Information Rx: Western Libraries’ Prescription for Accessing Clinical Evidence SWOMEN/Family Medicine Teaching Retreat Ro...
Disclosure <ul><li>I received fellowship funding from the National Library of Medicine (who produces PubMed) </li></ul>
Agenda <ul><li>Library services </li></ul><ul><li>Accessing Western Libraries’ collections </li></ul><ul><li>Using Western...
Library Services <ul><li>Canadian Library of Family Medicine </li></ul><ul><li>Hospital Libraries </li></ul><ul><li>Leddy ...
Western Libraries: What we’ve got Journals and databases   Books   Clinical Tools  Learning modules Calculators   Drug Ide...
Medicine Information: How to access -  Go to:  http://www.lib.uwo.ca/ <ul><li>Log in to Off-Campus Access with your UWO us...
http://www.lib.uwo.ca/programs/clinicaloutreach/ Use this page to find selected medical resources Electronic Books Point o...
How to search our collections Select  “Catalogue” <ul><li>Search the Catalogue to find anything Western Libraries owns or ...
Catalogue Searching You can even search for electronic full-text journals.  Select “Journal Title”  Then enter the name of...
Parts of a Catalogue Record Full title of the journal Links to electronic articles Coverage dates Call # & location of pri...
Other ways to access electronic full text <ul><li>When searching for articles in databases, use the   button to link to fu...
Using the  button  Select the “Go” button to link to full text
Access Exercise 1 <ul><li>How would you get a hold of this article?  </li></ul><ul><li>Weber M. Achieving blood pressure g...
Access Exercise 2 <ul><li>How would you get a hold of this article?  </li></ul><ul><li>Olsson SB, Orndahl G, Erneström S, ...
Access Key Points <ul><li>Off-Campus Access – Remember to log in </li></ul><ul><li>Browse by Program > Clinical Outreach <...
Answering questions using Western’s collections
Background Questions <ul><li>What are the general preventative measures for otitis externa? </li></ul><ul><li>What are the...
Resources for Background Questions <ul><li>Textbooks </li></ul><ul><li>Library Catalogue (can limit to electronic) </li></...
Clinical/Foreground Questions
Using the Evidence to Answer Clinical Questions <ul><li>Identify your problem </li></ul><ul><li>Define a structured questi...
Case study <ul><li>Using the PICO model, formulate an  answerable  question </li></ul>A patient with chronic asthma and a ...
Create an answerable question <ul><li>In patients with asthma, does a low-calorie diet help to decrease symptoms? </li></u...
6 Question Types <ul><ul><li>Aetiology:  the causes of the disease and their modes of operation </li></ul></ul><ul><ul><li...
Find the Best Evidence <ul><li>Studies which best answer each question type </li></ul>4   Heneghan, Carl, and Douglas Bade...
Evidence Pyramid Less time Less work Less evidence More time More work More evidence http://www.mh.org.au/royal_melbourne_...
Exercise <ul><li>Search the following resources to answer the question:  In patients with asthma, does a low-calorie diet ...
Conclusions <ul><li>Number of results </li></ul>Source  Hits Cochrane Library 7 Essential Evidence Plus 23 PubMed 949 (75 ...
Evidence Pyramid Cochrane Library EMBASE PubMed SCOPUS
Summary & Key Points <ul><li>Library Services </li></ul><ul><li>Access </li></ul><ul><ul><li>Log  in to off-campus access ...
QUESTIONS?
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Swomen Retreat Oct 2009

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Presentation given to clinical preceptors as part of the SWOMEN (Southwestern Ontario Medical Education Network) Teaching Retreat, held on October 24, 2009 at the Elm Hurst Inn in Ingersoll, Ontario

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Swomen Retreat Oct 2009

  1. 1. Information Rx: Western Libraries’ Prescription for Accessing Clinical Evidence SWOMEN/Family Medicine Teaching Retreat Robin Featherstone, BA, MLIS Clinical Medicine Librarian University of Western Ontario [email_address]
  2. 2. Disclosure <ul><li>I received fellowship funding from the National Library of Medicine (who produces PubMed) </li></ul>
  3. 3. Agenda <ul><li>Library services </li></ul><ul><li>Accessing Western Libraries’ collections </li></ul><ul><li>Using Western’s collections to answer background questions </li></ul><ul><li>Using Western’s collections to answer clinical questions </li></ul>
  4. 4. Library Services <ul><li>Canadian Library of Family Medicine </li></ul><ul><li>Hospital Libraries </li></ul><ul><li>Leddy Library </li></ul><ul><li>Western Libraries </li></ul>
  5. 5. Western Libraries: What we’ve got Journals and databases Books Clinical Tools Learning modules Calculators Drug Identification Tools Images
  6. 6. Medicine Information: How to access - Go to: http://www.lib.uwo.ca/ <ul><li>Log in to Off-Campus Access with your UWO username and password (same as your UWO email account) </li></ul><ul><li>jsmith27 </li></ul><ul><li>sdK?8N*5 </li></ul>- Select Browse by Program - Select Medicine and Dentistry - Select Clinical Outreach
  7. 7. http://www.lib.uwo.ca/programs/clinicaloutreach/ Use this page to find selected medical resources Electronic Books Point of Care & EBM Tools Databases Image and video collections And more...
  8. 8. How to search our collections Select “Catalogue” <ul><li>Search the Catalogue to find anything Western Libraries owns or subscribes to </li></ul><ul><li>...including: </li></ul><ul><li>Journals </li></ul><ul><li>Books </li></ul><ul><li>Databases </li></ul><ul><li>Point of Care Tools </li></ul>
  9. 9. Catalogue Searching You can even search for electronic full-text journals. Select “Journal Title” Then enter the name of the journal And select “Go” Tip: For best results, use the Advanced Search
  10. 10. Parts of a Catalogue Record Full title of the journal Links to electronic articles Coverage dates Call # & location of print volumes
  11. 11. Other ways to access electronic full text <ul><li>When searching for articles in databases, use the button to link to full-text </li></ul><ul><li>Tip: To see the buttons in PubMed </li></ul><ul><ul><ul><li>Use the PubMed links from the library website </li></ul></ul></ul><ul><ul><ul><li>Change the display in PubMed to Abstract or AbstractPlus </li></ul></ul></ul>
  12. 12. Using the button Select the “Go” button to link to full text
  13. 13. Access Exercise 1 <ul><li>How would you get a hold of this article? </li></ul><ul><li>Weber M. Achieving blood pressure goals: should angiotensin II receptor blockers become first-line treatment in hypertension? J Hypertens. 2009 Jul;27 Suppl 5:S9-14. </li></ul>
  14. 14. Access Exercise 2 <ul><li>How would you get a hold of this article? </li></ul><ul><li>Olsson SB, Orndahl G, Erneström S, Eskilsson J, Persson S, Grennert ML, Johansson BW. Spontaneous reversion from long-lasting atrial fibrillation to sinus rhythm . Acta Med Scand. 1980;207(1-2):5-20. PubMed PMID: 7368973. </li></ul>
  15. 15. Access Key Points <ul><li>Off-Campus Access – Remember to log in </li></ul><ul><li>Browse by Program > Clinical Outreach </li></ul><ul><li>Search the catalogue to find anything UWO owns or subscribes to </li></ul><ul><li>Use Getit@Western button to access full-text </li></ul><ul><li>Select “Request Item” from the catalogue to request ARCC and RDL items for Desktop Delivery </li></ul>
  16. 16. Answering questions using Western’s collections
  17. 17. Background Questions <ul><li>What are the general preventative measures for otitis externa? </li></ul><ul><li>What are the mechanisms of Gabapentin? </li></ul><ul><li>What conditions are in the differential diagnosis for atrial fibrillation? </li></ul><ul><li>What are current guidelines for use of carotid endarterectomy? </li></ul>
  18. 18. Resources for Background Questions <ul><li>Textbooks </li></ul><ul><li>Library Catalogue (can limit to electronic) </li></ul><ul><li>Books@Ovid (623 clinical textbooks) </li></ul><ul><li>Harrison’s Online (AccessMedicine) </li></ul><ul><li>STAT!Ref (27 clinical textbooks) </li></ul>
  19. 19. Clinical/Foreground Questions
  20. 20. Using the Evidence to Answer Clinical Questions <ul><li>Identify your problem </li></ul><ul><li>Define a structured question </li></ul><ul><li>Find the best evidence </li></ul><ul><li>How valid is the evidence? </li></ul><ul><li>What are the results? </li></ul><ul><li>How should I apply the results to patient care? 1 </li></ul>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
  21. 21. Case study <ul><li>Using the PICO model, formulate an answerable question </li></ul>A patient with chronic asthma and a BMI of 36 asks if the low-calorie diet that you’ve recommended may also help with her asthma.
  22. 22. Create an answerable question <ul><li>In patients with asthma, does a low-calorie diet help to decrease symptoms? </li></ul>Population Patients with asthma Intervention Low-calorie diet Comparison Outcomes Decreased symptoms
  23. 23. 6 Question Types <ul><ul><li>Aetiology: the causes of the disease and their modes of operation </li></ul></ul><ul><ul><li>Diagnosis: signs, symptoms or tests for diagnosing a disorder </li></ul></ul><ul><ul><li>Prognosis: the probable course of the disease over time </li></ul></ul><ul><ul><li>Therapy: selection of effective treatments which meet you patient’s values. </li></ul></ul><ul><ul><li>Cost-effectiveness: is one intervention more cost-effective than another? </li></ul></ul><ul><ul><li>Quality of life: what will be the quality of life of the patient? 3 </li></ul></ul>3 Heneghan, Carl, and Douglas Badenoch. Evidence-Based Medicine Toolkit. 2nd ed. Malden, Mass.: BMJ Books/Blackwell Pub., 2006.
  24. 24. Find the Best Evidence <ul><li>Studies which best answer each question type </li></ul>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
  25. 25. Evidence Pyramid Less time Less work Less evidence More time More work More evidence http://www.mh.org.au/royal_melbourne_hospital/www/353/files/pyramidopt.jpg
  26. 26. Exercise <ul><li>Search the following resources to answer the question: In patients with asthma, does a low-calorie diet help to alleviate symptoms associated with the condition? </li></ul><ul><ul><ul><ul><ul><li>Cochrane Library </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Essential Evidence Plus </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>PubMed </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>SCOPUS </li></ul></ul></ul></ul></ul>
  27. 27. Conclusions <ul><li>Number of results </li></ul>Source Hits Cochrane Library 7 Essential Evidence Plus 23 PubMed 949 (75 if using Clinical Queries) SCOPUS 2010
  28. 28. Evidence Pyramid Cochrane Library EMBASE PubMed SCOPUS
  29. 29. Summary & Key Points <ul><li>Library Services </li></ul><ul><li>Access </li></ul><ul><ul><li>Log in to off-campus access </li></ul></ul><ul><ul><li>Browse by Program > Clinical Medicine </li></ul></ul><ul><ul><li>Search the Catalogue (use the Advanced search) </li></ul></ul><ul><ul><li>Access full text by using the Get it @ Western button </li></ul></ul><ul><li>Searching </li></ul><ul><ul><li>Use textbooks to answer background questions </li></ul></ul><ul><ul><li>Use PICO to formulate answerable clinical questions </li></ul></ul><ul><ul><li>Save time by searching filtered information sources first </li></ul></ul>
  30. 30. QUESTIONS?

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