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Effective Search Techniques for Asking and Answering Clinical Questions Gale G. Hannigan Internal Medicine Clerkship Informatics Rotation 2006-07 General information New to topic Orientation Refresher Often answered by texts Specific to patient For decision making Action
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Effective Search Techniques for Asking and AnsweringClinical Questions Gale G. Hannigan Internal Medicine Clerkship Informatics Rotation 2006-07
General information New to topic Orientation Refresher Often answered by texts Specific to patient For decision making Action “Best evidence” New tools for clinicians Background vs Foreground Questions Throughout your practice you will have both kinds of questions, but the proportion will change
Clinical Question (PICO Format) Patient Problem: Intervention: or Comparison: Outcome:
Clinical Question in PICO Format Patient Problem: Type II Diabetes Intervention: Glyburide or Comparison: Metformin Outcome: Lower Hb A1c
Clinical Question (PICO Format) Patient Problem: Intervention: or Comparison: Outcome:
Dr. Suma Pokala suma.pokala@med.va.gov Send question by Tuesday evening. Do not work on answer until you hear from her – Thursday morning when we meet is soon enough.
Systematic Reviews Summarized Evidence- Referenced Resources Research Articles Other Sources
Systematic Reviews Cochrane Library (SRs and DARE) PubMed Clinical Queries(Systematic Reviews) PubMed Limits(Meta-analysis)
Systematic Reviews Summarized Evidence- Referenced Resources InfoPOEMS/InfoRetriever ACP Journal Club Up-To-Date
Systematic Reviews Summarized Evidence- Referenced Resources Research Articles MEDLINE
PubMed MEDLINE • Newest interface • Premier database – content and organization • Features • Subheadings • Limits • Find Related Articles • Clinical Queries • Patient/Consumer Information • Automatic article request service
PubMed Hints • Use the MeSH Database • Use specific terminology • Start with disease term • Use subheadings • Restrict to Major Topic if common disease • “AND” other terms with/without subheadings, major topic restriction • Use Limits for language, human, age groups, years of publication • Use system capabilities until your retrieval set is approximately <30
Systematic Reviews Summarized Evidence- Referenced Resources Research Articles Other Sources Where to look - Textbooks, reviews, experts
Aggregators Ex. InfoRetriever