370 likes | 611 Views
. Harvard ??????? Dr. Sydney Burwell:. ?????????,???????????????????????,???????????????????:Pickering GW, (BMJ 1956; 2: 113-6). ??????????. ??????????3????,????2??????1?????,????3?????????:????????,???? ????. ??????,????????. MEDLINE????????????,????????????????: - 43% 46% ???,?????????????????? - 27 ?? 43 ?????????????J Fam Pract. 1996;43:140-144.Bull Med Libr Assoc. 1994;82:140-146. .
E N D
1. ???:??? ??
EBSCO Publishing Taiwan, Hong Kong and Macau
E-mail: etsai@ebscohost.com
3. ?????????? ???????
???3????,????2???
???1?????,????3???
??????:????????,????
????
6. Evidence-based medicine is the integration of best research evidence with clinical expertise and patient values ?(?????????????,????????????)
Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB. Evidence-Based Medicine. How to Practice and Teach EBM. 2nd ed. London: Harcourt Publishers Ltd. 2000. p. 1.
??????????????????,?????????????????????,??????????????,??????????????????,?????????????????????????????????
10. EBM?????? ???????
???????? Evidence Based Medicine Toolkit Clinical Epidemiology Glossary
11. Warning of EBM!!! Not all that evidence-based is golden
Evidence-based information is perishable: the date of publication should be recent
Many authors and advertisers use the term evidence-based to sell their boo-journals and services
12. ???????????????????? ????? (????????????:link to reference)
????? (??????????????)
????? (???????????)
15.
1. ?????????????????? ??????????????????:
16. ??????? ?? ?????????????????
????/???? ????????????
??? ?????????????.
???? ?????????,??????
??????????????? ???????????
17.
1. ??????????????????
Step 1: Systematic identification of evidence
2. ???????????????????????????
Step 2: Systematic selection of the best available evidence from that identified
??????????????????:
18.
1. ??????????????????
Step 1: Systematic identification of evidence
2. ???????????????????????????
Step 2: Systematic selection of the best available evidence from that identified
3. ???????????????????????????
Step 3: Systematic evaluation of the selected evidence (critical appraisal)
??????????????????:
19.
1. ??????????????????
Step 1: Systematic identification of evidence
2. ???????????????????????????
Step 2: Systematic selection of the best available evidence from that identified
3. ???????????????????????????
Step 3: Systematic evaluation of the selected evidence (critical appraisal)
4. ?????????????????????
Step 4: Accurate summarization of the evidence and its quality
??????????????????:
20. 1. ??????????????????
Step 1: Systematic identification of evidence
2. ???????????????????????????
Step 2: Systematic selection of the best available evidence from that identified
3. ???????????????????????????
Step 3: Systematic evaluation of the selected evidence (critical appraisal)
4. ?????????????????????
Step 4: Accurate summarization of the evidence and its quality
5. ??????????????????
Step 5: Making conclusions dependent on the evidence
??????????????????:
21.
1. ??????????????????
Step 1: Systematic identification of evidence
2. ???????????????????????????
Step 2: Systematic selection of the best available evidence from that identified
3. ???????????????????????????
Step 3: Systematic evaluation of the selected evidence (critical appraisal)
4. ?????????????????????
Step 4: Accurate summarization of the evidence and its quality
5. ??????????????????
Step 5: Making conclusions dependent on the evidence
6. ??????????????????????
Step 6: Synthesizing multiple bits of evidence for overall conclusions ????????????? ???:
22.
1. ??????????????????
Step 1: Systematic identification of evidence
2. ???????????????????????????
Step 2: Systematic selection of the best available evidence from that identified
3. ???????????????????????????
Step 3: Systematic evaluation of the selected evidence (critical appraisal)
4. ?????????????????????
Step 4: Accurate summarization of the evidence and its quality
5. ??????????????????
Step 5: Making conclusions dependent on the evidence
6. ??????????????????????
Step 6: Synthesizing multiple bits of evidence for overall conclusions
7. ????????????????????
Step 7: Changing the conclusions when new evidence alters the best available evidence ????????????????:
23.
?????????????
?????????????????????????
??????????????? (??????)?
????????????????????
?????????????
??????????,???????????
?????????????????,???????????? ????????????????:
25. DynaMed Systematic Literature Surveillance Surveillance of more than 500 journals directly and indirectly through many journal review services
Each article is assessed for clinical relevance andeach relevant article is further assessed for validity relative to existing DynaMed content
The most valid articles are summarized, the summaries are integrated with DynaMed content,and overview statements and outline structure are changed based on the overall evidence synthesis
Systematic Literature Surveillance occurs daily
We have achieved critical mass. EBSCOhost now has more than 100 databases 48 of which are secondary databases. We have achieved critical mass. EBSCOhost now has more than 100 databases 48 of which are secondary databases.
33. Does DynaMed Help PhysiciansAnswer More Questions? Research: supported by the National Science Foundation*
Objective: determine if access to DynaMed helps clinicians answer more clinical questions than without access to DynaMed
Method: Randomized Controlled Trial of 52 primary care clinicians; 698 clinical questions
Results-1
With access to DynaMed, primary care clinicians answered more clinical questions than without access to DynaMed
With DynaMed, primary care clinicians found more answers that changed clinical decisions
Answers were found in DynaMed for approximately 70% of clinical questions (far exceeds any other point-of-care resource; UpToDate answers 34% of clinical questions**)
34. Does DynaMed Answer Physicians QuestionsWith Better Evidence Than the Competition? Results-2:
Level of Evidence for answers in DynaMed met or exceeded what could be found in a combination of commonly used point-of-care references 87% of the time
Conclusion: DynaMed provides the best available evidence among the most commonly used rapid references
37. DynaMed PDA
38. Navigation of Sections In many diseases the Treatment section can get so large that it does not fit on one page. You need to learn to get around this by using the outlines on each section.In many diseases the Treatment section can get so large that it does not fit on one page. You need to learn to get around this by using the outlines on each section.