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Introduction to the Medical Literature. Robert D. Hadley, PhD, PA-C PAS 851 June 23, 2003. Why read the literature?. Secret: your faculty don’t know everything! Goal: As students and practicing PAs, you need to be able to: 1. Find information for yourself
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Introduction to the Medical Literature Robert D. Hadley, PhD, PA-C PAS 851June 23, 2003
Why read the literature? • Secret: your faculty don’t know everything! • Goal: As students and practicing PAs, you need to be able to: 1. Find information for yourself 2. Critically evaluate information that is found 3. Apply to practice
Requires familiarity with the medical literature. • How many students read medical literature? • What journals? • Do you receive PA journals? • What type of journals are the PA journals. • Are papers in PA journals research?
What are the different types of articles you might read? • original research • research reviews • meta-analyses • clinical case studies • practice guidelines • clinical reviews • etc.
What is EBM? • Has anyone heard of it? • What is definition? • Evidence-Based Medicine will be further expanded in PAS 610, Research Methods.
Where would you find: • Review of clinical presentation of CAP? • A large study on the risk reduction associated with aspirin use in CAD? • Practice guidelines for lipid therapy? • Patient handouts? • CME?
The use of the WWW in medical literature • How many journals at UK are available as online versions? • Are journals equally available at home and at UK/Morehead? • What are ways that UK libraries restrict access to online journals? • Why does UK library restrict access to online journals?
What is a WWW portal? • Which are good? • How do you know? • Examples:
How do you decide what papers to read? • What does the title assert? • Abstract: What do they claim? Is this paper worth reading? • What kind of paper is it: review, retrospective study, controlled study, “randomized, double‑blind, placebo‑controlled clinical trial”, etc.? • What did they do? What methods did they use?
How do you decide what papers to read? • What were their results? Statistical significance vs. size of the effect? • Do their results support their conclusions? Are the results significant (i.e. important)? • Where was it published? We put more stock in the New England Journal of Medicine, or Science than in the Herald‑Leader. • Peer‑reviewed papers are more reliable, but the peer review process is no guarantee.
How do you decide what papers to read? • Who are the authors? Are they employees/ supported by the company that manufactures/ sells the drug in the study? • The bottom line: “How can this study influence the way I practice?” • Do I need to educate my co-workers (or professors) about a new standard of care based on this work?
How do you find time to read? JUST DO IT! • Email alerting services (e.g. www.journaltogo.com, Medscape, etc.) • See www.uky.edu/~hadleyr/journals for a selected listing • Use literature to extend your knowledge in clinical courses. Look up clinical practice guidelines or pathophysiology for clinical entity that is discussed. • Read the PA journals when they are mailed to you
Assignment: • Read a paper and decide how the new information fits into clinical practice. • Write a paragraph describing: • Citation • How you found it • Type of paper • Summary of results • Application to clinical practice • Email paragraph to hadleyr@uky.edu
This PowerPoint available at: • www.uky.edu/~hadleyr/downloads/lit.ppt