Post on 15-Jan-2016
Synthesizes the medical literature, incorporates the
latest evidence, and provides specific recommendations for
patient care
About UpToDate
Evidence is derived from a number of Sources
• Journals: 440+ peer viewed journals• Databases:
– MEDLINE, The Cochrane Database, Clinical Evidence and ACP Journal Club
• Guidelines• Clinical trials
– FDA, CDC, NIH• Proceedings• Clinical experience and observations
Including but not limited
The editorial process
Leading and Evidence Based Literature and Resources
UpToDate Topic Review
Read ..... Analyze ..... Summarize .....
..... Synthesize .....
..... Expert Comments .....
..... Expert Opinion .....
..... Recommendations .....
..... Grade the Evidence .....
..... Editorial Peer Review .....
Quick Facts about UpToDate
• 4,400+ world-renowned physician authors (international)
• 7,775 clinical topics in 16 specialties
• 4,619 unique drug entries in adult, pediatrics, international, and natural drugs (Lexi-Comp)
• 24,637 graphics
• 262,209 references (Medline)
• Update every 4 months (March, July, November)
Specialties• Adult and Pediatric Emergency Medicine • Dermatology
• Adult Primary Care & Internal Medicine • Psychiatry
• Allergy and Immunology • Surgery
• Cardiovascular Medicine
• Endocrinology & Diabetes
• Family Medicine
• Gastroenterology & Hepatology
• Hematology
• Infectious Diseases
• Nephrology & Hypertension
• Neurology
• Obstetrics , Gynecology & Women’s Health
• Oncology
• Pediatrics
• Pulmonary, Critical Care & Sleep Medicine
• Rheumatology
To Access UpToDate
• Please go to library homepage
• Just “Accept” the license agreement and you are brought to the search page, ready for your use; within a few seconds
How to Search
• New Search– search display result output
• Others– Patient Information– What’s new– Calculators– Evidence grading
• RECOMMENDATIONS– Drug interactions– ECG Test– Movies
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 drugs
我們以 obesity drug 來做查詢
當我們把關鍵字鍵入後系統會跳出相關的詞以供選擇
關鍵字可以是- 病名 , 藥名 , 症狀- 大小寫皆可- 可同時輸入二個字以上- 接受布林邏輯裡的 and 以及 or- 系統亦提供拼錯檢查- 單複數不會影響檢索結果
此為檢索結果另外有三個選項可以改變檢索結果的順序-Prioritize adult topics-Prioritize pediatric topics-Prioritize patient topics
-星號欄位必填-Your name 為寄件人的名字-Your e-mail 為寄件人的帳號-E-mail address of recipient 為收件人的帳號- 填寫完畢後,點選 Send
ccheng@uptodate.com
ccheng@uptodate.com
cc
Evidence Grading – UTD GRADE
RECOMMENDATION GRADES
Grade 1
Strong RecommendationBenefits clearly outweigh the risks and burdens (or vice versa) for most, if not all, patients “ We recommend…”
Grade 2Weaker Recommendation Benefits and risks closely
balanced and/or uncertain “ We suggest…”
EVIDENCE GRADES
Grade A High Quality Evidence
Consistent evidence from randomized trials, or overwhelming evidence of some other form
Grade BModerate Quality Evidence
Evidence from randomized trials with important limitations, or very strong evidence of some other form
Grade C Low Quality Evidence
Evidence from observational studies, unsystematic clinical observations, or from randomized trials with serious flaws