Internal Med Orientation July 2009

Need to Know: Western Libraries Internal Medicine Residents

Agenda ,[object Object],[object Object]

1. Western Libraries: What we’ve got Journals and databases Books Clinical Tools Learning modules Calculators Drug Identification Tools Images

2. Medicine Info: How to access - Go to: http://www.lib.uwo.ca/ - Log in to Off-Campus Access with your UWO username and password (same as email) - Select Browse by Program - Select Medicine and Dentistry - Select a specialty

http://www.lib.uwo.ca/programs/generalmedicine/ Use this page to find selected resources for general medicine Electronic Books Point of Care Tools Databases Image and video collections

2. How to search our collections Select “Catalogue” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

http://alpha.lib.uwo.ca You can even search for electronic full-text journals. Select “Journal Title” Then enter the name of the journal And select “Go”

Parts of a Catalogue Record Full title of the journal Links to electronic articles Coverage dates Call # & location of print volumes

Other ways to access electronic full text ,[object Object],[object Object],[object Object],[object Object]

Exercise ,[object Object],[object Object]

Exercise 1 ,[object Object],[object Object],[object Object]

Using the Evidence to Answer Clinical Questions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],1 Guyatt, Gordon, Drummond Rennie, Evidence-Based Medicine Working Group, and American Medical Association. Users‘ Guides to the Medical Literature :A Manual for Evidence-Based Clinical Practice. Chicago, IL: AMA Press, 2002. We’ll be focusing on two steps

Case study ,[object Object],A patient with atrial fibrillation wishes to discontinue taking warfarin. You consider aspirin as an alternative therapy for reducing the patient’s risk of stroke when a colleague suggests you prescribe both aspirin and clopidogrel

Create an answerable question ,[object Object],Population Patients with atrial fibrillation Intervention Aspirin alone Comparison Aspirin combined with clopidogrel Outcomes Prevention of stroke

Clarify the question type ,[object Object],[object Object]

6 Question Types ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],3 Heneghan, Carl, and Douglas Badenoch. Evidence-Based Medicine Toolkit. 2nd ed. Malden, Mass.: BMJ Books/Blackwell Pub., 2006.

Find the Best Evidence ,[object Object],4 Heneghan, Carl, and Douglas Badenoch. Evidence-Based Medicine Toolkit. 2nd ed. Malden, Mass.: BMJ Books/Blackwell Pub., 2006. Type of Question Type of Evidence Aetiology Case-control or cohort study Diagnosis Diagnostic validation study Prognosis Inception cohort study Therapy Randomized controlled trial Cost-effectiveness Economic evaluation Quality of life Qualitative study 4

Evidence Pyramid Less time More time http://www.mh.org.au/royal_melbourne_hospital/www/353/files/pyramidopt.jpg

Formulating your search ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Exercise ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Conclusions ,[object Object],Source Hits PubMed 100 (11 if searching narrow/therapy study category) Cochrane Library 6 Embase 256 Micromedex 2 e-CPS 1 drug monograph

Evidence Pyramid Cochrane Library Micromedex e-CPS PubMed EMBASE

Summary & Key Points ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

And, finally... ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Internal Med Orientation July 2009

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Internal Med Orientation July 2009