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Keck Year 2 Evidence Based Medicine - Guidelines

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Keck Year 2 Evidence Based Medicine - Guidelines

  1. 1. Evidence-Based Guidelines Lynn Kysh, MLIS kysh@usc.edu Information Services Librarian Norris Medical Library
  2. 2. Evidence Pyramid – Publication Types Evidence-Based Guidelines Systematic Review & Metaanalysis Higher Quality of Information Fewer Articles Randomized Controlled Trials Cohort Studies Case Control Studies Lower Quality of Information More Articles Case Series, Case Reports
  3. 3. Agenda • A note about guidelines • Clinical Scenario: Prostate Cancer Screening • Ask • PICO • Acquire • PubMed • National Guidelines Clearinghouse • What about clinical information tools?
  4. 4. Evidence (research) Clinical expertise Patient values
  5. 5. Guide to formulate a question • Problem/Patient • Intervention • Comparison (if any) • Outcome
  6. 6. Clinical Scenario Your patient is a 50 year old African-American Chief Executive Officer for a Los Angeles company presents for his executive physical. His friend was recently diagnosed with prostate cancer and he wants to know if he should have a digital rectal examination and/or PSA. How would you respond?
  7. 7. Using PICO •P •I •C •O 50 y/o African American man Digital rectal exam or PSA No screening Decrease morbidity and mortality related to prostate cancer
  8. 8. Finding guidelines: Use “Article Type” filter
  9. 9. National Guidelines Clearinghouse • Guidelines Information • Organization • Process • Evidence used • Disclosures • Comparison feature
  10. 10. But what about clinical information tools?
  11. 11. Are these EBM Resources? • Opinions vary (and that’s okay!) • Appraise the information • Check evidence ratings • Follow links to evidence • Check author information
  12. 12. Examined from UpToDate & Dynamed articles on: • erectile dysfunction • fibromyalgia • hypogonadism • Psoriasis • rheumatoid arthritis • Crohn's disease All articles from the UpToDate articles demonstrated a conflict of interest. At times, the editor and author would have a financial relationship with a company whose drug was mentioned within the article.
  13. 13. Agenda • A note about guidelines • Clinical Scenario: Prostate Cancer Screening • Ask • PICO • Acquire • PubMed • National Guidelines Clearinghouse • What about clinical information tools?
  14. 14. Questions? Lynn Kysh, MLIS Information Services Librarian kysh@usc.edu (323) 442-1124
  15. 15. Thanks! Lynn Kysh, MLIS Information Services Librarian kysh@usc.edu (323) 442-1124

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