I am Beverly Rossini, Outreach Librarian for the USA Biomedical Library. I will be introducing you to some of your library resources and to the concept of evidence based medicine.
My contact information is on this slide, which will be posted along with an assignment based on this lecture. To complete the assignment you will work through modules about library resources and answer questions using those resources. Your answers will be submitted for a course grade. If you need help with any of the work, or if you are not sure about what you are being asked to do, please contact me for help or for clarification. The assignment will be due January 14, 2011, and it can be accessed and then submitted from our Library homepage. I will show you that exact link at the end of the presentation.
We will be working from the library’s home page for the purposes of this lecture, so I suggest you bookmark the site for easy reference.
Our library home page is also linked from the COM site under Resources.
We have three library locations. You are probably most familiar with the campus site.
The UMC site is on the third floor of the hospital .
At C&W the library is located behind the hospital next to Human Resources.
The learning objectives for this assignment are stated here. After you work through all modules of this class, you should demonstrate competency in all stated objectives.
The objectives for this assignment relate directly to the COM educational object #15
In the various modules for this lecture I am going to walk you through these resources which you will use to complete the class assignment. These are the same resources the health care providers associated with USA’s health system use to access the evidence they need to successfully practice Evidence Based Medicine.
The need for proficiency in navigating the medical literature is well documented. In this cited study, and in other studies, the clinicians voiced three main barriers between them and the information they needed: Lack of time Outdated resources Perceived disorganization of the journal literature 1 Alper BS, , Hand JA, and Elliott SG. &quot;How much effort is needed to keep up with the literature relevant for primary care?.&quot; Journal Medical o the Library Association. 92.4 (2004): 429-437.
We have seen some phenomenal advances in biomedical research in the past three decades, and we have made great strides in organizing that information, but the volume of medical papers doubles every 10-15 years.* 2 Weeber M, Kors JA, Mons B. Online tools to support literature-based discovery in the life sciences.” Briefings in Bioinformatics . 2005 September; 6 (3): 277. *Sicily statement on evidence-based practice PMID 15634359
There are two trends you can look forward to hearing more about: EBM also called EBP. The goal of EBM is to provide a scientific basis for patient care using the highest level of evidence possible. We will take a closer look at what other characteristics constitute EBM in a moment. The other trend is the educated health care consumer. The educated health care consumer is a huge topic right now –Startling in the Pew Report is the statistic that 80% of all people who use the Internet use it to find health information – and then asking their doctors questions about what they find.
But back to Evidence Based Medicine – a term you will hear a lot about. EBM requires that decisions about health care be based on the best available, current, valid and relevant evidence. Basically EBM combines the external evidence (the medical literature and the body of knowledge) with the clinical expertise of the health care provider AND important here – what the patient wants. Think of it graphically with the three spheres.
Every time you see a patient, you will need new information about some element of the diagnosis, prognosis or management. Because your time to find this information is often limited, you need to be very efficient in your searching. To achieve this efficiency, you need to become skilled at using the resources identified by the Levels of Evidence hierarchy.
This slide outlines some of the resources medical professionals (and students) at USA have access to. The list is a top down: that is, the better resources are at the top of the pyramid and get more general (therefore more information to sift through) as the levels go down. The primary research – the clinical trials and observational studies are at the bottom. Evidence from these studies are reported and reviewed. They may or may not become guidelines: all research conducted with federal tax dollars is now mandated (April 2008) to be deposited in PubMed to be accessible free of charge six months after the published information appears in a journal. ACP Journal Club and Cochrane have synthesized the literature for you - so the information is then reported back to you in a more easily digested format. The second to the top resources are called “Point of Care tools” which health care providers can access (again – for the evidence) at the patient’s bedside for information that may fall outside their own clinical expertise – or to verify their diagnosis or treatment plan. Many of these tools are now available for mobile technologies. Finally, at the top is what will probably become the future of health care –the electronic health record - Health information that is pertinent to one patient only. Many hospitals are in the early stages of implementing the EHR
From our home page, we have further resources you can explore about Evidence Based Medicine. Just toggle the link under Resources called Evidence Based Healthcare.
Helping you become more proficient in the applied science of information management is just one of the services offered by the USA Biomedical Library. Please feel free to contact us with any questions or needs.
Your assignment can be found on library’s home page. Two clicks: Library Courses and then
Your class PHE 131 Both this PowerPoint (without audio) and the assignment will be archived here.
If you want to work incrementally on the assignment, I would copy and paste this form into a Word document while you are working on it and then enter the answers back into the form from the word document to submit to me via email by January 14, 2011. Remember, you can contact me with any questions. Thank you and good luck.
Using the Biomedical Library and its Resources
Public Health & Epidemiology PHE 131
Becoming Efficient Information Managers
Assignment will be due January 14, 2011 Submit via email to [email_address]
Keeping Current: The Challenges Keeping up-to-date with the newest advancements in medical research and treatments. In a set of journals pertinent to primary care physicians in 2002: 7,287 articles are published monthly. A physician trained in epidemiology would take an estimated 627.5 hours per month to evaluate articles pertinent to his practice. 1 1 Alper BS, , Hand JA, and Elliott SG. "How much effort is needed to keep up with the literature relevant for primary care?." Journal Medical o the Library Association . 92.4 (2004): 429-437.
Keeping Current: The Challenges Information available through multiple sources in numerous formats.
In biomedical research , the amount of experimental data and published scientiﬁc information is “ overwhelming and ever increasing , which may inhibit rather than stimulate scientiﬁc progress.” 2
2 Weeber M, Kors JA, Mons B. Online tools to support literature-based discovery in the life sciences.” Briefings in Bioinformatics . 2005 September; 6 (3): 277.
Combining clinical skills with evidence found in the best, most current research.
Better informed general public
8 in 10 Internet users go online to look up health related information. 1
Among Internet users who say their last health related search had an impact, 54% say the information led them to ask their doctors new questions or get a second opinion from another doctor. 1
1 Online health search 2006. Pew Internet & American Life Project. Available online at http://www.pewinternet.org/pdfs/PIP_Online_Health_2006.pdf.
Evidence Based Medicine (EBM) “ Evidence-based medicine (EBM) is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” 2 Short definition: “the integration of best research evidence with clinical expertise and patient values.” 3 2 Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB, Richardson WS. Evidence-based medicine: what it is and what it isn't. BMJ 1996; 312: 71-2. 3 Sackett, DL. Evidence-based medicine: how to practice and teach EBM. New York: Churchill-Livingston, 2000.
Evidence Based Medicine (EBM) Research Evidence Since EBM’s focus is on patient-oriented, outcomes-based research (as opposed to expert led medicine), the medical literature is searched and evaluated to determine what data is available to address the questions arising in clinical practice.
Electronic Health Record - Computer system Clinical Evidence , PIER, Dynamed, UpToDate ACP Journal Club, Cochrane Library PubMED Clinical Queries, guidelines Original Studies Levels of Evidence Hierarchy
Public Health & Epidemiology Library Assignment http://biomedicallibrary.southalabama.edu/library/classes/modules/phe.htm
Assignment will be due January 14, 2011 by 5 PM. Submit via email to [email_address] There are ten questions to answer for 31 possible points. I will simply grade # correct out of 31. Your instructor will assign a weight to the assignment.