Presentation on PDA resources for medical students

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  • DON’T CLICK
    History:
    McMaster University, Guyatt, Haynes, 1980s, seminal article published 1992: went on to produce a series called the Users’ guides to the medical literature
    (any body know the first historical rct? First RCT: 1747, citrus fruit and scurvy )
    --as the literature was growing in leaps and bounds, and McMaster was creating an innovative problem-based curriculum the biostats department was looking at innovative ways
    Overwhelming growth in medical literature
    Doubles in size every 19 years (J. Wyatt, Lancet, 338, Nov 30 1991)
    Limitations of traditional sources
    Need new way to stay up-to-date
    What’s the evidence for evidence based medicine, well, could we ethically do a randomized controlled trial
    What we can point to is evidence that evidence based practice is effective, and not following the evidence is harmful
    --Myocardial Infarction survivors treated with aspirin and beta blockers have lower mortality;
    --Carotid surgery—if they meet evidence based requirements 3 times less likely to have stroke or die in next month than those operated on who didn’t.
  • Overwhelming growth in medical literature
    Doubles in size every 19 years (J. Wyatt, Lancet, 338, Nov 30 1991)
    Limitations of traditional sources
    Need new way to stay up-to-date
  • Presentation on PDA resources for medical students

    1. 1. Cindy Sheffield, MBA, MLS Claire Twose, MLIS Brian Pinto, PharmD Mark Dodd PDA Resources for Evidence-Based Medicine The Welch Medical Library May 6, 2004
    2. 2. Today’s Lecture Intro to Evidence-Based Medicine Intro to Personal Digital Assistants Resources Government Guidelines Clearinghouse PubMed FIRSTConsult mobileMICROMEDEX Lexi-COMP (fee) PICO Maker EBM Calc Other Learning Opportunities Other Resources Questions and Answers
    3. 3. EBM Definition Evidence-Based Medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. Glossary, Centre for Evidence Based Medicine, Oxford accessed April 28, 2004 http://www.cebm.net/glossary.asp
    4. 4. No Yes 1 Refine Question 2 Formulate Query 2 Perform Search 2 Evaluate results: Satisfactory? 5 Evaluate Process 4 Incorporate into Patient Care 2 Select Sources for Pre-processedPre-processed literature 3 Evidence is Critically Appraised by Reputable Source Finding EBM Flow Chart
    5. 5. Managing the Literature Usefulness ofUsefulness of MedicalMedical InformationInformation = RelevanceRelevance x Validity Work Shaughnessy AF, Slawson DC, Bennett JH. Becoming an information master: a guidebook to the medical information jungle. J Fam Pract 1994 Nov; 39(5):489-99
    6. 6. Levels of Evidence: study design Medical Center Library, Duke University Stronger Weaker
    7. 7. Welch’s EBM Page: Quicklinks, EBM
    8. 8. Intro to PDAs: Palm vs. Pocket PC Operating Systems Palm Pocket PC
    9. 9. Intro to PDAs: Palm vs. Pocket PC
    10. 10. Introduction to PDAs – more info • Jim’s Palm Pages – http://www.jimthompson.net/palmpda/ • Dalhouise – http://handheld.medicine.dal.ca/introduction/index.htm • pdaMD.com Learning Center – http://www.pdamd.com/vertical/features/wireless_2.xml • Etopicbrain – http://pbrain.hypermart.net/basics.html
    11. 11. Government Guidelines Clearinghouse • Public resource for evidence-based clinical practice guidelines • NGC is an initiative of the Agency for Healthcare Research and Quality • Can use a Reader with Palm; wireless direct access available on Pocket PC http://www.guideline.gov/
    12. 12. Government Guidelines Clearinghouse
    13. 13. PubMed • Search in Medline for citations and abstracts • Will provide interactive access in a wireless environment http://certif.nlm.nih.gov:8080/nlm/ • Can use same address as Avantgo Channel • Project called PubMed on Tap http://archive.nlm.nih.gov/proj/pmot/pmot.php
    14. 14. PubMed Search directly with a wireless connection or use Avantgo and create a custom channel.
    15. 15. FIRSTConsult • 330 Differential Diagnoses • 450 Medical Conditions • 3 Different download sizes • Updated quarterly http://www.welch.jhu.edu/internet/ebr.ht ml#PDAs
    16. 16. FIRSTConsult
    17. 17. mobileMICROMEDEX • Drug information and interactions • Alternative medicine information • Acute care • Toxicology information • Formulary advisories http://jhmcis.jhmi.edu/mdxcgi/mdxhtml.e xe? &tmpl=mobile.tm1&SCRNAME=mobile &CTL=E:mdxmdxcgimegat.sys
    18. 18. mobileMICROMEDEX
    19. 19. Lexi-COMP • Provides drug interaction information • JHH Formularies www.lexi.com
    20. 20. Lexi-COMP
    21. 21. PICO Maker • Store queries in PICO format for later • Assist students and clinicians with evidence based practice. • Palm based http://www.library.ualberta.ca/pdazone/pico/
    22. 22. PICO Maker
    23. 23. EBM Calc • Statistics for Diagnostic, Prospective, Case Control & Randomized studies • Can graph pre- and post test probability with likelihood ratio for Diagnostic Studies. • Can save results and view at another time EBM Calculator – Centre for EBM – University Health Network http://www.cebm.utoronto.ca/palm/ebmcalc
    24. 24. EBM Calc
    25. 25. Other Learning Opportunities Library Classes (Resources for Research and Information Management & Presentations): • Evidence-Based Health Care – 6/24/04 pm • Pharmacology Resources – 8/12/04 am • Evidence-Based Critical Appraisal for Patient Care - 7/27/04 am • Registration @ http://www.welch.jhu.edu/classes
    26. 26. October 12th All Day Event See http://mobileathopkins.jhu.edu/ For details
    27. 27. Other PDA Resources of Interest • Avantgo – host server https://my.avantgo.com/home/ • Hopkins Antibiotic Guide http://hopkins-abxguide.org • ePocrates www.epocrates.com • MedCalc http://www.collectivemed.com/jump/medca.shtml
    28. 28. Where to find PDA Resources http://www.welch.jhu.edu/classes/elearning/pdaresources.html • Dalhousie University Handheld Recommendations - Organized set of hardware descriptions and software specifically for medicine with informative recommendations • ectopicbrain - List of medical applications with descriptions for each • handheldmed - Delivers point of care content and applications for healthcare professionals • pdaMD.com - Premier website providing tutorials, forums, news, and software for health care professionals who use PDAs • Skyscape - Extensive list of medical reference titles
    29. 29. Where to find PDA Resources • CollectiveMed - Owned and operated by healthcare professionals • MedicalPocketPC - Software, news, and reviews for PocketPC and WinCE medical users • HealthyPalmPilot - Over 700 downloadable healthcare resources from pdaMD.com • Memoware Medical Downloads - Over 300 downloads for medical specialties • Johns Hopkins Office of Academic Computing – Several medical applications for the Palm OS. • WelchWeb’s Personal Digital Assistants – A guide to resources for healthcare.
    30. 30. How to Evaluate PDA Resources Knowing What’s What and What’s Not http://www.media-awareness.ca/english/resources/educational Ten C’s for Evaluating Internet Sources http://www.uwec.edu/Library/Guides/tencs.html

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