Applied Evidence-Based Medicine: Resources on the Hardin Electronic Library Site Steven R. Craig, MD, MACP 2020 Organization & Objectives of Presentation ◼ Review on-line EBM resources (Emphasis on Hardin Electronic Library resources) ◼ Understand the hierarchy of evidence & EBM resources ◼ Demonstrate mobile (downloadable) resources ◼ Demonstrate the ability to quickly search easily accessible EBM resources www.lib.uiowa.edu/hardin Quick Access to Popular Resources Hawk ID & Password: Must be Re-set Every 6 months Call 319-384-HELP (4357) if Assistance Needed Many free MedlinePlus For Med Students downloadable FamilyDoctor.org & For Residents resources Ethno Med • BMJ Best Practice • DynaMed Plus • Clinical Key First Consult ACP Journal Club BMJ Updates TRIP & SUMSearch search these simultaneously Hardin’s EBM Resources ◼ BMJ Best Practice ◼ Clinical Key (First Consult, formerly MD Consult) ◼ Cochrane Clinical Answers ◼ Cochrane Library ◼ DynaMed Plus ◼ Natural Medicines (complementary & alternative therapies) Hardin’s EBM Resources (continued) ◼ PubMed Clinical Queries ◼ SUMSearch ◼ TRIP Database ◼ UpToDate Clinical Key / First Consult ◼ First Consult: High quality, regularly updated medical reference ◼ Commercial Product by Elsevier ◼ Search clinical condition, diagnosis, drug, procedure ◼ Summary of evidence quality with citations provided ◼ Free downloadable version available from Hardin Cochrane Library ◼ Independently done systematic reviews of therapies ◼ Gold Standard of systematic reviews ◼ Library Includes: * Cochrane Database of Systematic Reviews * Cochrane Clinical Answers * Trials (CENTRAL = Clinical Trials Registry) Cochrane Clinical Answers are very truncated summaries of systematic reviews. DynaMed Plus ◼ Clinical reference tool for point-of-care use ◼ Produced by EBSCO Publishing ◼ Updated daily based on monitoring of over 500 medical journals + systematic review databases ◼ New evidence is integrated with existing content so synthesis of best available evidence provided ◼ Organized in a structured note format ◼ Free downloadable version available from Hardin DynaMed Plus Evidence Ratings ◼ Level of Evidence Ratings Level 1: highly reliable Level 2: mid-level (moderately) reliable Level 3: lacking solid evidence Natural Medicines ◼ High quality, evidence-based reviews of complementary and alternative therapies ◼ Each product review covers: Effectiveness Interactions Safety Mechanisms of Action Dosing Pharmacokinetics Adverse Effects References ◼ NMBR ratings for each product combine evidence- based effectiveness ratings and safety ratings PubMed ◼ Free Search engine developed by NLM to retrieve publications from MEDLINE & other sources ◼ MEDLINE developed by NLM to access biomedical journal articles (5200+ journals / 37 languages) ◼ All articles indexed using NLM’s MeSH ◼ Limits feature allows you to restrict types of publications retrieved ◼ My NCBI option allows you to set preferences, save old searches, receive alerts if new citations ◼ Session with librarians will demonstrate features SUMSearch 2: A multi-source search engine ◼ Site developer works at KU-Wichita (formerly at UT-SA) ◼ Automates the search for evidence ◼ Primarily searches NLM, DARE, NGC for journal entries, systematic reviews, practice guidelines ◼ Categories of Answers Provided: * Original Research * Systematic Reviews * Practice Guidelines TRIP (Turning Research into Practice) Another multi-source search engine ◼ Developed at University of Wales, supported by UK NHS but also accept other sponsors and advertisers ◼ Tool for quickly locating evidence from multiple sources to answer key clinical questions ◼ Categories of Answers Provided: * Systematic Reviews * Evidence-Based Synopses * Guidelines * Key Primary Research * Clinical Q & As * Ongoing Primary Research * eTextbooks The Early Crowd Favorite: UpToDate UpToDate Concerns Advantages Concerns ◼ Extensive review of both ◼ Variable quality of topics pediatric & adult topics reviewed ◼ Easy to search ◼ Lack of consistency in stating ◼ Very easy to read quality of evidence behind recommendations ◼ Excellent graphics: tables, photos, references ◼ Difficulty separating expert opinion from fact ◼ PDA version for easy point-of-care use (available ◼ Updates can be misleading: from Hardin) don’t address all new evidence The Hierarchy of Evidence The Evidence Pyramid Resources for Systematic Reviews ◼ Cochrane Systematic Reviews (gold standard) ◼ TRIP Database ◼ SUMSearch 2 ◼ PubMed Clinical Queries search for systematic reviews Resources for Critically-Appraised Topics ◼BMJ Best Practice ◼DynaMed Plus ◼First Consult ◼SUMSearch 2 ◼TRIP Database Resources for Critically-Appraised Individual Articles ◼ ACP Journal Club ◼ TRIP Database Unfiltered Resources ◼ Individual Research Studies: RCTs > Cohort Studies > Case-Controlled Studies > Case Series * PubMed Search Engine * Medline (commercial product) * CINAHL (mostly nursing & allied health) * PsycInfo (psych studies) * Embase (more basic science) Background Information & Expert Opinion ◼ UpToDate* ◼ Other electronic textbooks such as Harrison’s Online, Nelson’s Textbook of Pediatrics, Schwarz Principles of Surgery etc. *Some Topics are more evidence-based & updated when new evidence emerges Mobile Resources ◼ On the Specialty Resource Home Page: Click on Mobile Devices Subject Guide ◼ Hardin Library Staff can assist you. Contact staff at: [email protected] or 319-335-9151 MOBILE APPS AVAILABLE • AccessMedicine • Browzine • BMJ Best Practice • Clinical Key (First Consult) • DynaMed Plus • Gale Human Anatomy • Hopkins ABX Guide • The Medical Letter • MicroMedex (Drug (Info/Interactions) • Micromedex Neofax & Peds Essentials • OvidToday • StatRef! • UpToDate • VisualDX Browzine: Resource to access Browzine Available for: iOS and Android tablets, iPhones, and Android “Small Screen" Smartphones BrowZine Features: Quickly scan vast numbers of journals from over 1000 publishers/imprints from one location regardless of publisher or aggregator • Create a personalized "reading room”: follow up to 64 journals via “My Bookshelf“ • Receive alert notifications when new articles are published • Maximize productivity: save articles to read later when it’s convenient The End. Questions?.