Janet G Schnall, MS, AHIPJanet G Schnall, MS, AHIP
Information Management LibrarianInformation Management Librarian
Health...
ObjectivesObjectives
 IdentifyIdentify 10 ways10 ways to improve patient careto improve patient care
using library and in...
#1#1
Search a Database to findSearch a Database to find
Journal ArticlesJournal Articles
DatabasesDatabases
 PubMed
pubmed.gov
 NLM Gateway
gateway.nlm.nih.gov/gw/Cmd
PubMedPubMed
pubmed.govpubmed.gov
 Includes MEDLINE (1950’s to present)Includes MEDLINE (1950’s to present)
 Indexes 5,0...
Can easilyCan easily limitlimit your search to:your search to:
Age groupsAge groups
Human or Animal studiesHuman or Animal...
Related Articles
Advantages ofAdvantages of PubMedPubMed
 FreeFree
 LinksLinks to publisher’s sites for full-textto publisher’s sites for...
Try
healthlinks.washington.edu/howto/pubmed
NLM GatewayNLM Gateway
gateway.nlm.nih.govgateway.nlm.nih.gov
 ProvidesProvides "one-stop shopping""one-stop shopping" fo...
NLM Gateway gateway.nlm.nih.govgateway.nlm.nih.gov
E-JournalsE-Journals
 Check with your library for access toCheck with your library for access to
full-text e-journalsfull...
Open Access Journal SitesOpen Access Journal Sites
 BioMed CentralBioMed Central
www.biomedcentral.comwww.biomedcentral.c...
Order Articles Online for a FeeOrder Articles Online for a Fee
 Document Services/University of WashingtonDocument Servic...
https://healthlinks.washington.edu/hsl/docservices/services.htmlhttps://healthlinks.washington.edu/hsl/docservices/service...
Loansome Doc
#2#2
Search for EvidenceSearch for Evidence
What is evidence-based practice?What is evidence-based practice?
 Evidence based medicine is theEvidence based medicine i...
EBP and Guidelines ResourcesEBP and Guidelines Resources
 PubMed Clinical Queries/Systematic Reviews
www.ncbi.nlm.nih.gov...
PubMed Strategies forPubMed Strategies for
Evidence-Based CitationsEvidence-Based Citations
 PubMed Limits

Randomized C...
PubMed LimitsPubMed Limits
obesity American Indians
obesity american indians
PubMed Clinical Queries
www.cochrane.org
Pressure ulcers beds
guideline.gov
TRIP DatabaseTRIP Database
www.tripdatabase.comwww.tripdatabase.com
 Metasearch engineMetasearch engine
 Performs a simp...
TRIP search:TRIP search:
prevention of pressure ulcersprevention of pressure ulcers
#3#3
Keep Current with EmailKeep Current with Email
Alert ServicesAlert Services
Information Overload!Information Overload!
 2 million articles published in biomedical journals2 million articles publish...
What are Email Alert Services?What are Email Alert Services?
 Deliver current citations into your emailDeliver current ci...
PubMedPubMed:: My NCBIMy NCBI
 Your personal space on the NLM computerYour personal space on the NLM computer
system fors...
My NCBI
My NCBI
Go to: pubmed.gov
And click on My NCBI
Health NewsHealth News
 CNN Health
www.cnn.com/HEALTH
 New York Times Health
nytimes.com/pages/health
 USA Today Health...
#4#4
Explore e-TextbooksExplore e-Textbooks
e-Textbookse-Textbooks
 UpToDate (fee)UpToDate (fee)

Concise comprehensive uptodate reviews of clinicalConcise comprehe...
UpToDate
Textbookotitis media
Patient Handout
e-Textbookse-Textbooks
 HealthLinks Textbooks pageHealthLinks Textbooks page

550+ e-texts550+ e-texts

Most UW restric...
healthlinks.washington.edu/textbookshealthlinks.washington.edu/textbooks
Free Text ResourcesFree Text Resources
 Merck Manual of Medical InformationMerck Manual of Medical Information
www.merck....
Merck Manual of Medical InformationMerck Manual of Medical Information
www.merckhomeedition.comwww.merckhomeedition.com
www.merck.com/mrkshared/mmg/home.jspwww.merck.com/mrkshared/mmg/home.jsp
emedicine.com
#5#5
Keep up with Drug ResourcesKeep up with Drug Resources
Drug Information: Basic CompilationsDrug Information: Basic Compilations
 MicromedexMicromedex (fee)(fee) www.micromedex....
Micromedex
CDERCDER
www.fda.gov/CDERwww.fda.gov/CDER
Additional Drug ResourcesAdditional Drug Resources
 DrugInfoNetDrugInfoNet
www.druginfonet.com/index.php?pageID=drug.htmw...
DrugInfoNetDrugInfoNet
druginfonet.com/index.php?pageID=drug.htmdruginfonet.com/index.php?pageID=drug.htm
Drugs.com-Pill IdentifierDrugs.com-Pill Identifier
drugs.comdrugs.com
PillbotPillbot
pillbot.compillbot.com
RxListRxList rxlist.comrxlist.com
Accupril side effectsAccupril side effects
Drug Information: HerbalsDrug Information: Herbals
 MedlinePlus: Drugs, Supplements andMedlinePlus: Drugs, Supplements an...
Drugs, Supplements & Herbal Information pageDrugs, Supplements & Herbal Information page
105 Herbs and Supplements Monographs105 Herbs and Supplements Monographs
in English & Spanishin English & Spanish
Peppermi...
Drug Information for PDAsDrug Information for PDAs
 Epocrates RxEpocrates Rx
epocrates.comepocrates.com

monographs for ...
#6#6
Explore Patient Ed SitesExplore Patient Ed Sites
MedlinePlusMedlinePlus
medlineplus.govmedlineplus.gov
 #1 SOURCE#1 SOURCE for basic quality consumer/patientfor basic qua...
Health topics
(today):
741 English
699 Spanish
2 drug and
herbal
databases:
approx 1700
monographs
ADAM.com
encyclopedia:
...
MedlinePlus
New Interactive TutorialsNew Interactive Tutorials
 New titles:New titles:

BronchoscopyBronchoscopy

AmniocentesisAmni...
Recently added OR-Live: Surgical WebcastsRecently added OR-Live: Surgical Webcasts
 Pre-recordedPre-recorded
webcasts of ...
Medical Encyclopedia & DictionaryMedical Encyclopedia & Dictionary
 Encyclopedia includes:Encyclopedia includes:

4,000+...
Do you need…Do you need…
 Articles or research studies:Articles or research studies:
Go toGo to PubMedPubMed
 Informatio...
Additional Patient Ed ResourcesAdditional Patient Ed Resources
 MLA Top 10 Most Useful Health Web SitesMLA Top 10 Most Us...
Medical Library Association’sMedical Library Association’s
Top Ten Most Useful WebsitesTop Ten Most Useful Websites
mlanet...
MLA’s Top Ten, continuedMLA’s Top Ten, continued
mlanet.org/resources/medspeak/topten.htmlmlanet.org/resources/medspeak/to...
healthlinks.washington.edu/myhealthhealthlinks.washington.edu/myhealth
Lab Tests OnlineLab Tests Online labtestsonline.orglabtestsonline.org
Search by disease
or
name of test
#7#7
Use Cross-CulturalUse Cross-Cultural
Healthcare ResourcesHealthcare Resources
Cross-Cultural Healthcare ResourcesCross-Cultural Healthcare Resources
 EthnoMedEthnoMed
ethnomed.orgethnomed.org
A cross...
ethnomed.org
Somali Health and Illness
depts.washington.edu/pfes/cultureclues.html
SPIRAL
spiral.tufts.edu
#8#8
Navigate the WebNavigate the Web
Beyond Basic GoogleBeyond Basic Google
Navigation DifficultiesNavigation Difficulties
 Size of the WebSize of the Web
 Lack of control or reviewLack of control...
GoogleGoogle
google.comgoogle.com
 Largest: over 8 billion8 billion pages
 Relevance rankingRelevance ranking based on l...
Google Advanced Search FeaturesGoogle Advanced Search Features
www.google.com/advanced_search?hl=en
 File FormatFile Form...
Google ScholarGoogle Scholar
scholar.google.comscholar.google.com
 Searches forSearches for scholarly literaturescholarly...
Meta-Search EnginesMeta-Search Engines
Allow you to send searches to more
than one search engine at a time
Meta -Search EnginesMeta -Search Engines
DogPile
dogpile.com
Clusty
clusty.com
ClustyClusty
clusty.comclusty.com
 All the speed and functionality ofAll the speed and functionality of GoogleGoogle,,
wi...
Clusty
clusty.com
DogpileDogpile
dogpile.comdogpile.com
 Makes searching the web easier byMakes searching the web easier by
returning the b...
MetaCrawler HitsMetaCrawler Hits
Getting results for query: infant GERD
AltaVista: 10 references returned
Webcrawler: 10 r...
Tips and StrategiesTips and Strategies
 Select one orSelect one or two toolstwo tools and get to knowand get to know
them...
#9#9
Evaluate Web ResourcesEvaluate Web Resources
Evaluating Health Website Strategies
 Evaluate usingEvaluate using Criteria for Evaluating WebCriteria for Evaluating Web...
Criteria for Evaluating Web SitesCriteria for Evaluating Web Sites
healthlinks.washington.edu/howto/navigating/criteria.pd...
Anatomy of a URLAnatomy of a URL
 eduedu
 orgorg
 comcom
 govgov
The URL includes the name of the hostThe URL includes...
Guides for Evaluating HealthGuides for Evaluating Health
InformationInformation
 Criteria for Evaluating Web ResourcesCri...
#10#10
Contact your ultimate searchContact your ultimate search
engine: a librarian!engine: a librarian!
Final ThoughtsFinal Thoughts
 UseUse Ten Steps for Finding HealthTen Steps for Finding Health
Information on the Web to I...
For more information…For more information…
 If you areIf you are affiliated with the UW,affiliated with the UW, contact:c...
Finding Health Information on theFinding Health Information on the
Web To Improve Patient CareWeb To Improve Patient Care
...
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
Finding Health Information on the Web to Improve Patient Care.
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  • Advantage to short clips: 40 seconds to 3 ½ minutes long
    easy to rerecord, update – example, MeSH Browser not MeSH Database change, easy to rerecord.
    Worth the time, since reaches more people, on and off site
    Usage stats:
  • Biomed Central:
    Not free sections: Images.md and Faculty of 1000
    UW faculty can publish for free because institutional member
    --------------
    July 14, 2004: U.S.House Appropriations Committee recommends that NIH provide free public access to research articles resulting from NIH-funded research.
    The Report calls on NIH to offer access to authors' final manuscripts (as accepted for journal publication) and supplemental materials via PubMed Central six months after publication.
    If the grantee used NIH funds to pay any publication charges (e.g., page or color charges, or fees for digital distribution), PMC access would be immediate.
    The Report instructs NIH to inform the Committee by December 1, 2004 how it intends to implement the policy. Needs to pass in Senate…
    --------------
    BRITISH PARLIAMENTARY PANEL ENDORSES OPEN ACCESS TO SCIENTIFIC LITERATURE
    By Lila Guterman of the Chronicle of Higher Education In a
    much-anticipated report scheduled to be released today, the Science and
    Technology Committee of Britain's House of Commons endorsed open access to
    research results and criticized the scientific-publishing industry for the
    escalating prices of its journals. The report comes just days after a U.S.
    Congressional committee recommended requiring free access to papers based on
    research financed by the National Institutes of Health (The Chronicle, July
    19).
    http://chronicle.com/prm/daily/2004/07/2004072002n.htm
  • Evidence-based practice uses the results of scientific studies whenever possible and expert opinion and extensive experience when data are lacking.
  • Why use email alerts?
    Keep abreast of new literature in your field
    Receive automatic updates
    View tables of contents from your home or office
    Some free, some via UW
  • RxList Top 300:
  • Prescription & OTC Drug information for consumers & professionals.
    Welcome to Drugs.com, the most popular, comprehensive and up-to-date drug information resource available online. Fast, easy searching on over 24,000 prescription and over the counter medicines.
  • RxList:
    Top 300 by prescriptions written: hydrocodone; lipitor
  • USP Advice for the Patient.
    New feature: Natural Standard herbal supplement database
    released – late Fall 2005
    This is the 105 monographs in English and Spanish - written for the layperson. It is the same as on Harvard's site and Mayo clinic ( http://www.mayoclinic.com/findinformation/druginformation/index.cfm ) it’s the only appropriate one that is evidence based. 
  • English and Spanish with pictures
    Includes evidence-based information on effectiveness, side effects, interactions, dosing, and pregnancy, breastfeeding.
  • There are so many places to go on the Internet for quality information. We are going to describe the very best websites here. These websites are all consumer-oriented, up to date and contain accurate information.
    MedlinePlus is one of the best places of many to go for basic, quality consumer health information on the Web. In most cases you can start here.
    Why is it one of the best?
    The National Library of Medicine produces it
    The information is reviewed and reliable. It links to governmental and non-profit organizations’ Web sites.
    Continually updated
    No advertising or links to commercial sites
    Minimum redundancy
    American Customer Satisfaction Index Scores, Q1 2004
    Government Web Sites: Health
    #1: MedlinePlus
    #2: MedlinePlus en español
    MedlinePlus is available in Spanish by clicking on the “español” link
    This is not a “mirror” site, all the materials here are responsive to the language, dietary, and cultural needs of the Hispanic population
  • Slide provided by Angela B. Ruffin, Head
    NN/LM National Network Office
    National Library of Medicine
    National Institutes of Health, HHS
    October 18, 2005
    Senior Health: can enlarge text and view in high contrast
    Clinical Trials: provides easy information on clinical trials for a wide range of conditions
    Pre-recorded webcasts of surgical procedures
    Actual operations performed at medical centers in U.S.
    One-hour programs with printable transcripts
  • 2004
    1 hour videos
    Need Real Player
  • Encyclopedia includes:
    4,000+ entries on diseases, tests, symptoms, injuries and surgeries
    an extensive library of photographs and illustrations.
  • Cancer.gov
    Centers for Disease Control and Prevention (CDC) A-Z Topics
    familydoctor.org
    healthfinder®
    HIV InSite
    Kidshealth®
    Mayo Clinic
    MEDEM: an information partnership of medical societies
    MedlinePlus (English | Spanish)
    NOAH: New York Online Access to Health
  • Familydoctor.org:
    American Academy of Family Practitioners www.familydoctor.org
    Conditions A-Z
    Healthy Living
    Other links
    Parents & kids
    Health tools
  • Medem:
    Professional Associations
    Provides patient information through a web site called Medemwww.medem.com
  • Lab Tests Online (www.labtestsonline.org) This is a very good web site for information about lab tests for the consumer; it uses easy to understand language.
    Produced by a collaboration of professional societies in the lab community
    Peer-reviewed, non-commercial, patient-centered
    Can be searched by disease or the name of a test
    Example: “The doctor prescribed a lipid profile for my wife. What is he looking for?”
    Scroll down to lipid profile on the right. The results of the search describe the test, normal values and ends with common questions about the test.
    Many will ask if their test results are “normal” or what the “normal” value of a test is. For many tests, there is no single reference range that applies to everyone because the tests performed may be affected by the age and sex of the patient, as well as many other considerations.
  • Somali Asthma Cultural Profile
    Foods commonly consumed
    Dietary beliefs
    Religious dietary beliefs
    Diet related health problems
  • <number>
    Combined coverage of eleven majorsearch engines is 42% of the Web.
    No individual search engine coversmore than 16% of the Web.
    Overlap between individual searchengines is low.
  • View cached page to resurrect dead pages
    Includes similar pages feature
    Search for images
    Includes pdf and other file types
    Search within results
  • Authority:
    Is the author an authority on the subject?
    Can you even identify an author?
    If it is unsigned, is it posted in a usually authoritative place (NIH, for example)
    Does the author bring any biases in posting the information?
    Is there contact information?
    Is there an “about us” link?
    Does the site state the evidence upon which the material is based?
    Accuracy:
    Are the facts accurate?
    Are the sources of information clearly given? Refs to verify info?
    Is the information consistent with other sources?
    Is the information well written, well organized, and logically presented? Is it free from spelling and grammatical errors?
    Objectivity/bias:
    Web pages often function as “soapboxes”
    Goals of the person presenting the material aren’t clearly stated
    Watch out for the emotional “kick” – photographs, exclamation points, huge fonts
    Can you judge the author’s purpose in posting the information – Persuade? Selling a product?
    Who paid for the web page?
    EX of bias:
    Toilet Training: Signs of Readiness
    www.pampers.com
    What about the statement: “While children begin to master most of the necessary skills between the ages of 18 and 30 months, your toddler may not be ready to master toilet training until as late as the end of her fourth year.”
    Currency:
    Is the information timely and current?
    Dates are not always included on web pages
    If dates are included, it may not be clear if the date is the date created, the date revised, or the date the page was placed on the web.
    Is the information likely to change?
    Is it recent enough to be useful?
    Ex for currency:
    Even if information is accurate, is it comprehensive? What’s missing?
    How does this information compare with other sources (including print sources) on the same topic?
    Is a better source available?
    Does the site have a disclaimer that describes any limitations, purpose, scope, currency, etc.?
    Hormone Replacement
    www.pslgroup.com/dg950925.htm
    What dates can you find on the page?
    Has much changed on this topic since then?
    Who is the author? Is s/he an authority?
    What type of site is this? What is its purpose?
    Coverage:
    Even if information is accurate, is it comprehensive? What’s missing?
    How does this information compare with other sources (including print sources) on the same topic?
    Is a better source available?
    Does the site have a disclaimer that describes any limitations, purpose, scope, currency, etc.?
    Ex of coverage:
    “Runny Nose”
    www.medical-library.net
    What conditions are associated with a runny nose, according to this site?
    What other conditions could be associated with a runny nose that aren’t included here?
  • You can often tell something about a web site by its address
    Examples:
    www.jcpenney.comwww.hmassoc.org
    www.washington.eduwww.cdc.gov
  • PubMed, including Clinical Queries and My NCBI
  • Finding Health Information on the Web to Improve Patient Care.

    1. 1. Janet G Schnall, MS, AHIPJanet G Schnall, MS, AHIP Information Management LibrarianInformation Management Librarian Health Sciences LibrariesHealth Sciences Libraries University of Washington, Seattle, WAUniversity of Washington, Seattle, WA schnall@u.washington.eduschnall@u.washington.edu Finding Health Information on the Web toFinding Health Information on the Web to Improve Patient CareImprove Patient Care
    2. 2. ObjectivesObjectives  IdentifyIdentify 10 ways10 ways to improve patient careto improve patient care using library and internet resourcesusing library and internet resources  Describe different tools toDescribe different tools to navigatenavigate thethe webweb to find clinical resourcesto find clinical resources  Describe web resources forDescribe web resources for evidence-evidence- based practicebased practice  Identify ways to find and obtainIdentify ways to find and obtain full-textfull-text articlesarticles
    3. 3. #1#1 Search a Database to findSearch a Database to find Journal ArticlesJournal Articles
    4. 4. DatabasesDatabases  PubMed pubmed.gov  NLM Gateway gateway.nlm.nih.gov/gw/Cmd
    5. 5. PubMedPubMed pubmed.govpubmed.gov  Includes MEDLINE (1950’s to present)Includes MEDLINE (1950’s to present)  Indexes 5,000 biomedical journalsIndexes 5,000 biomedical journals  Covers all aspects of biosciences andCovers all aspects of biosciences and healthcarehealthcare  75% of citations have abstracts75% of citations have abstracts  Updated 5x/weekUpdated 5x/week
    6. 6. Can easilyCan easily limitlimit your search to:your search to: Age groupsAge groups Human or Animal studiesHuman or Animal studies LanguageLanguage Research or Review articlesResearch or Review articles Subsets, such as Core ClinicalSubsets, such as Core Clinical Journals or CAMJournals or CAM
    7. 7. Related Articles
    8. 8. Advantages ofAdvantages of PubMedPubMed  FreeFree  LinksLinks to publisher’s sites for full-textto publisher’s sites for full-text journalsjournals  Or, canOr, can orderorder full-text journal articlesfull-text journal articles  Can easily findCan easily find related articlesrelated articles  Clinical QueriesClinical Queries andand SystematicSystematic ReviewsReviews sections limit retrieval usingsections limit retrieval using research filtersresearch filters
    9. 9. Try healthlinks.washington.edu/howto/pubmed
    10. 10. NLM GatewayNLM Gateway gateway.nlm.nih.govgateway.nlm.nih.gov  ProvidesProvides "one-stop shopping""one-stop shopping" for many of NLM's databasesfor many of NLM's databases  Offers citations, full text, video, audio, and imagesOffers citations, full text, video, audio, and images  Accesses:Accesses:  PubMedPubMed  NLM Catalog - catalog information for books, serial titles, audiovisualsNLM Catalog - catalog information for books, serial titles, audiovisuals  TOXLINE® Special - toxicology citationsTOXLINE® Special - toxicology citations  DART® - Developmental and Reproductive ToxicologyDART® - Developmental and Reproductive Toxicology  MedlinePlus® - consumer health informationMedlinePlus® - consumer health information  ClinicalTrials.gov - information for the public about clinical trialsClinicalTrials.gov - information for the public about clinical trials  DIRLINE® - Directory of Health OrganizationsDIRLINE® - Directory of Health Organizations  Genetics Home Reference™ - consumer info for genetic conditionsGenetics Home Reference™ - consumer info for genetic conditions  Household Products DatabaseHousehold Products Database  HSRProj - health services research projectsHSRProj - health services research projects  OMIM - Online Mendelian Inheritance in ManOMIM - Online Mendelian Inheritance in Man  HSDB® - Hazardous Substances Data BankHSDB® - Hazardous Substances Data Bank AND MORE…AND MORE…
    11. 11. NLM Gateway gateway.nlm.nih.govgateway.nlm.nih.gov
    12. 12. E-JournalsE-Journals  Check with your library for access toCheck with your library for access to full-text e-journalsfull-text e-journals  For UW Affiliates: use the Proxy service toFor UW Affiliates: use the Proxy service to access full-text e-journals from off-campusaccess full-text e-journals from off-campus healthlinks.washington.edu/howto/connecthealthlinks.washington.edu/howto/connect
    13. 13. Open Access Journal SitesOpen Access Journal Sites  BioMed CentralBioMed Central www.biomedcentral.comwww.biomedcentral.com Independent publishing house providing immediate freeIndependent publishing house providing immediate free access to peer-reviewed biomedical researchaccess to peer-reviewed biomedical research  PubMed CentralPubMed Central pubmedcentral.govpubmedcentral.gov National Library of Medicine's free digital archive ofNational Library of Medicine's free digital archive of biomedical and life sciences journal literaturebiomedical and life sciences journal literature
    14. 14. Order Articles Online for a FeeOrder Articles Online for a Fee  Document Services/University of WashingtonDocument Services/University of Washington https://healthlinks.washington.edu/hsl/docservices/services.htmlhttps://healthlinks.washington.edu/hsl/docservices/services.html  Loansome DocLoansome Doc healthlinks.washington.edu/hsl/docservices/lds-na.htmlhealthlinks.washington.edu/hsl/docservices/lds-na.html  Allows you to order full-text articles while searchingAllows you to order full-text articles while searching PubMedPubMed
    15. 15. https://healthlinks.washington.edu/hsl/docservices/services.htmlhttps://healthlinks.washington.edu/hsl/docservices/services.html
    16. 16. Loansome Doc
    17. 17. #2#2 Search for EvidenceSearch for Evidence
    18. 18. What is evidence-based practice?What is evidence-based practice?  Evidence based medicine is theEvidence based medicine is the conscientious, explicit,conscientious, explicit, and judicious use of current best evidence in makingand judicious use of current best evidence in making decisionsdecisions about the care of individual patients.about the care of individual patients.  The practice of evidence based medicine meansThe practice of evidence based medicine means integrating individual clinical expertise with the bestintegrating individual clinical expertise with the best available external clinical evidenceavailable external clinical evidence from systematicfrom systematic research.research. Sackett DL et al.Sackett DL et al. Evidence based medicine: what it is and what it isn't.Evidence based medicine: what it is and what it isn't. BMJ 1996BMJ 1996 Jan 13; 312 (7023): 71-2.Jan 13; 312 (7023): 71-2.
    19. 19. EBP and Guidelines ResourcesEBP and Guidelines Resources  PubMed Clinical Queries/Systematic Reviews www.ncbi.nlm.nih.gov/entrez/query/static/ clinical.shtml  Cochrane Library (fee): gold standard www.cochrane.org  National Guideline Clearinghouse guideline.gov  TRIP (Turning Research into Practice) www.tripdatabase.com
    20. 20. PubMed Strategies forPubMed Strategies for Evidence-Based CitationsEvidence-Based Citations  PubMed Limits  Randomized Controlled Trial  Meta-Analysis  Practice Guideline  Clinical Trial  PubMed Clinical Queries and Systematic Reviews
    21. 21. PubMed LimitsPubMed Limits
    22. 22. obesity American Indians obesity american indians PubMed Clinical Queries
    23. 23. www.cochrane.org Pressure ulcers beds
    24. 24. guideline.gov
    25. 25. TRIP DatabaseTRIP Database www.tripdatabase.comwww.tripdatabase.com  Metasearch engineMetasearch engine  Performs a simple search of more than 75Performs a simple search of more than 75 databasesdatabases  Finds evidence based resourcesFinds evidence based resources  Searches Cochrane, National GuidelineSearches Cochrane, National Guideline Clearinghouse, Bandolier, etc.Clearinghouse, Bandolier, etc.
    26. 26. TRIP search:TRIP search: prevention of pressure ulcersprevention of pressure ulcers
    27. 27. #3#3 Keep Current with EmailKeep Current with Email Alert ServicesAlert Services
    28. 28. Information Overload!Information Overload!  2 million articles published in biomedical journals2 million articles published in biomedical journals each yeareach year  considering everything of potential biomedicalconsidering everything of potential biomedical importance would require perusing about 6,000importance would require perusing about 6,000 articles per day…articles per day…  If a physician only read 2 articles a day, at theIf a physician only read 2 articles a day, at the end of year you would be 60 centuries behind.end of year you would be 60 centuries behind. Lundberg GD. Perspective from the editor of JAMA, The Journal of the American Medical AssociationLundberg GD. Perspective from the editor of JAMA, The Journal of the American Medical Association Bull Med Libr Assoc.Bull Med Libr Assoc. 1992 Apr;80(2):110-4.1992 Apr;80(2):110-4.
    29. 29. What are Email Alert Services?What are Email Alert Services?  Deliver current citations into your emailDeliver current citations into your email  Based on a search strategy you createBased on a search strategy you create  In most cases, abstracts of the articles areIn most cases, abstracts of the articles are providedprovided  May provide links toMay provide links to PubMedPubMed and full-textand full-text articlesarticles
    30. 30. PubMedPubMed:: My NCBIMy NCBI  Your personal space on the NLM computerYour personal space on the NLM computer system forsystem for storing search strategiesstoring search strategies to generateto generate updatesupdates  FreeFree registration requiredregistration required  RecentRecent PubMedPubMed citations sentcitations sent automaticallyautomatically toto your emailyour email  PubMed: My NCBI help page:PubMed: My NCBI help page: healthlinks.washington.edu/howto/myncbi.htmlhealthlinks.washington.edu/howto/myncbi.html
    31. 31. My NCBI My NCBI Go to: pubmed.gov And click on My NCBI
    32. 32. Health NewsHealth News  CNN Health www.cnn.com/HEALTH  New York Times Health nytimes.com/pages/health  USA Today Health www.usatoday.com/news/health/front.htm  Yahoo! News news.yahoo.com
    33. 33. #4#4 Explore e-TextbooksExplore e-Textbooks
    34. 34. e-Textbookse-Textbooks  UpToDate (fee)UpToDate (fee)  Concise comprehensive uptodate reviews of clinicalConcise comprehensive uptodate reviews of clinical topics in multiple specialtiestopics in multiple specialties  uptodate.comuptodate.com  MD Consult (fee)MD Consult (fee)  online medical information system that includesonline medical information system that includes textbooks, journals, drug information, patient edtextbooks, journals, drug information, patient ed materials, practice guidelinesmaterials, practice guidelines  mdconsult.commdconsult.com
    35. 35. UpToDate
    36. 36. Textbookotitis media
    37. 37. Patient Handout
    38. 38. e-Textbookse-Textbooks  HealthLinks Textbooks pageHealthLinks Textbooks page  550+ e-texts550+ e-texts  Most UW restricted, but some open to allMost UW restricted, but some open to all  healthlinks.washington.edu/textbookshealthlinks.washington.edu/textbooks
    39. 39. healthlinks.washington.edu/textbookshealthlinks.washington.edu/textbooks
    40. 40. Free Text ResourcesFree Text Resources  Merck Manual of Medical InformationMerck Manual of Medical Information www.merck.com/mmhewww.merck.com/mmhe  Merck Manual of Geriatric InformationMerck Manual of Geriatric Information www.merck.com/mrkshared/mmg/home.jspwww.merck.com/mrkshared/mmg/home.jsp  emedicineemedicine emedicine.comemedicine.com
    41. 41. Merck Manual of Medical InformationMerck Manual of Medical Information www.merckhomeedition.comwww.merckhomeedition.com
    42. 42. www.merck.com/mrkshared/mmg/home.jspwww.merck.com/mrkshared/mmg/home.jsp
    43. 43. emedicine.com
    44. 44. #5#5 Keep up with Drug ResourcesKeep up with Drug Resources
    45. 45. Drug Information: Basic CompilationsDrug Information: Basic Compilations  MicromedexMicromedex (fee)(fee) www.micromedex.comwww.micromedex.com  Clinical information on toxicology, drugs, drugClinical information on toxicology, drugs, drug interactions, and reproductive risksinteractions, and reproductive risks  Provides evidence-based medical informationProvides evidence-based medical information  Available at most hospitalsAvailable at most hospitals  CDERCDER www.fda.gov/CDERwww.fda.gov/CDER  Center for Drug Evaluation and ResearchCenter for Drug Evaluation and Research  IncludesIncludes Drugs @ FDADrugs @ FDA, a catalog of FDA Approved, a catalog of FDA Approved Drug ProductsDrug Products
    46. 46. Micromedex
    47. 47. CDERCDER www.fda.gov/CDERwww.fda.gov/CDER
    48. 48. Additional Drug ResourcesAdditional Drug Resources  DrugInfoNetDrugInfoNet www.druginfonet.com/index.php?pageID=drug.htmwww.druginfonet.com/index.php?pageID=drug.htm  Includes official package inserts and patient package insert informationIncludes official package inserts and patient package insert information  Drugs.comDrugs.com drugs.comdrugs.com  Includes Pill IdentifierIncludes Pill Identifier  MedlinePlus: Drugs, Supplements and Herbal InformationMedlinePlus: Drugs, Supplements and Herbal Information http://www.nlm.nih.gov/medlineplus/druginformation.htmlhttp://www.nlm.nih.gov/medlineplus/druginformation.html  Information on thousands of prescription and over-the-counter medications,Information on thousands of prescription and over-the-counter medications, herbals and supplementsherbals and supplements  PillBot.comPillBot.com pillbot.compillbot.com  Prescription comparison shopping guidePrescription comparison shopping guide  RxListRxList rxlist.comrxlist.com  Includes the Top 200 list, the Top 300 list, and a Tablet/Capsule Imprint CodeIncludes the Top 200 list, the Top 300 list, and a Tablet/Capsule Imprint Code
    49. 49. DrugInfoNetDrugInfoNet druginfonet.com/index.php?pageID=drug.htmdruginfonet.com/index.php?pageID=drug.htm
    50. 50. Drugs.com-Pill IdentifierDrugs.com-Pill Identifier drugs.comdrugs.com
    51. 51. PillbotPillbot pillbot.compillbot.com
    52. 52. RxListRxList rxlist.comrxlist.com Accupril side effectsAccupril side effects
    53. 53. Drug Information: HerbalsDrug Information: Herbals  MedlinePlus: Drugs, Supplements andMedlinePlus: Drugs, Supplements and Herbal InformationHerbal Information www.nlm.nih.gov/medlineplus/druginformation.htmlwww.nlm.nih.gov/medlineplus/druginformation.html  Information on thousands of prescription andInformation on thousands of prescription and over-the-counter medications, herbals andover-the-counter medications, herbals and supplements provided bysupplements provided by MedMasterMedMaster and theand the Natural StandardNatural Standard
    54. 54. Drugs, Supplements & Herbal Information pageDrugs, Supplements & Herbal Information page
    55. 55. 105 Herbs and Supplements Monographs105 Herbs and Supplements Monographs in English & Spanishin English & Spanish Peppermint oil
    56. 56. Drug Information for PDAsDrug Information for PDAs  Epocrates RxEpocrates Rx epocrates.comepocrates.com  monographs for the most prescribed medsmonographs for the most prescribed meds  free download after registrationfree download after registration  PDA resources for UWPDA resources for UW healthlinks.washington.edu/howto/pdahealthlinks.washington.edu/howto/pda
    57. 57. #6#6 Explore Patient Ed SitesExplore Patient Ed Sites
    58. 58. MedlinePlusMedlinePlus medlineplus.govmedlineplus.gov  #1 SOURCE#1 SOURCE for basic quality consumer/patientfor basic quality consumer/patient informationinformation  Includes drug informationIncludes drug information  Medical Encyclopedia – full-text with illustrationsMedical Encyclopedia – full-text with illustrations  Spanish versionSpanish version  PreformulatedPreformulated PubMedPubMed searchessearches  Interactive tutorialsInteractive tutorials  Current health newsCurrent health news
    59. 59. Health topics (today): 741 English 699 Spanish 2 drug and herbal databases: approx 1700 monographs ADAM.com encyclopedia: approx 4000 monographs Health news: Approx 15-20 new stories added per day Directories: Over 100 directories covering doctors, hospitals, clinics and libraries. Interactive tutorials: 175 total (soon) NIH- Seniorhealth 31 topics OR-Live surgery videos: 73 Announcement listservs: 11 daily & weekly MedlinePlus ContentMedlinePlus Content ClinicalTrials links on display: 640 (today)
    60. 60. MedlinePlus
    61. 61. New Interactive TutorialsNew Interactive Tutorials  New titles:New titles:  BronchoscopyBronchoscopy  AmniocentesisAmniocentesis  Low testosteroneLow testosterone  Upper GI endoscopyUpper GI endoscopy  PneumoniaPneumonia
    62. 62. Recently added OR-Live: Surgical WebcastsRecently added OR-Live: Surgical Webcasts  Pre-recordedPre-recorded webcasts of surgicalwebcasts of surgical proceduresprocedures  Actual operationsActual operations performed at medicalperformed at medical centers in U.S.centers in U.S.  One-hour programsOne-hour programs with printablewith printable transcriptstranscripts
    63. 63. Medical Encyclopedia & DictionaryMedical Encyclopedia & Dictionary  Encyclopedia includes:Encyclopedia includes:  4,000+ entries on diseases, tests, symptoms,4,000+ entries on diseases, tests, symptoms, injuries and surgeriesinjuries and surgeries  an extensive library of photographs andan extensive library of photographs and illustrations.illustrations.  Medical DictionaryMedical Dictionary
    64. 64. Do you need…Do you need…  Articles or research studies:Articles or research studies: Go toGo to PubMedPubMed  Information written for patients:Information written for patients: Start withStart with MEDLINEplusMEDLINEplus
    65. 65. Additional Patient Ed ResourcesAdditional Patient Ed Resources  MLA Top 10 Most Useful Health Web SitesMLA Top 10 Most Useful Health Web Sites mlanet.org/resources/medspeak/topten.htmlmlanet.org/resources/medspeak/topten.html  MyHealth ToolkitMyHealth Toolkit healthlinks.washington.edu/myhealthhealthlinks.washington.edu/myhealth  Lab Tests OnlineLab Tests Online labtestsonline.orglabtestsonline.org
    66. 66. Medical Library Association’sMedical Library Association’s Top Ten Most Useful WebsitesTop Ten Most Useful Websites mlanet.org/resources/medspeak/topten.htmlmlanet.org/resources/medspeak/topten.html 1.1. Cancer.govCancer.gov 2.2. Centers for Disease Control andCenters for Disease Control and Prevention (CDC) A-Z TopicsPrevention (CDC) A-Z Topics 3.3. familydoctor.orgfamilydoctor.org 4.4. healthfinder®healthfinder® 5.5. HIV InSiteHIV InSite
    67. 67. MLA’s Top Ten, continuedMLA’s Top Ten, continued mlanet.org/resources/medspeak/topten.htmlmlanet.org/resources/medspeak/topten.html 6.6. Kidshealth®Kidshealth® 7.7. Mayo ClinicMayo Clinic 8.8. MEDEM: an information partnership ofMEDEM: an information partnership of medical societiesmedical societies 9.9. MedlinePlus (English | Spanish)MedlinePlus (English | Spanish) 10.10. NOAH: New York Online Access toNOAH: New York Online Access to HealthHealth
    68. 68. healthlinks.washington.edu/myhealthhealthlinks.washington.edu/myhealth
    69. 69. Lab Tests OnlineLab Tests Online labtestsonline.orglabtestsonline.org Search by disease or name of test
    70. 70. #7#7 Use Cross-CulturalUse Cross-Cultural Healthcare ResourcesHealthcare Resources
    71. 71. Cross-Cultural Healthcare ResourcesCross-Cultural Healthcare Resources  EthnoMedEthnoMed ethnomed.orgethnomed.org A cross-cultural medicine database containing information aboutA cross-cultural medicine database containing information about cultural beliefs and medical issues pertinent to healthcare of ethniccultural beliefs and medical issues pertinent to healthcare of ethnic groups in Seattle areagroups in Seattle area  Culture CluesCulture Clues depts.washington.edu/pfes/cultureclues.htmldepts.washington.edu/pfes/cultureclues.html Tip sheets designed to increase awareness about concepts andTip sheets designed to increase awareness about concepts and preferences of patients from diverse culturespreferences of patients from diverse cultures  SPIRALSPIRAL spiral.tufts.edu Patient ed resources in East Asian languagesPatient ed resources in East Asian languages
    72. 72. ethnomed.org
    73. 73. Somali Health and Illness
    74. 74. depts.washington.edu/pfes/cultureclues.html
    75. 75. SPIRAL spiral.tufts.edu
    76. 76. #8#8 Navigate the WebNavigate the Web Beyond Basic GoogleBeyond Basic Google
    77. 77. Navigation DifficultiesNavigation Difficulties  Size of the WebSize of the Web  Lack of control or reviewLack of control or review  Lack of quality standardsLack of quality standards
    78. 78. GoogleGoogle google.comgoogle.com  Largest: over 8 billion8 billion pages  Relevance rankingRelevance ranking based on link analysis  Google Advanced Search www.google.com/advanced_search?hl=en  Google Scholar scholar.google.com
    79. 79. Google Advanced Search FeaturesGoogle Advanced Search Features www.google.com/advanced_search?hl=en  File FormatFile Format,, i.e.i.e. pdfpdf  DateDate,, i.e.i.e. pages updated in last 3 monthspages updated in last 3 months  OccurrencesOccurrences,, i.e.i.e. terms appear in titleterms appear in title  DomainDomain,, i.e.i.e. .gov, .edu.gov, .edu  LinksLinks,, i.e.i.e. pages that link to the pagepages that link to the page
    80. 80. Google ScholarGoogle Scholar scholar.google.comscholar.google.com  Searches forSearches for scholarly literaturescholarly literature, including peer-reviewed, including peer-reviewed papers, theses, books, abstracts and technical reportspapers, theses, books, abstracts and technical reports  Finds articles from academic publishers, professionalFinds articles from academic publishers, professional societies, universities, etc. as well as scholarly articlessocieties, universities, etc. as well as scholarly articles on the webon the web  ""Cited by" linkCited by" link identifies # that have cited the originalidentifies # that have cited the original  Access to full text only available with subscriptionAccess to full text only available with subscription  NEW:NEW: Now links to full text articles the UW subscribes toNow links to full text articles the UW subscribes to  Caution:Caution: Not a reliable sole source for searchingNot a reliable sole source for searching scholarly literaturescholarly literature
    81. 81. Meta-Search EnginesMeta-Search Engines Allow you to send searches to more than one search engine at a time
    82. 82. Meta -Search EnginesMeta -Search Engines DogPile dogpile.com Clusty clusty.com
    83. 83. ClustyClusty clusty.comclusty.com  All the speed and functionality ofAll the speed and functionality of GoogleGoogle,, with clustering addedwith clustering added  Clustered resultsClustered results in left marginin left margin  Why use clustering?Why use clustering? • Learn at a glance types of information availableLearn at a glance types of information available • Uncover results that are otherwise buriedUncover results that are otherwise buried
    84. 84. Clusty clusty.com
    85. 85. DogpileDogpile dogpile.comdogpile.com  Makes searching the web easier byMakes searching the web easier by returning the best results from thesereturning the best results from these leading search engines:leading search engines: Google · Yahoo · Ask.comGoogle · Yahoo · Ask.com About · LookSmart ·About · LookSmart ·  Search for audio, images, and multimediaSearch for audio, images, and multimedia formatsformats
    86. 86. MetaCrawler HitsMetaCrawler Hits Getting results for query: infant GERD AltaVista: 10 references returned Webcrawler: 10 references returned Thunderstone: 8 references returned Lycos: 1 references returned Excite: 10 references returned Infoseek: 10 references returned Looksmart: 0 references returned Finished sending hits ... Dogpile dogpile.com
    87. 87. Tips and StrategiesTips and Strategies  Select one orSelect one or two toolstwo tools and get to knowand get to know them wellthem well • Read theRead the HelpHelp • TryTry Advanced SearchAdvanced Search optionsoptions  Know whenKnow when NOTNOT to search:to search: 10 minute rule10 minute rule  Is it worth your time?Is it worth your time?  Would a phone call to a colleague or librarian be moreWould a phone call to a colleague or librarian be more productive?productive?  Is the information you seek likely to be on the web?Is the information you seek likely to be on the web?
    88. 88. #9#9 Evaluate Web ResourcesEvaluate Web Resources
    89. 89. Evaluating Health Website Strategies  Evaluate usingEvaluate using Criteria for Evaluating WebCriteria for Evaluating Web ResourcesResources  Determine the type of site by analyzingDetermine the type of site by analyzing website Addresseswebsite Addresses  UseUse guidesguides to evaluating health Informationto evaluating health Information on the webon the web
    90. 90. Criteria for Evaluating Web SitesCriteria for Evaluating Web Sites healthlinks.washington.edu/howto/navigating/criteria.pdfhealthlinks.washington.edu/howto/navigating/criteria.pdf  AuthorityAuthority  AccuracyAccuracy  ObjectivityObjectivity  CurrencyCurrency  CoverageCoverage
    91. 91. Anatomy of a URLAnatomy of a URL  eduedu  orgorg  comcom  govgov The URL includes the name of the hostThe URL includes the name of the host computer which can indicate the purpose of thecomputer which can indicate the purpose of the web site.web site. http://www.cdc.gov/nip/child.htm sub directory name of host computer how information is transmitted filename
    92. 92. Guides for Evaluating HealthGuides for Evaluating Health InformationInformation  Criteria for Evaluating Web ResourcesCriteria for Evaluating Web Resources healthlinks.washington.edu/howto/navigating/criteria.pdfhealthlinks.washington.edu/howto/navigating/criteria.pdf  Thinking Critically about Discipline-BasedThinking Critically about Discipline-Based World Wide Web ResourcesWorld Wide Web Resources www.library.ucla.edu/libraries/college/help/critical/discipline.htmwww.library.ucla.edu/libraries/college/help/critical/discipline.htm
    93. 93. #10#10 Contact your ultimate searchContact your ultimate search engine: a librarian!engine: a librarian!
    94. 94. Final ThoughtsFinal Thoughts  UseUse Ten Steps for Finding HealthTen Steps for Finding Health Information on the Web to ImproveInformation on the Web to Improve Patient CarePatient Care  Navigate the web efficiently with aNavigate the web efficiently with a search engine, Advanced Googlesearch engine, Advanced Google oror Google ScholarGoogle Scholar  RememberRemember PubMed, MedlinePlus,PubMed, MedlinePlus, EthnoMed,EthnoMed, andand drug resourcesdrug resources  Ask aAsk a colleague or librarian,colleague or librarian, youryour ultimate search engineultimate search engine
    95. 95. For more information…For more information…  If you areIf you are affiliated with the UW,affiliated with the UW, contact:contact: Janet G. Schnall, MS,AHIPJanet G. Schnall, MS,AHIP 206.543.7474206.543.7474 schnall@u.washington.eduschnall@u.washington.edu  Or, contact theOr, contact the National Network of Libraries ofNational Network of Libraries of Medicine (NN/LM)Medicine (NN/LM) for exhibits, workshops,for exhibits, workshops, classes, and project collaborationsclasses, and project collaborations NN/LMNN/LM 800.338.7657800.338.7657 Linda MilgromLinda Milgrom 206.221.3400206.221.3400 lmilgrom@u.washington.edulmilgrom@u.washington.edu
    96. 96. Finding Health Information on theFinding Health Information on the Web To Improve Patient CareWeb To Improve Patient Care PowerPoint presentation:PowerPoint presentation: healthlinks.washington.edu/hsl/liaisons/schnall/auburn.ppthealthlinks.washington.edu/hsl/liaisons/schnall/auburn.ppt Handout:Handout: healthlinks.washington.edu/hsl/liaisons/schnall/auburn.dochealthlinks.washington.edu/hsl/liaisons/schnall/auburn.doc
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