Cover Slide Evidence Matters! KU-03 2003, Quebec, Canada Ofer Allan Avital M.D., Anne Bourbonnais RN, MSc (cand) Founders,...
Our Scientific Advisors <ul><li>Stuart Macleod   M.D . -  former dean of medicine at McMaster university </li></ul><ul><li...
Outline Presentation Outline   <ul><li>The Problems With Evidence </li></ul><ul><li>Current Resources </li></ul><ul><li>Ex...
Example of a Clinical Question A Clinician or Manager Asks: For a 35 year old woman with breast cancer (with bone metastas...
Outline Presentation Outline   <ul><li>The Problems With Evidence </li></ul><ul><li>Current Resources </li></ul><ul><li>Ex...
Outline Challenges - Philosophical   <ul><li>Leave room for experience, judgment </li></ul><ul><li>Evidence can sometimes ...
Outline Challenges - Practical   <ul><li>Evidence can be slow/hard to synthesize </li></ul><ul><li>Varying levels of evide...
Outline Presentation Outline   <ul><li>The Problem With Finding Evidence </li></ul><ul><li>Current Resources </li></ul><ul...
Spectrum of Professional Literature Research Resources <ul><li>Medline/Pubmed   </li></ul>Find   -  Index Medicus -  Libra...
Spectrum of Professional Literature The Spectrum of Professional Literature MDConsult Harrison’s Online <ul><li>Graph Summ...
Outline Presentation Outline   <ul><li>The Problem With Finding Evidence </li></ul><ul><li>Current Resources </li></ul><ul...
Home Page & Login DrKoop
Graph 1 – Intro: All therapies Search! Answer:
Graph 1b - Level of Evidence
Graph 1c - Case Series Label
Graph 1d - Legend & Drill Down
List View 1
List View 2
Article Summary 1a - Recurrence Outcome
Article Summary 1b - Other Outcomes
Article Summary 1a - Recurrence Outcome
Article Summary 1c - Scroll Down
Construct new Question/Search
Question Wizard - Step 1a
Question Wizard - Step 1b
Question Wizard - Step 2a
Question Wizard - Step 2a1
Question Wizard - Step 2b1
Question Wizard - Step 2b2
Question Wizard - Step 2b2-P
Question Wizard - Step 3
Question Wizard - Step 3a
Question Wizard - Step 3b
Question Wizard - Step 3b6
Question Wizard - Step 3b62
Question Wizard - Step 3b62b
Question Wizard - Step 3b62b-OverallS
Question Wizard - Generate Graph
Graph 2 - Prednisone  Prednisone
Favorites
EM Feature Summary - Graph Summary Views  Feature Summary   - Multiple types of research  - Daily Updates - User-defined c...
Outline Presentation Outline   <ul><li>The Problem With Finding Evidence </li></ul><ul><li>Current Resources </li></ul><ul...
Accolades from Test Users « This is the most time-friendly device for medical information I’ve ever seen » « I cannot beli...
Awards •  Finalist for Best New Company  in Canada,  Canadian Youth Business Foundation • December 2002: $350 000 Federal ...
Activities - 2003 •  CHLA 2003, EBL,  in Edmonton, Alberta.  Paper presentation, Poster September June •  KU-03: Knowledge...
Outline Presentation Outline   <ul><li>The Problem With Finding Evidence </li></ul><ul><li>Current Resources </li></ul><ul...
Access to Our System <ul><li>1) Free Trials available in 3-6 months  </li></ul>2) Some Content always free 4) Browser-base...
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  • Over ten years experience designing world-class marketing and PR for a wide array of offline and online brands. She is president of Armada Global Inc. a marketing firm in San Francisco
  • Overhead: quote re in 2yrs solutions will be analysis of information available (perhaps put this at end)
  • Not machine translation. Several thousand vocabulary elements to translate – takes about a month or two to add a new language
  • Not machine translation. Several thousand vocabulary elements to translate – takes about a month or two to add a new language
  • 1) EMB online search engines have legacy systems that cannot be adapted to our methods and are underfunded; MDConsult has good institution penetration but its revenue model and unscaleable offerings limit its strategy 2) Portable devices are a unique competitor category, the only one of which we know to be achieving serious penetration is ePocrates. They are the one we most need to beat to this market. 3) The eHealth portals such as the content branch of WebMD etc would stand the best chance in principle of competing directly with us. However, they are all struggling fairly unsuccessfully to meet their own core competencies. With $1B in the bank WebMD would most likely provide us with a good exit strategy if we prove our concept and attract eyeballs. 4) The5 big Cos would be cannibalizing their core business by creating a service like ours, since their bread and butter is providing new protocols &amp; research. 5) Similar for the offline publishers; their business is publishing as much research as possible. they are large public companies with fair cash reserves. They are staid institutions however, slow to change 6) HMOs and hospitals are all currently in their first or second year of installing internal databases to conduct internal outcomes research to see how effective &amp; cost-effective their therapies are in the real world. They are therefore creating an enormous volume of data that is complimentary to the more pure clinical research studies and is level () evidence. [overhead of 10 levels] In fact, an HMO would be very interested in acquiring our tool as a service both for it’s physicians, as well as a free web service to market to potential patients. I have had interest expressed by an HMO, an informatics company, and a member of the board of directors of a big pharma co 7) Big pharma would be interested in our tool as well, both as a service to market to MDs, to patients, and for internal use for its own research planning. They could be a source of extra income to fund initiatives to code in more basic science research, especially as the explosion of information from genomics starts to come in. (next slide: What we&apos;ve done so far)
  • Overhead: quote re in 2yrs solutions will be analysis of information available (perhaps put this at end)
  • Overhead: quote re in 2yrs solutions will be analysis of information available (perhaps put this at end)
  • Overhead: quote re in 2yrs solutions will be analysis of information available (perhaps put this at end)
  • EM will earn revenue from at least 8 sources: 1)     We give away the database with entries up to 1998-9 for free. Clinicians and consumers will pay to have the up-to-date version (updated weekly or daily), to use added-value features (such as an up-to-date database) after the first year. As opposed to 240-1200$US annually for other, less robust services, we will charge $200US per clinician annually. Users may also pay to read premium content (i.e. full journal articles), or to have resources (e.g. Patient handouts or studies) mailed directly to someone they care about. 2)      Institutions that currently pay for evidence-based informatics services (like MD Consult) will pay a competitive ASP fee 3)      It will license its novel content (news, rankings, and graphical interface) to health institutions, libraries, drug companies, and web portals. (Already have interest from Mayo site and Medem site for medical specialties) 4)      We can charge for extra features such as access to full-text articles 5)      We can take a commission for features such as funds donated to specific research groups through our site 6)      Ecommerce affiliate program links (as CNET does) for consumer products including orthopedic aids and over-the-counter drugs from vendors such as Drugstore.com 7)      There will be a comprehensive database of anonymous health-seeking question information created that may sold to market researchers. 8) We will strive to avoid making advertising a significant revenue source, unless it is in the form of unrestricted grants for development, to avoid the potential for bias, or the perception of. We may eventually earn money through advertising, if market research shows this is acceptable to consumers (we must maintain the appearance of and de facto impartiality). Limited Palm-pilot based advertising for MDs may be more acceptable - (next slide competitive advantages)
  • "Evidence Matters When it Comes to Health: A New Tool of ...

    1. 1. Cover Slide Evidence Matters! KU-03 2003, Quebec, Canada Ofer Allan Avital M.D., Anne Bourbonnais RN, MSc (cand) Founders, Evidence Matters [email_address]
    2. 2. Our Scientific Advisors <ul><li>Stuart Macleod M.D . - former dean of medicine at McMaster university </li></ul><ul><li>Mo Watanabe , M.D . – former dean of medicine, University of Calgary, EBM Expert </li></ul><ul><li>Dr. Lewis Slotin – Former Director, MRC </li></ul><ul><li>Dr. Al Shrier – Chair of McGill Physiology Dept </li></ul><ul><li>Angela Lambrou , MSLIS , Librarian, McGill U </li></ul><ul><li>Louise Bourbonnais , MSLIS , Librarian, IUGM </li></ul>
    3. 3. Outline Presentation Outline <ul><li>The Problems With Evidence </li></ul><ul><li>Current Resources </li></ul><ul><li>Example of a Clinical Question </li></ul><ul><li>Accolades, Awards & Activities </li></ul><ul><li>How to Access </li></ul>- Evidence Matters
    4. 4. Example of a Clinical Question A Clinician or Manager Asks: For a 35 year old woman with breast cancer (with bone metastases), what are the therapies available with: Goal : Include multiple types of research designs, organized by level of evidence - Highest remission rates at five years? - Lowest nausea rates during therapy? - Least hair loss? - Outcomes above and lowest costs?
    5. 5. Outline Presentation Outline <ul><li>The Problems With Evidence </li></ul><ul><li>Current Resources </li></ul><ul><li>Example of a Clinical Question </li></ul><ul><li>Accolades, Awards & Activities </li></ul><ul><li>How To Access </li></ul>- Evidence Matters The Problem With Finding Evidence
    6. 6. Outline Challenges - Philosophical <ul><li>Leave room for experience, judgment </li></ul><ul><li>Evidence can sometimes be rigid </li></ul><ul><li>Evidence should inform, not dictate </li></ul>The Problem With Finding Evidence
    7. 7. Outline Challenges - Practical <ul><li>Evidence can be slow/hard to synthesize </li></ul><ul><li>Varying levels of evidence </li></ul><ul><li>Evidence can be slow/hard to amass </li></ul><ul><li>Timeliness of synthesized resources vary </li></ul><ul><li>No standardization of outcomes </li></ul>- Contradictory findings The Problem With Finding Evidence
    8. 8. Outline Presentation Outline <ul><li>The Problem With Finding Evidence </li></ul><ul><li>Current Resources </li></ul><ul><li>Example of a Clinical Question </li></ul><ul><li>Accolades, Awards & Activities </li></ul><ul><li>How To Access </li></ul>- Evidence Matters
    9. 9. Spectrum of Professional Literature Research Resources <ul><li>Medline/Pubmed </li></ul>Find - Index Medicus - Library Collections <ul><li>Evidence Matters </li></ul>Read Synthesize Apply - Text - Article Summaries (“ Metagraph ”) - Expert/Researcher (+/- evidence) Construct Question “ Metaanalysis ” Can “Drill-down” to get - Reference Lists Choose Concept Term Do above Choose Concept/Keyword Do above Ask a Question Customized Answer
    10. 10. Spectrum of Professional Literature The Spectrum of Professional Literature MDConsult Harrison’s Online <ul><li>Graph Summary Views </li></ul>UpToDate Evidence Matters - Multiple types of research - Daily Updates <ul><li>Multilingual </li></ul><ul><li>Summaries of every article </li></ul>Cochrane ACP Clinical Evidence <ul><ul><li>User-defined </li></ul></ul><ul><ul><li>Outcomes-based </li></ul></ul>Medline Traditional Opinion Evidence-Based Cancer Focus
    11. 11. Outline Presentation Outline <ul><li>The Problem With Finding Evidence </li></ul><ul><li>Current Resources </li></ul><ul><li>Example of a Clinical Question </li></ul><ul><li>Accolades, Awards & Activities </li></ul><ul><li>How To Access </li></ul>- Evidence Matters
    12. 12. Home Page & Login DrKoop
    13. 13. Graph 1 – Intro: All therapies Search! Answer:
    14. 14. Graph 1b - Level of Evidence
    15. 15. Graph 1c - Case Series Label
    16. 16. Graph 1d - Legend & Drill Down
    17. 17. List View 1
    18. 18. List View 2
    19. 19. Article Summary 1a - Recurrence Outcome
    20. 20. Article Summary 1b - Other Outcomes
    21. 21. Article Summary 1a - Recurrence Outcome
    22. 22. Article Summary 1c - Scroll Down
    23. 23. Construct new Question/Search
    24. 24. Question Wizard - Step 1a
    25. 25. Question Wizard - Step 1b
    26. 26. Question Wizard - Step 2a
    27. 27. Question Wizard - Step 2a1
    28. 28. Question Wizard - Step 2b1
    29. 29. Question Wizard - Step 2b2
    30. 30. Question Wizard - Step 2b2-P
    31. 31. Question Wizard - Step 3
    32. 32. Question Wizard - Step 3a
    33. 33. Question Wizard - Step 3b
    34. 34. Question Wizard - Step 3b6
    35. 35. Question Wizard - Step 3b62
    36. 36. Question Wizard - Step 3b62b
    37. 37. Question Wizard - Step 3b62b-OverallS
    38. 38. Question Wizard - Generate Graph
    39. 39. Graph 2 - Prednisone Prednisone
    40. 40. Favorites
    41. 41. EM Feature Summary - Graph Summary Views Feature Summary - Multiple types of research - Daily Updates - User-defined comparisons <ul><li>Multilingual </li></ul><ul><li>Summaries of every article </li></ul>- Outcomes-based
    42. 42. Outline Presentation Outline <ul><li>The Problem With Finding Evidence </li></ul><ul><li>Current Resources </li></ul><ul><li>Example of a Clinical Question </li></ul><ul><li>Accolades, Awards & Activities </li></ul><ul><li>How To Access </li></ul>- Evidence Matters
    43. 43. Accolades from Test Users « This is the most time-friendly device for medical information I’ve ever seen » « I cannot believe this will not become the new standard of care » « I find it hard to get medical articles from the MEDLINE database, but this is easy and fast » Dr. George Michaels Assistant professor Family Medicine McGill University, Assistant Physician-in-Chief St-Mary’s Hospital Dr. Campbell Davies, Gastroenterologist, St. Mary’s Hospital
    44. 44. Awards • Finalist for Best New Company in Canada, Canadian Youth Business Foundation • December 2002: $350 000 Federal grant signed from CANARIE • Financial backing from MedTech Partners inc. 2003 2002 • Best Company – Samson Belair Deloitte Touche Investors night - $5 000 prize 2001 • Governor’s Circle : Best New Company - $20 000 grant from City of Montreal, “Fondation du Maire de Montreal”
    45. 45. Activities - 2003 • CHLA 2003, EBL, in Edmonton, Alberta. Paper presentation, Poster September June • KU-03: Knowledge Utilization / Transfer Colloquium, KU-UC/CHSRF/CIHR, Invited Speaker February • TEKT Think Tank, CIHR - Vancouver, B.C. • McGill Medical Class - Invited Speaker, class on Evidence Based Medicine • USMLA 2003, San Diego. Registrant
    46. 46. Outline Presentation Outline <ul><li>The Problem With Finding Evidence </li></ul><ul><li>Current Resources </li></ul><ul><li>Example of a Clinical Question </li></ul><ul><li>Accolades, Awards & Activities </li></ul><ul><li>How To Access </li></ul>- Evidence Matters
    47. 47. Access to Our System <ul><li>1) Free Trials available in 3-6 months </li></ul>2) Some Content always free 4) Browser-based (no installation) 3) Subscription to the rest Questions : [email_address] 5) Leave your contact information or contact us to be notified of the launch and trials
    48. 48. End

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