Clinical Information Resources OPT 5191 Intro to Clinic II Sandra A. Martin, M.L.I.S. Health...
-
Upload
paul-wright -
Category
Documents
-
view
213 -
download
0
Transcript of Clinical Information Resources OPT 5191 Intro to Clinic II Sandra A. Martin, M.L.I.S. Health...
Clinical Information ResourcesOPT 5191 Intro to Clinic II
Sandra A. Martin, M.L.I.S.Health Sciences Resource Coordinator
Instructor of Library ServicesJohn Vaughan Library Room 305B
[email protected] – 918-444-3263
Existing knowledge can prevent…
•Waste•Errors•Poor quality clinical care•Poor patient experience•Adoption of interventions of low value•Failure to adopt interventions of high value
Source: Sir Muir Gray, Chief Knowledge Officer of Britain’s National Health Service. Quoted on http://www.nks.nhs.uk/.
Learning Objectives
To familiarize students with the information retrieval process for evidence-based patient care
To enable students to access and use synthesized, evidence-based resources to answer clinical questions
To enable students to conduct efficient online searches of databases, e-Journals, and e-Books to answer clinical questions
Sandra Provides….
Instruction Research Assistance Consulting for individuals and small groups Database Searches Help in Locating Full Text Articles
Online – Mobile - Print RUSH delivery of Interlibrary loan requests Assistance with any health-related information need
Helpful Tools Optometry Web Page
Optometry Databases, e-journals, e-books, and other tools available 24/7
Supports specific research, teaching, and patient care needs of NSUOCO faculty, students, and residents
Start Here to find resources for all vision science and medical topics http://library.nsuok.edu/collegeop/index.html
Guide to Library Resources and Services Lists current online databases, e-Journals, and e-Books
Database Guides and Tutorials Clinical Key, OVID,
Remote Access
Enter NT-NSU user id and password to access the library’s electronic resources
Contact Tom Tinnell if you have problems with your user id or password
Contact Sandra to report other technical problems or for search assistance
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
Integration of Clinical Research into Patient Care Process
www.cebm.net
“Evidence-based medicine is the integration of best research evidence with clinical expertise and patient values”
Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS: Evidence based medicine: what it is and what it isn’t. BMJ 1996;312:71-2.
Patient Concerns
Clinical Expertise
Best research evidence
EBM
What is EBM?
Information Retrieval to Answer Clinical Questions Requires New Skills
Clinical question formulation Search and retrieval of best evidence Critical appraisal of study methods
Clinical Questions
Most common types: Therapy/prevention Diagnosis
Answerable Questions: Are most important to the patient’s well being Fill gaps in your clinical knowledge Are feasible to answer in the time available
Is All Evidence Created Equal?
Small portion of medical literature is immediately useful to answer clinical questions
Understanding “wedge or pyramid of evidence” is helpful in finding highest level of evidence
High levels of evidence may not exist for all questions due to nature of medical problems and research limitations
As you move up the pyramid the amount of available literature decreases, but it increases in its relevance to the clinical setting.
Source: Sackett, D.L., Richardson, W.S., Rosenberg, W.M.C., & Haynes, R.B. (1996). Evidence-Based Medicine: How to practice and teach EBM. London: Churchill-Livingstone.
Best Study Design for Type of Question
Type of Question Study Design
Therapy/prevention Randomized controlled trials
Diagnosis Prospective cohort, blind comparison to a gold standard
Prognosis Cohort, Case Control, Case Series
Etiology/Harm Cohort, Case Control, Case Series
Therapy/Prevention Question
1. In patients with open angle glaucoma [patient], does lowering intraocular pressure [intervention] versus no treatment[comparison] delay visual field loss [outcome]? PICO Model
2. Find the answer that is supported by valid studies appropriate to the type of question and that is available in a timely manner
4S Hierarchy
Critically Appraised Content
Evidence Based Summaries Dynamed, Clinical Key, First Consult, UptoDate
ACP Journal Club
Cochrane Database of Systematic Reviews
Clinical Key & Ovid MEDLINE
SOURCE: Haynes, R. B. (2001). Of studies, syntheses, synopses, and systems: the “4S” evolution of services for finding current best evidence. Evidence-Based Medicine, 6 (2), 36-38. Retrieved 2-07-07 from http://ebm.bmj.com/cgi/reprint/6/2/36
New Resource – 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 Easier than Google – but with reliable, evidence-based
results
Clinical Key includes all 4S levels plus MEDLINE, books and overviews
Systems/Summaries• FirstConsult
– 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 Clinical Key username and
password– Summaries are detailed and include sections
on Differential Diagnosis– Eyes and Vision topics well covered
Systems/Summaries
• DynaMed– Summaries for more than 3,000 topics– Monitors >500 medical journals and
systematic review databases– Updated daily– Each article evaluated for clinical relevance
and scientific validity– Includes “graded evidence”
Glaucoma Summary
Evidence-based answer found in 1 minute, 39 seconds
Systems/Summaries• UptoDate
– Evidence based summaries of over 9,500 topics in over 20 specialties
– Ophthalmology not one of the specialties– Good for information on systemic conditions– Available through individual subscription.
Online access plus Mobile app for iPhone and iPad. Cost: $199 per year in training; $499 per year in practice
Available in the Optometry Clinic at Hastings Hospital. Use Resource tab and scroll down to the UptoDate linkSample summary at http://www.uptodate.com/contents/management-of-persistent-hyperglycemia-in-type-2-diabetes-mellitus
If you need Help, contact Sandra
Click on the Optometry Librarian’s Page link from the Optometry web page http://library.nsuok.edu/collegeop/index.html
Email: [email protected] Phone: ext. 3263 or 918.444.3263 Location: Library Room 305B Available for individual or small group consultation Send email with “OPT Clinical” in the subject line -
Receive a response within 24 hours