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Answering Clinical Questions at the Point of Care

Answering Clinical Questions at the Point of Care. Outline. About UpToDate Evidence Grading How to Search Q&A. UpToDate. UpToDate is a Clinical decision support system that helps clinicians throughout the world provide the best patient care

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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

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

  3. 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 3

  4. Evidence is derived from a number of sources………………including but not limited • Journals: 460+ 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 4

  5. Quick Facts about UpToDate Written by Physicians for Physicians • Topic reviews • Patient Information • Drug Information • systemic, topical, inhalation, nasal, ophthalmic 5

  6. Quick Facts about UpToDate • 4,800+ world-renowned physician authors (international) • 9,000+ clinical topic in 19 specialties • 5,000+ unique drug entries in adult, pediatrics, international and natural drugs (Lexi-Comp) • 23,000+ graphics • 328,000+ references (Medline) • Updated every 4 months (March, July, November) 6

  7. Specialties • Adult and Pediatric Emergency Medicine {November 2009} • Adult Primary Care & Internal Medicine • Allergy and Immunology {March 2010} • Cardiovascular Medicine • Endocrinology & Diabetes • Family Medicine • Gastroenterology & Hepatology • Geriatric Specialty {July 2011} • Hematology • Hospital Medicine {November 2010} • Infectious Diseases • Nephrology & Hypertension • Neurology {March 2009} • Obstetrics, Gynecology & Women’s Health • Oncology • Pediatrics • Pulmonary, Critical Care & Sleep Medicine • Rheumatology • Surgery {November 2011} 7

  8. Specialties in Development • Dermatology • Psychiatry 8

  9. 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 9

  10. Evidence Grading 10

  11. How to Search • New Search • Search  display results  topic review  output • Others • Evidence grading • RECOMMENDATIONS • 125 Calculators • Drug Interactions • ECG test • Movies  no need install software • Graphics  new search function 11

  12. How to use UpToDate based on a Clinical scenario • A 50 year old woman is obese (BMI=32) and has hypertension. She has not achieved weight loss despite counseling for diet and lifestyle changes. What is the best medication for pharmacologic management of her obesity. • Keyword: • Obesity drug 12

  13. Q&A 13

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