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Answering Clinical Questions at the Point of Care

Answering Clinical Questions at the Point of Care. 劉嫻秋 Rachel Liu rliu@wolterskluwer.com Tel : 05-2642681 Mobile : 0920-992-950. Agenda. About UpToDate Evidence Grading How to Search Q&A. About UpToDate.

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Answering Clinical Questions at the Point of Care

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  1. Answering Clinical Questions at the Point of Care 劉嫻秋Rachel Liu rliu@wolterskluwer.com Tel : 05-2642681 Mobile : 0920-992-950

  2. Agenda About UpToDate Evidence Grading How to Search Q&A

  3. About UpToDate • UpToDate is a Clinical decision support system that helps clinicians throughout the world provide the best patient care • We use the best available current evidence to answer clinical questions, quickly and easily at the point of care • This saves clinicians time, improves patient outcomes and lowers health care costs

  4. Evidence is derived from a number of sources………………including but not limited • Journals: 450+ peer reviewed journals • Databases: • MEDLINE, The Cochrane Database, Clinical Evidence and ACP Journal Club • Guidelines • Clinical trials • FDA, CDC, NIH • Proceedings • Clinical experiences and observations

  5. Quick Facts about UpToDate • Topic reviews • Patient Information • What’s New • Calculators • Drug Information • systemic, topical, inhalation, nasal, ophthalmic

  6. Specialties In Development Palliative Care • Adult and Pediatric Emergency Medicine • Adult Primary Care & Internal Medicine • Allergy and Immunology • Cardiovascular Medicine • Dermatology (Launched in Mar 2013) • Endocrinology & Diabetes • Family Medicine • Gastroenterology & Hepatology • General Surgery • Geriatric Specialty • Hematology • Hospital Medicine • Infectious Diseases • Nephrology & Hypertension • Neurology • Obstetrics, Gynecology & Women’s Health • Oncology • Pediatrics • Psychiatry (Launched in 2012) • Pulmonary, Critical Care & Sleep Medicine • Rheumatology

  7. Evidence Grading • In 2001, we began a collaboration with Gordon Guyatt, a world leader in EBM, and his colleagues in the international GRADE collaborative to implement a grading system for recommendations • UpToDate grades specific treatment and screening recommendations

  8. Evidence Grading

  9. How to Search • New Search • Search  display results  topic review  output • Graphic Search • Local Language Search • Others • Evidence grading • RECOMMENDATIONS • New button : Summary and Recommendations • Drug Interactions • ECG test • Newsletter

  10. PICO問題的組成 • P：patient and/or problem --誰是相關的「病人」，是否具有何種問題？ • I：intervention --有興趣的治療處置、診斷工具或暴露因子為何？ • C：comparisonof intervention -- 如果有的話，對照組的處置、診斷工具或暴露因子為何？ • O：clinical outcome-- 與病人最相關之（可測量）結果是什麼？

  11. How to use UpToDate based on a Clinical scenario • Case: • 45 year old female with long standing gastroesophageal reflux disease. Refractory symptoms can no longer be managed effectively with medical therapy. What are the surgical treatment options for refractory GERD? • P:45 year old female with long standing gastroesophageal reflux disease. • I: symptoms can no longer be managed effectively with medical therapy. • C:pharmacotherapy /surgical • O: What are the surgical treatment options for refractory GERD.

  12. Q&A • Thank you

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