Answering Clinical Questions at the Point of Care

Cecilia Changcchang@uptodate.comTel : 04-22930887Mobile : 0930380588

Outline

About UpToDate Evidence Grading How to Search Q&A

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瞎子摸象的故事 -----訊息全方位對病患的重要性

Bud Rose with Taiwan Team

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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

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Evidence is derived from a number of sources………………including but not limited Journals: 440+ 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

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The editorial process

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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 .....

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Quick Facts about UpToDate

Topic reviews Patient Information Drug Information

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Written by Physicians for Physicians

Quick Facts about UpToDate

4,400+ world-renowned physician authors (international)

8,000+ clinical topic in 16 specialties 4,600+ unique drug entries in adult,

pediatrics, international and natural drugs (Lexi-Comp)

21,000+ graphics 385,000+ references (Medline) Updated every 4 months (March, July,

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Specialties

Adult and Pediatric Emergency Medicine Adult Primary Care & Internal Medicine Allergy and Immunology {NEW} 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

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Specialties in Development

Dermatology Psychiatry Surgery

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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

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Evidence Grading

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RECOMMENDATION GRADES

Grade 1Strong Recommendation Benefits 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

How to Search

New Search

Search display results topic review output

Others Evidence grading

Grading Tutorial RECOMMENDATIONS

Calculators Drug Interactions ECG test Movies

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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

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Feedback

-歡迎並感謝給予任何意見-Email內容直接至美國主編群，並由主編群直接回覆

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About UpToDate

You don’t need more information

You need the right information

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UpToDate - Key Development Purpose

Save your Cost !!

Save your Time !!

Answer Clinical Question !!

使得醫療專家可以在搜尋與判讀的過程中節省時間 , 將主要的心力集中在研讀更重要的治療主題資訊上

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Q & A

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Thank you for your attention !!