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来自 BMJ 的全新的循证医学在线资源 -- 帮助临床医生有效解决诊、治疑问的权威工具 王赫 BMJ Group hwang@bmjgroup

来自 BMJ 的全新的循证医学在线资源 -- 帮助临床医生有效解决诊、治疑问的权威工具 王赫 BMJ Group hwang@bmjgroup.com. Do you ever use it?. BMJ Clinical Evidence “ 临床证据”. 基于现有各种原始研究证据资源，针对重要的临床问题高度提炼后的总汇。. 电子临床资讯系统. 针对临床问题结合证据的概述. (Clinical Evidence). 单篇循证文献摘要性评述. (Evidence Based Medicine). 系统性综述.

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来自 BMJ 的全新的循证医学在线资源 -- 帮助临床医生有效解决诊、治疑问的权威工具 王赫 BMJ Group hwang@bmjgroup

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  1. 来自BMJ的全新的循证医学在线资源 --帮助临床医生有效解决诊、治疑问的权威工具 王赫 BMJ Group hwang@bmjgroup.com

  2. Do you ever use it? BMJ Clinical Evidence “临床证据” 基于现有各种原始研究证据资源，针对重要的临床问题高度提炼后的总汇。

  3. 电子临床资讯系统 针对临床问题结合证据的概述 (Clinical Evidence) 单篇循证文献摘要性评述 (Evidence Based Medicine) 系统性综述 (Cochrane Library / PubMed-Systematic Review) 原始研究文献 (PubMed –Clinical study search)

  4. What is new in Best Practice? 新在何处？ For each condition, Best Practice covers the following categories: 对每一种收录的疾病都提供了标准结构内容： Highlights要点: Summary/ Overview Basics基础: Definition / Epidemiology / Aetiology / Pathophysiology / Classification Prevention预防: Primary / Screening / Secondary Diagnosis诊断: History & Examination / Tests / Differential / Step by Step / Criteria /Guidelines / Case History Treatment治疗: Details / Step by Step / Emerging / Guidelines / Evidence Follow-up随访: Recommendations / Complications / Prognosis Resources参考资料: References and Links / Images / Online resources / Patient Leaflets/Credits 26th June 2008

  5. Standard Monograph标准界面 Comprehensive information on a specific condition or group of conditions. 显示单个或多个病症的综合信息 It covers all aspects of the disease including: basic information, prevention, diagnosis, follow up-recommendations and resources A standard monograph for Vitamin C deficiency

  6. Highlights要点 . Standard Monograph标准界面 • Summary总结: Key highlights on the topic present the essential facts. • Overview概览: History and exam factors, diagnostic tests and patient groups with treatment types are listed to provide a brief synopsis of diagnosis and treatment.

  7. Basics基础 Fundamental information on the topic is provided on the definition, epidemiology, aetiology, pathophysiology and classification. Standard Monograph标准界面 Prevention预防 • Primary and secondary prevention are discussed. Information on population screening is provided for applicable topics.

  8. 病史和检查 This section takes the user through the process of diagnosis, addressing history and examination, diagnostic tests before elaborating on any possible differential diagnosis. 分步诊断 The Step-by-Step section guides the user through a verbal algorithm of the approach to diagnosis. 指南 Guidelines appropriate to diagnosis of the condition are listed from international and regional organisations. The user can also upload further guidelines from their local institutions. 病例 Case history describes one or two patient vignettes and may also discuss other less common presentations. Standard Monograph标准界面 Diagnosis诊断 .

  9. 治疗内容 Details on treatment conditions are provided according to recognised patient groups. Treatment is tiered according to primary, secondary and tertiary treatments. Comments provide information regarding treatment type, and medications are listed with dosing detail. 分步治疗 The "Step-by-Step" section provides an overview of how to treat the condition. It may also provide additional information on specific medications. 新的方法 Emerging treatments are discussed and may include those that are still undergoing trials or those that may have been approved but not yet in use. 证据 Evidence, when available, is provided in the form of evidence pop-ups. Users have the opportunity to link to discussion of the evidence on the Clinical Evidence website or within specific articles or systematic reviews. Links to evidence for all interventions for the same topic discussed in Clinical Evidence are also provided Standard Monograph标准界面 Treatment治疗

  10. Follow-up随访 Recommendations, complications and prognosis are discussed. Resources文献资源 参考文献 References are listed; key references highlighted. Most references have abstract and/or full text links. 图片资料 Images are presented within the image library and can also be found as image tags providing a pop-up image within the text of the monograph. 在线资源 Online resources appropriate to the topic may be listed and link to organisations providing further information on the condition and useful resources used in diagnosis such as patient questionnaires 患者教育 Patient leaflets from Best Health are provided for relevant and available Best Health topics. Standard Monograph标准界面

  11. Assessment Monograph分析和评估界面 Information on how to evaluate a symptom, clinical finding or diagnostic test finding提供关于如何分析症状、临床发现或诊断性检测发现的信息 It is presented in the following format: overview, emergencies, diagnosis and resources 包括概览，急诊，诊断和文献资源四个部分 An assessment monograph for chronic cough

  12. Summary may include information on definition, epidemiology, pathophysiology and classification as well as any additional pertinent information on the topic. Aetiology discusses or lists the various differentials causing the symptom, clinical or test finding Assessment Monograph分析和评估界面 Overview概览

  13. 列出可能的疾病以及紧急考虑给予的治疗方法 Emergencies list those conditions to which urgent consideration of treatment should be given Brief information on emergency treatment may be given and users can also click through to the standard monograph on a topic for further treatment information. Assessment Monograph分析和评估界面 Emergencies急诊

  14. Step-by-step section分步诊断 This section guides the user through a verbal algorithm of the approach to diagnosis and assists them to arrive at the differential diagnosis. Assessment Monograph分析和评估界面 Diagnosis诊断 Differential diagnosis鉴别诊断 • Each individual differential diagnosis is listed with details on history, examination and tests.

  15. 文摘或全文链接 References are listed: key references highlighted. Abstract and/or full text links. 图片和影音资料 （下载保存）Images are presented within the image library and can also be found as image tags providing a pop-up image within sections of the monograph 专业网站 Online resources appropriate to the topic may be listed and link to organisations providing further information on the condition and useful resources used in diagnosis such as patient questionnaires. 患者教育信息 Patient leaflets from Best Health are provided for relevant and available Best Health topics. 作者和评审专家信息 Credits list the author and peer reviewer details. Assessment Monograph分析和评估界面 Resources文献资源

  16. Best Practice from the BMJ Evidence Centre is a new, comprehensive online decision-support tool designed to be used at the point of care. Best Practice Highlights 要点 • 一万多种诊断方法 • 金标准同行评审 • 完全整合“临床证据” • 实时更新 ； • 每一疾病提供标准结构内容：总结，预防，诊断（诊断步骤，鉴别诊断，指南），治疗（方法，证据，指南）， 随访，参考图片影音资料；

  17. Features 特点： • The BMJ Evidence Centre is a division of the BMJ Group. Clinicians know they can trust us. Our expert team search, appraise and summarise over 200,000 new research articles, in some 8,000 journals, covering over 40 medical specialities, each year BMJ的专家队伍每年检索评估筛选出自8000多种期刊的超过200，000篇新发表的研究文章,涵盖40多个医学专业领域。

  18. Features 特点： • Best Practice is the best blend of expert opinion, guidelines and research evidence that make it quick and intuitive to use 整合了专家的观点、经验，诊、治指南和最新研究证据，方便用户快捷地找到需要的信息。

  19. 适合读者范围 Best Practice is designed for…

  20. Institutions机构 Hospitals医院 Medical schools医学院 Large primary care practices Biotech companies Consumer-facing organisations System vendors Policy makers政策治定者 Medical publishers

  21. Individuals个人 Hospital doctors医生 Primary care physicians Academic/teaching staff教学研究人员 Student doctors Nurse practitioners护理人员 Pharmacists药剂师

  22. Case 实例Find the answers in 3 Clicks and 30 seconds Question: • A 56 year old man with diabetes is currently taking lisinopril to control his essential hypertension. Today at follow-up, his blood pressure is 150/95, not at goal. How should his therapy be modified? • 56岁男性糖尿病患者，服用赖诺普利控制原发性高血压。今天血压测试结果为150/95，如何调整其治疗？

  23. Case 实例 Click 1: 检索 Hypertension

  24. Case 实例 Click 2: 选择 Treatment

  25. Find the answers in 3 Clicks and 30 seconds Click 3: 找到患者群，评估治疗方法

  26. Find the answers in 3 Clicks and 30 seconds Click 3: 找到患者群，评估治疗方法

  27. Other features其它特点 Available in different languages17种语言支持 • Best Practice is available in 17other languages including: Spanish; Chinese; Turkish; Japanese; German; Portuguese; Greek; French and Italian

  28. Other features其它特点 • Best Practice aims to provide full colour images for conditions when appropriate. Online images图片 Images available for wrist fractures (Complex) intra-articular fracture of the distal radius--lateral view. Extra-articular fracture of the distal radius--lateral view

  29. Online images图片

  30. Other features其它特点 • 上传本国指南 Ability to upload local guidelines, and web links • 远程访问 Remote access for authorised users at no additional cost • 非常见疾病 Rare disease

  31. Demo Online: http://bestpractice.bmj.com 检索： MI • Question？

  32. 谢 谢！ 王赫 BMJ Group hwang@bmjgroup.com

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