Bmi 18 April 2008 Geert Van Der Heijden

Medical Evidence Management Zoeken en selecteren van relevant origineel klinisch wetenschappelijk onderzoek in het internet tijdperk ,[object Object]

University Medical Center Utrecht Medical School Utrecht, The Netherlands

University Medical Center Utrecht Julius Center for Health Sciences and Primary Care www.juliuscenter.nl

University Medical Center Utrecht ,[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Epidemiology (CE) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Evidence Based Medicine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Evidence Based Practice ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Evidence Based Practice ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Evidence Based Practice gaat NIET over ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Patient presentation knowledge about diagnosis History Examination Investigations Diagnosis knowledge about prognosis Therapy Changes prognosis Clinical outcome knowledge about therapeutic effectiveness Etiology/pathogenesis knowledge about causation Research evidence sought from literature searches Clinical Process and knowledge requirements Etiologic Research Diagnostic Research Prognostic Research Therapy Research Basic Research

Conscious Competent ,[object Object],[object Object],Ignorant Untrained ,[object Object],[object Object],5 th yr 6 wks 6 th yr 24 wks

Scenario ,[object Object],[object Object],[object Object],[object Object]

Ik zoek alle relevante publicaties over … ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Doelstelling ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hoe het beste zoeken in PubMed? ,[object Object],[object Object],[object Object]

Kijk eens onder “details” ,[object Object],[object Object],[object Object],[object Object],[object Object]

Begin met goede vraagstelling PICO werkt verwarrend! Voldoet alleen voor therapie Mortaliteit etc Therapie Ziekte Therapie Mortaliteit etc Test Ziekte Prognose Ziekte Test Klachten Diagnose Uitkomst Determinant Domein

Selectie van zoektermen ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

PubMed Index ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Blanco papier 3 kolommen Vraagstelling (D / P / T & D / D / U) … .. … .. ..... Synomien 5 Synomien 5 Synomien 5 Synomien 4 Synomien 4 Synomien 4 Synomien 3 Synomien 3 Synomien 3 Synomien 2 Synomien 2 Synomien 2 Synomien 1 Synomien 1 Synomien 1 Term Term Term Uitkomst Determinant Domein OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR AND AND

Basis schema zoekfilter Vraagstelling Domein … OR … OR … Determinant … OR … OR … Uitkomst … OR … OR … Domein AND determinant AND uitkomst … AND clinical query (D / P / T)

Wanneer bekijkt u eigenlijk titels? ,[object Object],[object Object],[object Object]

Vuistregels bij titels bekijken ,[object Object],[object Object],[object Object],[object Object],[object Object]

Selectie op relevantie ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Low High Validity Relevance Low High Most Informative = valid & relevant Be flexible, avoid critical nihilism Accept lower relevance & validity

Bestaande overzichten? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Optimalisatie van zoekstrategie ,[object Object],[object Object],[object Object]

Sneeuwbal effect (1) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Sneeuwbal effect (2) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Sneeuwbal effect (3) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

MEM Prinicpes op een rij ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Voetangels & klemmen P-values Reporting bias Publicatie bias

Informatie waarde van artikel ,[object Object],[object Object],[object Object],[object Object],[object Object]

Publicatie waarde van artikel ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Reporting & publicatie bias? ? Mortaliteit etc ? Therapie Ziekte Therapie Mortaliteit etc ? Test ? Ziekte Prognose Ziekte Test ? Klachten ? Diagnose Uitkomst tiab Determinant tiab Domein tiab

Do you consider to MeSH up your search?

MeSH database ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Thesaurus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

MeSH = levende boom ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Overzicht aanpassing MeSH 2007/8 ,[object Object],[object Object],[object Object],[object Object],[object Object]

MeSH record indexering ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Queries? Pas op met gebruik ervan! ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Limits? Pas op met gebruik ervan! ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Learning by doing ,[object Object],[object Object]

Bmi 18 April 2008 Geert Van Der Heijden

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