Anesthesiology Orientation Aug 2009

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Orientation session given to Anesthesiology Residents at the University of Western Ontario on August 12th, 2009

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Anesthesiology Orientation Aug 2009

  1. 1. Need to Know: Western Libraries Anesthesiology Residents Robin Featherstone, MLIS Clinical Medicine Librarian, University of Western Ontario [email_address]
  2. 2. Agenda <ul><li>Library services </li></ul><ul><li>How to access the evidence </li></ul><ul><li>How to search the evidence </li></ul>
  3. 3. Library Services <ul><li>Hospital Libraries – Brad Dishan </li></ul><ul><li>Academic Libraries </li></ul>
  4. 4. 1. Western Libraries: What we’ve got Journals and databases Books Clinical Tools Learning modules Calculators Drug Identification Tools Images & Videos
  5. 5. 2. Anesthesiology 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 Anesthesiology and Perioperative Medicine
  6. 6. http://www.lib.uwo.ca/programs/anesthesiaandperioperativemedicine/ Use this page to find selected resources for anesthesiology Electronic Books Point of Care Tools Databases Image and video collections And more...
  7. 7. 2. 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>
  8. 8. 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” Tip: Use the Advanced Search
  9. 9. Parts of a Catalogue Record Full title of the journal Links to electronic articles Coverage dates Call # & location of print volumes
  10. 10. 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>
  11. 11. Exercise 1 <ul><li>How would you get a hold of this article? </li></ul><ul><li>Tian Q, Gomersall CD, Leung PP, Choi GY, Joynt GM, Tan PE, Wong AS. The adsorption of vancomycin by polyacrylonitrile, polyamide, and polysulfone hemofilters. Artif Organs. 2008 Jan;32(1):81-4. PubMed PMID: 18181809 . </li></ul>
  12. 12. Exercise 2 <ul><li>How would you get a hold of this article? </li></ul><ul><li>Kroh UF, Holl T, Feussner KD. Pharmacokinetics and dosage adjustment of antibiotics during continuous extracorporeal lung assistance and hemofiltration. Artif Organs. 1992 Oct;16(5):457-60. </li></ul>
  13. 13. Exercise 3 <ul><li>How would you get a hold of this article? </li></ul><ul><li>Duffy BL. Vancomycin reaction during spinal anaesthesia. </li></ul>
  14. 14. To Register for RACER (InterLibrary Loan ordering system) <ul><li>http://www.lib.uwo.ca/ill/firsttimeracer.shtml </li></ul>
  15. 15. Access Key Points <ul><li>Off-Campus Access – Remember to log in </li></ul><ul><li>Browse by Program > Anesthesiology </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>Request electronic copies of ARCC (storage) items for desktop delivery </li></ul><ul><li>Request items using ILL (InterLibrary Loan) - RACER </li></ul>
  16. 16. Searching
  17. 17. Exercise 1 <ul><li>Answer the following background question using the library website: </li></ul><ul><li>Which coexisting diseases influence anesthesia management? </li></ul>
  18. 18. Clinical Questions
  19. 19. 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
  20. 20. Case study <ul><li>Using the PICO model, formulate an answerable question </li></ul>A patient expresses concern before cataract surgery about the amount of pain they will experience. You consider administering intracameral anaesthetic (lidocaine) as a supplement to topical anaesthetic, but you’re not sure if the additional anaesthesia will reduce intraoperative pain perception compared with topical anaesthetic alone.
  21. 21. Create an answerable question <ul><li>In cataract surgery patients, does topical anaesthetic alone reduce pain perception when compared to topical anaesthetic supplemented by intracameral lidocaine? </li></ul>Population Cataract surgery patients Intervention Topical anaesthesia alone Comparison Topical anaesthesia with intracameral lidocaine Outcomes Reduction of pain perception
  22. 22. Clarify the question type <ul><li>In cataract surgery patients, does topical anaesthetic alone reduce pain perception when compared to topical anaesthetic supplemented by intracameral lidocaine? </li></ul><ul><li>What kind of question is this? </li></ul>
  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 More time http://www.mh.org.au/royal_melbourne_hospital/www/353/files/pyramidopt.jpg
  26. 26. Formulating your search <ul><li>State the search question </li></ul><ul><li>Isolate and prioritize the main concepts </li></ul><ul><li>Search each concept separately </li></ul><ul><li>Use controlled vocabulary if available (MeSH, EMTree) and keywords </li></ul><ul><li>Combine search sets to get final results, if necessary </li></ul><ul><li>Apply limits (language, age group) </li></ul>
  27. 27. Exercise <ul><li>Search the following resources to answer the question: In cataract surgery patients, does topical anaesthetic alone reduce pain perception when compared to topical anaesthetic supplemented by intracameral lidocaine? </li></ul><ul><ul><ul><li>Cochrane Library </li></ul></ul></ul><ul><ul><ul><li>TRIP Database </li></ul></ul></ul><ul><ul><ul><li>PubMed </li></ul></ul></ul><ul><ul><ul><li>EMBASE </li></ul></ul></ul>
  28. 28. Conclusions <ul><li>Number of results </li></ul>Source Hits Cochrane Library 1 TRIP Database 8 PubMed 418 (13 using clinical queries) Embase 600 (188 if using clinical queries) Google 3,420 (444 if using Google Scholar)
  29. 29. Evidence Pyramid Cochrane Library TRIP Database PubMed EMBASE Google
  30. 30. Summary & Key Points <ul><li>“ Off campus access” </li></ul><ul><li>Browse by Program pages </li></ul><ul><li>The Library Catalogue </li></ul><ul><li>Electronic textbooks for background questions </li></ul><ul><li>Constructing a search using PICO for clinical questions </li></ul><ul><li>Identify the study type which will best answer your question </li></ul><ul><li>Save time by searching summaries first </li></ul>
  31. 31. And, finally... <ul><li>Who to call for help: </li></ul><ul><ul><li>Research Help: General or access type questions </li></ul></ul><ul><ul><ul><li>Phone: 519 661 3168 </li></ul></ul></ul><ul><ul><ul><li>Email, Chat: http://www.lib.uwo.ca/taylor/researchhelp.shtml </li></ul></ul></ul><ul><ul><li>Subject Librarian (Robin): Specific searching questions </li></ul></ul><ul><ul><ul><li>Phone: 519 661 2111 ext: 86383 </li></ul></ul></ul><ul><ul><ul><li>Email: [email_address] </li></ul></ul></ul><ul><ul><ul><li>Chat: http://www.lib.uwo.ca/programs/anesthesiaandperioperativemedicine/ </li></ul></ul></ul><ul><ul><li>Hospital Librarians (Brad Dishan at St. Joe’s): for on-site support </li></ul></ul><ul><ul><ul><li>Phone: 519 646 6000 ext: 65727 </li></ul></ul></ul><ul><ul><ul><li>Email: [email_address] </li></ul></ul></ul>
  32. 32. Questions?

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