MISSIONCommitted to improving

patient care by providing the most

CURRENT CLINICAL

EVIDENCE TO CLINICIANS so they can make the best decisions

for their patients.

The Next Generation Clinical Information Resource

• Re-created from the ground up

• New physician leadership

• New platform

• New search algorithm

• New interface

• New content

• New features

…Not a textbook

A TOOL Created by

physicians who are

EXPERTSin their

respective fieldswho provide

OBJECTIVE ANALYSIS of the evidence & recommendations

in an easilydigestible format

with access anytime, anywhere from any device or system

to DynaMed vs. UpToDate

• It doesn’t tell me what to do

• Lack of expert reviewers

• Lack of specialty content

• There are no images

• It’s hard to get an answer quickly

TOP FIVE OBJECTIONS

It doesn’t tell mewhat to do

OVERVIEWS AND RECOMMENDATIONS

• Overviews and Recommendations provide clinicians with concise, accurate overviews for highly relevant topics and evidence-based recommendations for action.

• Topics have been re-written from scratch to provide immediate context and direction

New Overviews and Recommendations at the topNew Overviews and Recommendations at the top

DynaMed Plus offers many examples of strong and weak recommendations

Clicking on a link provides the user with levels of evidence and guidelines behind each recommendation

DynaMed Plus offers many examples of strong and weak recommendations

Clicking on a link provides the user with levels of evidence and guidelines behind each recommendation

DynaMed Plus provides links to the levels of evidence and the guidelines behind each recommendation

DynaMed Plus provides links to the levels of evidence and the guidelines behind each recommendation

The GRADE (Grading of Recommendations Assessment,

Development and Evaluation) system was created in 2000

by a dedicated group of guideline developers.

RECOMMENDATIONS

are graded as Strong or Weak

EVIDENCE

is graded for the body of evidence as High, Moderate, Low or Very low quality (A, B, C, or

D).

QUALITY

grading for evidence is based on the risk of bias introduced by study methodology, the

precision the consistency of studies, the directness to the conclusion being made, and the

likelihood of publication bias.

What is GRADE?

GRADE is now the standard

• WHO

• The Endocrine Society

• ACCP

• ACP

• American Thoracic Society

• NKF/KDOQI

• KDIGO

• Norwegian Knowledge Center / Norwegian Directorate of Health

• Canadian Cardiovascular Society

• IDSA

• CDC

• AGA

• AASLD

• ICSI

• NICE

• SIGN

• NHS

• Kaiser Permanente

• Dutch College of GPs

• Multiple Red Cross groups

GUIDELINE GROUPSMore than 80 of the world’s leading organizations which produce guidelines formally use GRADE:

SYSTEMATIC REVIEWS Independent systematic

review organizations such as Cochrane have

incorporated GRADE

DynaMed Plus

EVIDENCE-BASED METHODOLOGY

Lack of expert reviewers

LEADERSHIP

BRIAN S. ALPER, MD, MSPH, FAAFPFounder of DynaMed, VP of EBM Research & Development, Policy and Content Quality, EBSCO Information Services, Clinical Research Assistant ProfessorDepartment of Family and Community Medicine, University of Missouri School of MedicineColumbia, MO

SHEILA BOND, MD Deputy Editor of Infectious Disease, Clinical Instructor in MedicineHarvard Medical SchoolBoston, MA

ALAN EHRLICH, MD Executive Deputy EditorAssistant Clinical Professor in Family Medicine, University of Massachusetts Medical SchoolWorcester, MA

KEVIN LOUGHLIN, MD, MBA, MA(HON)Deputy Editor of Oncology and Hematology, Senior SurgeonBrigham & Women's HospitalProfessor of Surgery, Harvard Medical School, Boston, MA

PETER OETTGEN, MD, FACC Deputy Editor of CardiologyDirector of Preventative Cardiology, Beth Israel Deaconess Medical Center, Associate ProfessorHarvard Medical SchoolBoston, MA

Editorial

FULLY INTEGRATED EXPERTS

• An extensive network of physicians

• Experts in their particular fields

• Select the best and most appropriate evidence

• Confirm the clinical applicability of content

• Peer-review topics

Matthew Coggins, MDInstructor of CardiologyHarvard Medical SchoolBeth Israel Deaconess Medical Center

Kevin Ard, MDInstructor of MedicineHarvard Medical SchoolAssistant in MedicineDivision of Infectious DiseasesMassachusetts General Hospital

Jennifer Johnson, MDInstructor in MedicineDivision of Infectious DiseasesHarvard Medical SchoolBrigham and Women's Hospital

Muhammad Mir, MD, FACPAssistant Professor of Hematology and Blood/Marrow Transplant Penn State UniversityMilton S. Hershey Medical Center

Obinna O. Adibe, MDAssistant Professor of Pediatric SurgeryDuke University Medical Center

Michelle Lin, MDAssociate Professor of Clinical Emergency MedicineAcademy Endowed Chair for Emergency Medicine EducationUniversity of California San Francisco

Jennifer Nan-Wah Wu, MDInstructor of Pediatric OncologyDana-Farber Cancer InstituteBoston Children's Hospital

Dawn Abbott, MD, FACC, FSCAIAssociate Professor of Medicine, Brown UniversityDirector of Interventional Cardiology FellowshipRhode Island and Miriam Hospitals

Christian Jackson, MDAssistant Professor of GastroenterologyLoma Linda UniversityChief of GastroenterologyLoma Linda VA Healthcare System

Kenneth Weiss, MD, FACPProfessor of MedicineCleveland Clinic Lerner College of Medicine

Physician Executive Board

We have established an

EXECUTIVE BOARD

charged with advising on editorial, EBM, and

editorial policy

Members represent JAMA, McMaster,

Penn, Emory, MGH, ACP and other

healthcare organizations.

Betsy JonesVice President of Medical Product Management and Chief Content Officer, EBSCO Health

Michael Berkwits, MD, MSCEDeputy Editor for JAMA 

Robert M. Centor, MD, MACPChair of the Board of Regents for the American College of Physicians

Julie Hollberg, MDCMIO for Emory Healthcare

William A. Kormos, MD, MPHChief of Medicine at the James Howard Means Firm, Department of Medicine

Holger Schünemann, MD, MSc, PhDProfessor and Chair of the Department of Clinical Epidemiology & Biostatistics 

 

Ilkka Kunnamo, MD, PhDFounder and Editor-in-Chief of EBM Guidelines and EBMeDS decision support program

Amir Qaseem, MD, PhD, MHA, FACPDirector of the Department of Clinical Policy at the American College of Physicians

Dr. Surendra K. Sharma, MBBS, MD, PhDChief of the Division of Pulmonary, Critical Care, and Sleep Medicine at the All India Institute of Medical Sciences

Craig Umscheid, MD, MSCEAssistant Professor of Medicine and Epidemiology at the University of Pennsylvania School of Medicine

Lack of specialty content

Editorial team structure

• General Internal Medicine

• Cardiology/Pulmonology/Critical Care

• ID/Immunology

• Oncology/Hematology

• Emergency Medicine

SPECIALTY PUBLISHING GROUPS:

Editorial team structure

• Harvard University

• Massachusetts General Hospital

• Beth Israel Deaconess Hospital

• Yale

• Brigham and Women’s Hospital

• Dana Farber Cancer Institute

• University of California San Francisco

• Cleveland Clinic

EXPERTS RECRUITED FROM:

AND MORE…

ROBUST SPECIALTY CONTENT

• Allergy

• Cardiology

• Critical Care

• Dermatology

• Infectious Disease

• Emergency Medicine

• Endocrinology

• Gastroenterology

• Hematology

• Nephrology

• Obstetrics and Gynecology

• Oncology

• Orthopedics

• Pediatrics

• Primary Care

• Psychiatry

• Rheumatology

• Sports Medicine

• Surgery

• Urology

There are no images

DynaMed Plus includes more than 4,000 images with more than 2000 from ACP. Images are searchable as well as embedded in relevant topics

DynaMed Plus includes more than 4,000 images with more than 2000 from ACP. Images are searchable as well as embedded in relevant topics

Selecting an image provides the user a larger viewSelecting an image provides the user a larger view

It’s hard to get an answer quickly

employs a brand-new, proprietary, semantically-

powered search engine, significantly improving

discoverability and speed-to-answer

Precise Search Results Search

DynaMed Plus employs intelligent auto-suggest, which identifies the user’s query and allows direct navigation to highly-accessed areas within topics

DynaMed Plus employs intelligent auto-suggest, which identifies the user’s query and allows direct navigation to highly-accessed areas within topics

Convenient filters allow quick access to images and calculators that are relevant to the user’s query

Convenient filters allow quick access to images and calculators that are relevant to the user’s query

DynaMed Plus offers superb navigation within the results display

With exact-match queries, DynaMed Plus displays a medical information placard, offering topic-specific links, images, and information

DynaMed Plus offers superb navigation within the results display

With exact-match queries, DynaMed Plus displays a medical information placard, offering topic-specific links, images, and information

By understanding the user’s intent, DynaMed Plus’ intelligent search is able to identify queries that yield robust image results and display them in a time-saving image carousel

By understanding the user’s intent, DynaMed Plus’ intelligent search is able to identify queries that yield robust image results and display them in a time-saving image carousel

This same technology presents the user with query-specific calculators

This same technology presents the user with query-specific calculators

Grouped results allow the clinician to quickly understand the context of the result

EXAMPLE: Result shows Pulmonary embolism within the Heart failure with reduced ejection fraction topic, and the path provides the context to understand that the result refers to treatment medications

Grouped results allow the clinician to quickly understand the context of the result

EXAMPLE: Result shows Pulmonary embolism within the Heart failure with reduced ejection fraction topic, and the path provides the context to understand that the result refers to treatment medications

Relevant results will navigate users directly to the specific section within DynaMed Plus’ clinically relevant outline-based structure

Relevant results will navigate users directly to the specific section within DynaMed Plus’ clinically relevant outline-based structure

Topic view offers next-generation navigation, providing immediate context to the user

Topic view offers next-generation navigation, providing immediate context to the user

Location within the topic is dynamically updated both in the navigation bar, as well as within the breadcrumb trail at the top of the screen

Location within the topic is dynamically updated both in the navigation bar, as well as within the breadcrumb trail at the top of the screen

DynaMed Plus offers all of the same quick-access features users have come to expect, including search within and highlighting

DynaMed Plus offers all of the same quick-access features users have come to expect, including search within and highlighting

DynaMed Plus employs a

FULLY RESPONSIVE DESIGN, which means it renders ideally for

any device or orientationiPhone Small Tablet iPad - Portrait iPad - Landscape

iPhone

Small Tablet

iPad - Portrait

iPad - Landscape

EHR IntegrationEHR Integration

EBSCO Health listens to the needs of our customers

and users which helps us build better products

overviews and recommendations

well-known expert reviewers

increased breadth/depth of specialty content

multimedia content

better search & discovery

DynaMed Plus has….

MICROMEDEX DRUG CONTENT

• Medication Management Standard Drug Information

• Drug Information for Medication Safety

• IV Compatibility for Reduced Complications

• Lab Recommendations

Micromedex evidence-based content is presented in concise,

sourced, and referenced blocks of information to help you get

answers quickly when the situation demands.

ACP Partnership

• ACP clinical leadership develops and maintains DynaMed Plus internal medicine topics

• Multiple members of ACP are part of the DynaMed Plus Executive Board 

Access anywhere, anytime

Graphics & Images

Access thousands of graphics and images

Precise Search Results

Get precise search results every time

Overviews & Recommendations

Read concise overviews and detailed recommendations

Specialty Content

DynaMed Plus includes robust specialty content

Expert Reviewers

Deputy Editors are supported by an extensive network of clinical experts

Mobile App

The mobile app is complimentary with every subscription, at no extra cost

Drug Content

Drug content to help with diagnosis with Micromedex® Clinical Knowledge Suite

SUMMARY OF NEW FEATURES

GRAZIEFabio Di Bello | Regional Manager Italy & Israel

349.4157827

fdibello@ebsco.com

Resources to Consider:

ACP Pier

BMJ Point of Care

Cochrane Library

DynaMed

Up-to-Date

Round 1

Who can find the answer most quickly?  Use any resource.

Round 1, Question 1

• Is glatiramer acetate effective for relapsing-remitting multiple sclerosis?  How does it compare to interferon beta?

Round 1, Question 2

What antibiotic should you use for a pregnant woman with acute cystitis?

Round 1, Question 3

• What is the dose of famciclovir for treating zoster in an immunocompetent patient?

Round 1, Question 4

• Are graduated compression stockings effective for reducing the risk for venous thromboembolism after acute stroke?

Round 1, Question 5

• You have a new patient who is an adolescent with obsessive-compulsive disorder.  Her parents state this is due to a strep throat.   What are the criteria for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infection (PANDAS)?

Round 1, Question 6

• How do you diagnose chronic fatigue syndrome?

Round 1, Question 7

• A 45-year-old man complains of shortness of breath for two hours and there was a sudden onset.  Two days ago he traveled 12 hours by airplane.  He has no history of prior thromboembolism, cancer, or other medical conditions.  He has tachycardia (pulse 106 beats/minute) but otherwise normal findings on physical examination.  Would you classify his risk for pulmonary embolism as high, intermediate, or low?

Round 1, Question 8

• For the man with an intermediate risk of pulmonary embolism, what testing should you do?   Consider the resources available for testing in your setting.

Round 1, Question 9

• How do triflusal and cilostazol compare to aspirin for secondary prevention of stroke in a patient with a history of transient ischemic attacks (TIAs)?

Round 1, Question 10

• What is the most effective antibiotic for uncomplicated symptomatic urinary tract infection in women?

Round 2

• Check different resources to see if the answers are consistent.  If not, why not?

Round 2, Question 1

• A 3 year-old girl weighing 13.3 kg (30 lbs) has rotaviral gastroenteritis and moderate dehydration. How do you start fluid replacement?

Round 2, Question 2

• A man complains of sudden sensorineural hearing loss.  You prescribe steroids. Should you also include antiviral therapy as part of your treatment plan?

Round 2, Question 3

• You are establishing a protocol for response to patients who develop anaphylaxis in your medical practice.  The nurse asks if epinephrine administration can be given subcutaneously instead of intramuscularly.  Is there a difference in efficacy between the subcutaneous and intramuscular routes?

Round 2, Question 4

• You are seeing a 22-month-old boy in follow-up after treatment for a urinary tract infection (UTI). He was found to have grade II vesicoureteral reflux (VUR). You wonder if you should start an antibiotic for prophylaxis, and if so, which antibiotic?

Round 2, Question 5

• How do you diagnose irritable bowel syndrome (IBS)?  What evaluation is indicated?

Round 2, Question 6

• You diagnosed irritable bowel syndrome.  Is fiber an effective treatment?

Round 2, Question 7

• Do antihypertensive medications reduce cardiovascular events in a patient with mild hypertension (blood pressure 145/95 mmHg) and no other cardiovascular risk factors?