point of care evidence-based tool with clinically-organized summaries for over 3,200 topics; information is updated daily.

• Dynamed  editors systematically identify, select and evaluate the content of 500+ medical journals on a daily basis, then provide summaries of the best evidence.

• Also provides treatment guidelines and patient information, as well as direct links to the SFGH formulary.

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What is “evidence-based”?

• Conclusions are based on best available evidence

• In clinical setting, best available evidence is typically:

– Systematic Reviews– Meta-Analysis– Randomized Controlled Trial

Image source: SUNY Downstate Medical Center. Medical Research Library of Brooklyn. The Evidence pyramid. Accessed January 3, 2013 from http://library.downstate.edu/EBM2/2100.htm

Dynamed’s “Levels of Evidence”Recommendations are graded by the level of evidence found; other grading

systems noted (e.g., ACCP) when appropriate

How to access resource

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sfghlibrary.ucsf.edu

Browse topics in DynaMed

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Enter key words in search box to see results ranked by

relevancy

OR Select a letter to browse alphabetically OR Select here to view

topics by category, e.g., “allergic disorders”

Condition summary

Treatment options, rated by level of

evidence

Includes symptoms

Links to guidelines

History & Physical

See symptoms under “History”

Treatment

“Levels of Evidence” label

Guidelines & Resources

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Links to full-text of guidelines

Patient Information

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Links to patient handouts from reliable sources

Case scenario example

Mr. B is in Med-Surg recovering after hip surgery. He is over 65 and obese, but has no other risk factors for deep vein thrombosis (DVT). Still, the physician suggests he be monitored for symptoms, ambulated early if he presents with DVT, and provided appropriate education for prevention.

You don’t have time to do all this research, so decide to use DynaMed. You hope to find a summary noting symptoms and evidence for early ambulation, prevention guidelines for post-surgical patients, as well as a handout on prevention for Mr B.

Exercise 1

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Mrs. T visits the clinic, complaining she can’t sleep due to “nervous legs”. The physician suspects “Restless Leg Syndrome” (RLS) and prescribes pramipexole. Mrs. T seems concerned about taking the medication so you wonder whether non-pharmacological approaches, such as exercise, may be effective in relieving symptoms.

1. Search for a report on RLS

2. Is there good evidence that exercise relieves RLS symptoms?

3. What do AASM guidelines say about non-pharmacological therapies?

4. Is there at least one patient handout that discusses both therapies?

Exercise 2

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A 65 yo man presents to the ED complaining of chest pain, fatigue and weakness. He is diagnosed with heart failure and prescribed a diuretic. You wonder if diuretics can effectively reduce his risk of death from heart failure and if there are any guidelines highlighting non-pharmacological ways to prevent recurrence.

1. Search for a report on heart failure

2. Is there good evidence that diuretics improve mortality rates?

3. Are there any guidelines for non-pharmacologic management?

4. Is there at least one patient handout noting ways to reduce his risk for heart failure?

How to access via mobile device

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• Use the DynaMed Mobile app from your mobile phone or other device

• Compatible with iPhone, iPad, iPod touch, Android, BlackBerry, Windows Phone & Palm

• Contact the Library to get instructions and a serial number to use

library@sfgh.ucsf.edu OR 206-3114

Need more help?

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DynaMed guidehttp://sfghdean.ucsf.libguides.com/dynamed

Contact meMichelle Henley

Barnett-Briggs Medical Library

206-6638 or michelle.henley@ucsf.edu