This document introduces evidence-based medicine and strategies for answering clinical questions. It discusses asking clinical questions using the PICO framework, acquiring evidence from resources like PubMed, UpToDate, and DynaMed, appraising the level of evidence, and applying evidence to patient care. Examples of clinical scenarios are provided to demonstrate formulating questions and searching various resources to find answers. Point-of-care tools, filtering information, and mobile devices to access resources are also outlined.
ARRIVE guidelines provides a list of information that should be incorporated in reporting research in a scientific article related to animals. 20 items should be reported in the articles. To increase its validity and authenticity, the ARRIVE guidelines are prepared by taking inputs from researchers, journal editors, research funders, and statisticians.
https://www.cognibrain.com/arrive-guidelines-for-preclinical-studies/
How Researchers Can Get Science Done Faster Using an R&D Services MarketplaceSC CTSI at USC and CHLA
Date: Feb 6, 2019
Topic: How Researchers Can Get Science Done Faster Using an R&D Services Marketplace
Speaker: Dr. Zev Wisotsky is a Senior Scientist and R&D Specialist at Science Exchange, where he assists researchers in connecting with the right R&D providers for their experiments and alerts his clients to newly available technologies. Dr. Wisotsky earned his PhD in neuroscience investigating taste detection using fruit fly and mosquito models at UC Riverside. He then completed postdoctoral research at Stanford studying the role of brain regions involved in fear memory and addiction through optogenetic silencing of different brain circuits.
Overview: Science Exchange is an open marketplace for scientific research that breaks down barriers to collaboration and innovation. The platform makes it easy for researchers to access more than 6,000 services from a network of over 2,500 qualified research providers. In this webinar, you will learn how researchers can use Science Exchange to access new technologies, get competitive quotes for specific projects, and order from any service provider under a single, pre-established contract. The presentation will also include examples of successful projects and collaborations, initiated on the Science Exchange platform, that have accelerated breakthrough
The Adapted ADAPTE approach to CPG adaptation proposed by the Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Egypt.
An oral presentation conducted by Prof. Tarek Omar during the national initiative of the Pediatrics Department, Armed Forces College of Medicine, themed; 'Towards National Guidelines' that was launched in 2018 and started by Pediatrics CPGs
ARRIVE guidelines provides a list of information that should be incorporated in reporting research in a scientific article related to animals. 20 items should be reported in the articles. To increase its validity and authenticity, the ARRIVE guidelines are prepared by taking inputs from researchers, journal editors, research funders, and statisticians.
https://www.cognibrain.com/arrive-guidelines-for-preclinical-studies/
How Researchers Can Get Science Done Faster Using an R&D Services MarketplaceSC CTSI at USC and CHLA
Date: Feb 6, 2019
Topic: How Researchers Can Get Science Done Faster Using an R&D Services Marketplace
Speaker: Dr. Zev Wisotsky is a Senior Scientist and R&D Specialist at Science Exchange, where he assists researchers in connecting with the right R&D providers for their experiments and alerts his clients to newly available technologies. Dr. Wisotsky earned his PhD in neuroscience investigating taste detection using fruit fly and mosquito models at UC Riverside. He then completed postdoctoral research at Stanford studying the role of brain regions involved in fear memory and addiction through optogenetic silencing of different brain circuits.
Overview: Science Exchange is an open marketplace for scientific research that breaks down barriers to collaboration and innovation. The platform makes it easy for researchers to access more than 6,000 services from a network of over 2,500 qualified research providers. In this webinar, you will learn how researchers can use Science Exchange to access new technologies, get competitive quotes for specific projects, and order from any service provider under a single, pre-established contract. The presentation will also include examples of successful projects and collaborations, initiated on the Science Exchange platform, that have accelerated breakthrough
The Adapted ADAPTE approach to CPG adaptation proposed by the Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Egypt.
An oral presentation conducted by Prof. Tarek Omar during the national initiative of the Pediatrics Department, Armed Forces College of Medicine, themed; 'Towards National Guidelines' that was launched in 2018 and started by Pediatrics CPGs
Part 1. An overview on implementation of CPGs
Part 2. CPGs & HTAs
Presented during the 2nd Regional Workshop for CPG Adaptation, Tunis, Tunisia May 24-26 2016
A collaborative between INA Sante, WHO-EMRO, KSU
What is the difference between development and adaptation of clinical practice guidelines? This was presented by Dr. Yasser Amer during the 2nd Regional Workshop for CPG adaptation, Tunis, Tunisia May 24-26 2016
Link:
https://www.facebook.com/media/set/?set=a.481589005298936.1073741852.215244758600030&type=1&l=67dff997c7
A personalized training workshop for the PRM Department Staff at KSUMC at large. The specific target audience is the CPG working groups and new committee members.
An introduction on Evidence-Based Clinical Practice Guidelines in Health Care Organizations
Brief on Alexandria Center for EBCPGs in Alexandria University Hospitals, Egypt
By Dr. Yasser Sami Abdel Dayem Amer, MBBCh, MS 2013
Special Thanks to
Prof Dr Mahmoud Elzalabany
Prof Dr Tarek Omar
Prof Dr Nabil Dowidar
Prof Dr Afaf Gaber
Overview of the Patient-Centered Outcomes Research Institute (PCORI), how PCORI views Patient-Centered Outcomes Research and how this is related to PCORI’s major funding mechanisms.
Overview of Evidence-Based Practice Guidelines Initiatives in the Hospitals of Two Universities in the Middle East and North Africa Countries: Alexandria University Faculty of Medicine and University Hospitals and King Saud University College of Medicine and Medical City
EVIDENCE-BASED CPGs FOR HEMATOLOGY - ONCOLOGY UNIT, KING SAUD UNIVERSITY HOPSITALS
Saudi Arabia, Riyadh
King Saud University Hospitals
CPGs Committee
Quality Management Dept
CPGs Program
By YASSER SAMI AMER
Part 1. An overview on implementation of CPGs
Part 2. CPGs & HTAs
Presented during the 2nd Regional Workshop for CPG Adaptation, Tunis, Tunisia May 24-26 2016
A collaborative between INA Sante, WHO-EMRO, KSU
What is the difference between development and adaptation of clinical practice guidelines? This was presented by Dr. Yasser Amer during the 2nd Regional Workshop for CPG adaptation, Tunis, Tunisia May 24-26 2016
Link:
https://www.facebook.com/media/set/?set=a.481589005298936.1073741852.215244758600030&type=1&l=67dff997c7
A personalized training workshop for the PRM Department Staff at KSUMC at large. The specific target audience is the CPG working groups and new committee members.
An introduction on Evidence-Based Clinical Practice Guidelines in Health Care Organizations
Brief on Alexandria Center for EBCPGs in Alexandria University Hospitals, Egypt
By Dr. Yasser Sami Abdel Dayem Amer, MBBCh, MS 2013
Special Thanks to
Prof Dr Mahmoud Elzalabany
Prof Dr Tarek Omar
Prof Dr Nabil Dowidar
Prof Dr Afaf Gaber
Overview of the Patient-Centered Outcomes Research Institute (PCORI), how PCORI views Patient-Centered Outcomes Research and how this is related to PCORI’s major funding mechanisms.
Overview of Evidence-Based Practice Guidelines Initiatives in the Hospitals of Two Universities in the Middle East and North Africa Countries: Alexandria University Faculty of Medicine and University Hospitals and King Saud University College of Medicine and Medical City
EVIDENCE-BASED CPGs FOR HEMATOLOGY - ONCOLOGY UNIT, KING SAUD UNIVERSITY HOPSITALS
Saudi Arabia, Riyadh
King Saud University Hospitals
CPGs Committee
Quality Management Dept
CPGs Program
By YASSER SAMI AMER
Portfolio de trabalhos desenvolvidos durante a faculdade de Arquitetura e Urbanismo (2009-2016) e durante período de estudos no exterior.
OBS: em inglês
This PowerPoint presentation was developed to highlight The Guild Restaurant and its services. This was also used during presentations at Hotel events and more.
The characteristics of the Ideal Source for practicing Evidence-Based Medicine are:-
Located in the clinical setting
Easy to use
Fast, reliable connection
Comprehensive /Full Text
Provides primary data
Most clinicians neither have enough time nor are trained to pick the best information from the enormous literature available. By practicing Evidence Based Medicine, they can give better patient care. EBM is the integration of the best research evidence with clinical expertise and patient values to make clinical decisions
Janet Schnall's presentation about Evidence Based Nursing Resources at our free monthly webcast. Recording available at https://webmeeting.nih.gov/p96958659/
Unit 4Instructions Enter total points possible in cell C14, under.docxmarilucorr
Unit 4Instructions: Enter total points possible in cell C14, under the rubric. Next enter scores (between 0 and 4) into yellow cells only in column F.Interpreting Statistical Output for Data Analysis PresentationUnsatisfacotrySatisfactoryAverageExcellentScoreWeightFinal Score1234Defined Key Clinical Questions Did not clearly define clinical question for research Attempted to define clinical question, without any reference necessary for database searchVaguely defined clinical question without the reference necessary for database researchClearly defined key clinical question used to search evidence-based databank (i.e, Pubmed, Medline, CINAHL, etc)020%0.00Database ReviewDid not provide a review of the evidence from a database searchProvide a brief overview of database results, not clearly linked to high levels of evidence Defined database results clearly, without generating a key clinical questionDefined database results clearly, generated from key clinical question database search results020%0.00Level 1 & 2 EvidenceOnly referenced Level 5-7 evidence, based on expert opinion andcase study reviews. Referenced research results from Level 4 and belowOnly referenced Level 3 evidenceReferenced randomized control study research and systematic review of randomized control studies (Level 1 and 2 evidence)015%0.00Intrepretation of Statistical ResultsAttemped to provide an overview of the evidence reviewed, but lacked statistically significant data. Attemped to provide a descriptive statistic overview of the evidence reviewed, inlcuding the sample size, p-factor and strength of evidence. But, unable to clearly intrept stength of evidence and the intrepretation was inaccurate. Attemped to provide a descriptive statistic overview of the evidence reviewed, inlcuding the sample size, p-factor and strength of evidence. But, unable to clearly intrept stength of evidence. Provides a descriptive statistic overview of the evidence reviewed, inlcuding the sample size, p-factor and strength of evidence.030%0.00LengthLess than 12 slides.NANAPresentation length 12-15.05%0.00Format/StyleDid not follow APA formatMajor errors with APA formattingText, title page, and references page follow APA guidelines . Minor references and grammar errorsText, title page and references page follow APA guidelines. No grammar, word usage or punctuation errors. Overall style is consistent with professional work.010%0.00100%0.00Final Score0PercentageERROR:#DIV/0!Total available points =4Rubric ScoreGrade pointsPercentageLowHighLowHighLowHigh3.54.00090%100%2.53.490080%89.99%1.72.490070%79.99%1.01.690060%69.99%0.01.0000059.99%
Effective obesity management
Introduction
The growing prevalence of obesity amongst adults and children is a major public health challenge both nationally and internationally.
Therefore the research aims at providing an effective understanding of effective obesity management when focusing on bariatric surgery and lifestyle changes.
...
Introduce IUON students to evidence-based nursing literature and effective strategies for searching for and accessing evidence-based research in nursing.
This ppt will help dentists in taking Evidence Based decision in daily practice and will also help researchers to categorized result of research on the basis of hierarchy of Evidence Based Dentistry
Point of care tools comparison chart 2013Naz Torabi
The purpose of this chart is to provide some general information about several top point-of-care resources in the medical field. This information should not be considered complete. I do not endorse any particular POC resources. The information gathered here by a literature review. Those articles published by medical expert which used bibliometric analysis are included. The articles which their methodology were solely based on user-centred analysis (i.e. medical community survey about the popularity of particular tools) are excluded to minimize risk of bias. If information about particular aspect of a POC was not obtained from the literature review, the editorial policy from their perspective website was cited. Please feel free to send me your feedback ntorabi at uwo.ca
RefWorks for DEPARTMENT OF FAMILY MEDICINE - Faculty Development Naz Torabi
RefWorks is an online research management, writing and
collaboration tool. It is designed to help researchers easily
gather, manage, store and share all types of information,
as well as generate citations and bibliographies.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Introduction to health informatics : Clinical questions
1. INTRODUCTION TO HEALTH INFORMATICS : Strategies for Answering Clinical Questions Nazi Torabi Research & Instructional Librarian Allyn & Betty Taylor Library April 14, 2011 http://www.slideshare.net/ntorabi/ 1
2. Objectives Addressing yourclinical information needs within an Evidence Based Medicine (EBM) framework To familiarize you with a variety of point-of-care tools 2
4. Evidence Based Medicine (EBM) “EBM is integration of best research evidence with clinical expertise and patient values” Sackett et al. 2000. Evidence based medicine. How to practice and teach EBM. Second edition. Churchill Livingstone. London 4
5. Steps in EBM Asking clinical questions Acquiring the evidence Appraising the evidence Applying the evidence Evaluating the effectiveness of applying the evidence in clinical practice 5
27. DynaMed Covers over 1,800 clinical topic summaries Point of care tool Updated daily Recommendations will be labeled as one of the following: Grade A recommendation (consistent high-quality evidence) Grade B recommendation (inconsistent or limited evidence) Grade C recommendation (lacking direct evidence) More info : http://support.ebscohost.com/help/index.php?help_id=271 11
28. UpToDate covers over 8500 topics in 17 medical specialties Summaries are a combination of synthesized literature reviews and expert knowledge. Point of care tool Grade 1 recommendation is a strong recommendation to do (or not do) something Grade 2 recommendation is a weaker recommendation, where the risks and benefits are more closely balanced or are more uncertain. For more info : http://www.uptodate.com/home/about/policies/editorial_policy.html#recommendations 12
29. ACP PIER PIER is a collection of over 400 evidence summaries Frequently updated (Monthly Content Updates and Module Additions) Consistently structured for rapid access Search or browse by organ system Integrated drug reference (AHFS DI Essentials) 13
30. The TRIP Database is free unified search tool of evidence-based sites such as ACP Journal Club, Bandolier, Cochrane, DARE, Health Technology Assessment, and the National Guideline Clearing House. TRIP is produced by the Centre for Research Support in the UK. 14
31. Centre for Reviews & Dissemination (CRD) DARE (Database of Abstracts of Reviews of Effects) NHS EED (NHS Economic Evaluation Database) HTA Database 15
32. Scenario 1: A 64 year old obese male who has tried many ways to lose weight presents with a newspaper article about ‘fat-blazer’ (chitosan). He asks for your advice. Adapted from : http://www.cebm.net/index.aspx?o=2311 16
35. Share your answer(s) and search strategies with the classPubMed Scopus UpToDate Cochrane Library CRD = Centre for Reviews & Dissemination DynaMed ACP PIER EMBASE Trip database CRD = Centre for Reviews & Dissemination Group A GroupB 17
36. Your patient is a 50 year old male with non-variceal upper GI bleed and you need to lower his stomach acidity. Should you use PPIs or H2 receptor antagonists? Scenario 2: Modified from http://ebmlibrarian.wetpaint.com/page/Gastroenterology 18
39. Share your answer(s) and search strategies with the classPubMed Scopus UpToDate Cochrane Library CRD = Centre for Reviews & Dissemination DynaMed ACP PIER EMBASE Trip database CRD = Centre for Reviews & Dissemination Group C Group D 19
40. Scenario 1: Clinical Question : Is Chitosan consumption an effective intervention for weight loss in obese adult individuals? Adapted from : http://www.cebm.net/index.aspx?o=2311 20
41. Clinical Question: In patients with non-variceal upper GI bleeds, are proton pump inhibitors more effective than H2 receptor antagonists in the reduction of stomach acid? Scenario 2: 21
42. EBM Resources Comparison Chart From Duke Program on Teaching Evidence-Based Practice http://www.mclibrary.duke.edu/training/courses/ebmworkshop/ebmchart.pdf 22
43. For more visit http://www.lib.uwo.ca/programs/generalmedicine/ under Clinical Tools 23 Drug Resources
44. Scenario 1 1 - What type of Iron supplement do you prescribe for a pregnant woman who has been diagnosed for with primary hypercholesterolemia and is taking cholestyramine? 24 You need to use more than one resource to find the accurate answer!!
45. 2 - Your patient, suffering from tuberculosis, is asking you whether he can drink alcohol while he is taking Isotamine. What is the right answer? 3- Do you recommend consumption of alcohol while a patient is on Mylan-Amoxicillin? Scenario 2 & 3 25
46. 4 - You want to prescribe Zoloft for a moderate depressed patient who does not have any psychotic symptoms. What do you need to know about Zoloft? Scenario 4 26
47. Appraising the evidence Aug 10, 2010 http://www.guardian.co.uk/science/2010/aug/10/autism-brain-scan Aug 12, 2010 http://www.guardian.co.uk/science/blog/2010/aug/12/autism-brain-scan-statistics 27
48. Mobile Devices http://www.lib.uwo.ca/programs/clinicaloutreach/guidetohandhelddevices.html 28
49. Questions Need library related assistance?Please don’t hesitate to contact us: Nazi Torabi 519-661-2111 x88992 ntorabi@uwo.ca IM a librarian https://www.lib.uwo.ca/chat/ 29
Editor's Notes
Find the highest levels of evidence using PubMed Clinical Queries Find Randomized Controlled Trials in PubMedFind systematic reviews using the Cochrane Library database
http://www.hsl.unc.edu/services/tutorials/ebm/studies2.htmCase series and Case reports consist of collections of reports on the treatment of individual patients or a report on a single patient. Because they are reports of cases and use no control groups with which to compare outcomes, they have little statistical validity. Case control studies are studies in which patients who already have a specific condition are compared with people who do not have the condition. The researcher looks back to identify factors or exposures that might be associated with the illness. They often rely on medical records and patient recall for data collection. These types of studies are often less reliable than randomized controlled trials and cohort studies because showing a statistical relationship does not mean than one factor necessarily caused the other. A case control study starts with patients who already have the outcome and looks backwards to possible exposures.Cohort studies take a large population who are already taking a particular treatment or have an exposure, follow them forward over time, and then compare them for outcomes with a similar group that has not been affected by the treatment or exposure being studied. Cohort studies are observational and not as reliable as randomized controlled studies, since the two groups may differ in ways other than in the variable under study. A cohort study starts with the exposure and follows patients forward to an outcome.Randomized, controlled clinical trials are carefully planned projects that introduce a treatment or exposure to study its effect on real patients. They include methodologies that reduce the potential for bias (randomization and blinding) and that allow for comparison between intervention groups and control groups (no intervention). A randomized controlled trial is an experiment and can provide sound evidence of cause and effect. A RCT randomly assigns the exposures and then follows patients forward to an outcome.Systematic Reviews usually focus on a clinical topic and answer a specific question. An extensive literature search is conducted to identify studies with sound methodology. The studies are reviewed, assessed, and the results summarized according to the predetermined criteria of the review question. - A Meta-analysis will thoroughly examine a number of valid studies on a topic and combine the results using accepted statistical methodology to report the results as if it were one large study. The Cochrane Collaboration has done a lot of work in the areas of systematic reviews and meta-analysis.A systematic review synthesises the results from all available studies in a particular area and provides a thorough analysis of the results, strengths and weaknesses of the collated studies. A systematic review has several qualities: 1. It addresses a focused, clearly formulated question. 2. It uses systematic and explicit methods: a. to identify, select and critically appraise relevant research b. to collect and analyse data from the studies that are included in the review Systematic reviews may or may not include a meta-analysis used to summarise and analyse the statistical results of included studies. The pyramid serves as a guideline to the hierarchy of study design. You may not always find the highest level of study to answer your question. In the absence of the best evidence, you then need to consider moving down the pyramid.
. Look for secondary sourcesGuidelines: UK National Library for Health, NICE, SIGN; US National Guidelines Clearinghouse; Canadian Medical Association; New Zealand Guidelines Group.CATs: CAT CrawlerEvidence-Based Summaries:Bandolier, Clinical EvidenceStructured Abstracts: EBM Online, ACP Journal ClubSystematic Reviews: Cochrane LibraryTo search several of the databases simultaneously you can use:www.tripdatabase.com
How to use DynaMedLevel of Evidence Labeling in DynaMedGrading
Screening for bladder cancerSUMMARY AND RECOMMENDATIONSPatients with a history of treated urothelial carcinoma have a high likelihood of developing recurrent disease or a second primary. Surveillance is necessary in this setting to detect disease recurrence. The role of and approaches to surveillance are discussed separately. (See "Treatment of non-muscle-invasive bladder cancer", section on 'Posttreatment management'.Urine biomarkers — A wide range of urinary biomarkers are being evaluated for their utility in surveillance following initial treatment of non-muscle invasive bladder cancer.In the United States several of these urine tests (eg, bladder tumor antigen [BTA] Stat, BTA TRAK, UroVysion, nuclear matrix protein [NMP] 22) are approved for the detection of tumor recurrence. However, none of these tests has been proven to have sufficient diagnostic reliability to eliminate the need for cystoscopy. Major problems with these assays include the lack of sensitivity for small tumors, particularly low-grade lesions, as well as a large number of false positives.The data supporting the use of these assays and their potential role in bladder cancer surveillance are discussed elsewhere. (See "Urine biomarkers for the detection of urothelial (transitional cell) carcinoma of the bladder", section on 'Urine biomarkers'.
DARE (Database of Abstracts of Reviews of Effects) is focused primarily on systematic reviews that evaluate the effects of health care interventions and the delivery and organisation of health services.NHS EEDfocuses primarily on the economic evaluation of health care interventions and aims to help decision makers interpret an increasingly complex and technical literature.The focus of the HTA database is on completed and ongoing health technology assessments from around the world. The HTA database is a valuable source for identifying grey literature as much of the information it contains is generally only available directly from individual funding agencies.DARE contains 15,000 abstracts of systematic reviews including over 6,000 quality assessed reviews and details of all Cochrane reviews and protocols.Summaries of all Cochrane reviews and protocols The database is focused on systematic reviews of the effects of health interventions and includes reviews of: interventions that are clearly health related; interventions that have the potential to affect health; adverse effects; diagnostic and prognostic studies; individual patient data (IPD).NHS EED contains 24,000 abstracts of health economics papers including over 7,000 quality assessed economic evaluations. DARE and NHS EED include details of abstracts in the process of being written and these can be 'fast-tracked' on request.HTA brings together details of over 8,000 completed and ongoing health technology assessments from around the world.
Chitosanobese OR obesity OR overweight (show then obes*) weight loss= 20 articles+adult = losing 9 articles and some of them are releventUptodate = under Drug therapy of obesity = Chitosan [57] and guar gum are ineffective for weight loss, and their use should be discouraged.DynaMed = Weight loss nonprescription medications and supplements = chitosan may induce some weight loss short-term but effect minimal and unlikely to be of clinical significance (level 2 [mid-level] evidence)ACP PIER = Obesity = A 4-week randomized clinical trial with chitosan showed no significant weight loss (571). Fecal fat loss was not increased by chitosan (572).Trip database = Chitosan for overweight or obesity
CRD = Centre for Reviews & Dissemination, University of York, York, UKDARE contains 15,000 abstracts of systematic reviews including over 6,000 quality assessed reviews and details of all Cochrane reviews and protocols.Summaries of all Cochrane reviews and protocols The database is focused on systematic reviews of the effects of health interventions and includes reviews of: interventions that are clearly health related; interventions that have the potential to affect health; adverse effects; diagnostic and prognostic studies; individual patient data (IPD).NHS EED contains 24,000 abstracts of health economics papers including over 7,000 quality assessed economic evaluations. DARE and NHS EED include details of abstracts in the process of being written and these can be 'fast-tracked' on request.HTA brings together details of over 8,000 completed and ongoing health technology assessments from around the world.
ACID SUPPRESSION
Chitosanobese OR obesity OR overweight (show then obes*) weight loss= 20 articles+adult = losing 9 articles and some of them are releventUptodate = under Drug therapy of obesity = Chitosan [57] and guar gum are ineffective for weight loss, and their use should be discouraged.DynaMed = Weight loss nonprescription medications and supplements = chitosan may induce some weight loss short-term but effect minimal and unlikely to be of clinical significance (level 2 [mid-level] evidence)ACP PIER = Obesity = A 4-week randomized clinical trial with chitosan showed no significant weight loss (571). Fecal fat loss was not increased by chitosan (572).Trip database = Chitosan for overweight or obesity
ACID SUPPRESSION
Monographs include: drug interactions; adverse reactions; cautions and toxicity; therapeutic perspective; specific dosage and administration information; preparations, chemistry, and stability; pharmacology and pharmacokinetics; contraindications; and more.Compendium of Pharmaceuticals and Specialties (e-CPS) - Produced by the Canadian Pharmacists Association, the e-CPS provides health care professionals with web access to the most current Canadian drug information. Please note: online access is by user name and password.