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Keck Year 2 Evidence Based Medicine - Guidelines
This document discusses evidence-based guidelines and summarizes different types of medical evidence publications from highest to lowest quality. It then presents a clinical scenario about prostate cancer screening and demonstrates how to formulate a question using PICO (Patient, Intervention, Comparison, Outcome). Resources for finding clinical guidelines like PubMed and the National Guidelines Clearinghouse are described. The presentation raises questions about whether clinical information tools should be considered evidence-based medical resources and how to evaluate them.
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Keck Year 2 Evidence Based Medicine - Guidelines
- 1. Evidence-Based Guidelines Lynn Kysh,MLIS kysh@usc.edu Information Services Librarian Norris Medical Library
- 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. Agenda • A noteabout guidelines • Clinical Scenario: Prostate Cancer Screening • Ask • PICO • Acquire • PubMed • National Guidelines Clearinghouse • What about clinical information tools?
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- 6. Guide to formulatea question • Problem/Patient • Intervention • Comparison (if any) • Outcome
- 7. Clinical Scenario Your patientis 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?
- 8. Using PICO •P •I •C •O 50 y/oAfrican American man Digital rectal exam or PSA No screening Decrease morbidity and mortality related to prostate cancer
- 9. Finding guidelines: Use “ArticleType” filter
- 10. National Guidelines Clearinghouse •Guidelines Information • Organization • Process • Evidence used • Disclosures • Comparison feature
- 11. But what aboutclinical information tools?
- 12. Are these EBMResources? • Opinions vary (and that’s okay!) • Appraise the information • Check evidence ratings • Follow links to evidence • Check author information
- 13. 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.
- 14. Agenda • A noteabout guidelines • Clinical Scenario: Prostate Cancer Screening • Ask • PICO • Acquire • PubMed • National Guidelines Clearinghouse • What about clinical information tools?
- 15. Questions? Lynn Kysh, MLIS InformationServices Librarian kysh@usc.edu (323) 442-1124
- 16. Thanks! Lynn Kysh, MLIS InformationServices Librarian kysh@usc.edu (323) 442-1124