MD Consult & First Consult Presented By: 莊立信 LiHsin Chuang L.chuang@elsevier.com Elsevier Taiwan 0928-367- 356
Agenda What s in MD Consult First Consult Online Demo (Case Study)
十大主題 First Consult Books Journals The Clinics Patient Education Drugs Guidelines Images News CME
Reference Books
Journals 收錄超過 80 種期刊 包括著名的 The Clinics of North America 同時搜尋 Medline 資料庫 每篇全文文章均包括書目資料及目錄
全文期刊 HTML Elservier 所出版的期刊和 Clinics 均提供全文內容 包含超過 30,000 篇文章
The Top 8 Journal Titles The Lancet Infectious Diseases Annals of Emergency Medicine Journal of Allergy and Clinical Immunology The Lancet Neurology Journal of Pediatrics Journal of the American Academy of Child and Adolescent Psychiatry Critical Care Medicine Anesthesiology
The Clinics 提供 35 種最具權威的北美醫學臨床雜誌 每篇全文文章均包括書目資料及目錄 簡單而靈活的搜尋選項方便進行精確檢索
Top Clinics Series
Patient Education
Drugs 提供藥物商品的圖片 藥物資訊包含 : 藥物分類 別名 學名 副作用 交互作用 藥物動力學 機轉 分子結構 等相關藥物資訊
Drugs Safety Notices FDA Approvals
Guidelines ( 臨床指引 ) 超過 1,000 份同儕評鑑臨床診療指南 (Peer- Review Articles) 按照作者 機構 專科及主題方式分類 每篇全文文章均包括書目資料及目錄
Medical Images ( 圖片 ) 超過 50,000 張圖片 可供查詢及圖片比對 來源 : 資料庫中的 Books
News ( 新聞 ) 每日更新 提供最新醫學發展新知 當週新聞
News Customization 提供自訂有興趣的科別 * 需先註冊個人帳密功能
Newsletter
CME Center Free CME offered through Clinical Cornerstone, a bimonthly CME journal. Print the CME Test Form and return by fax or mail for ACCME Category 1 credit. Free CME credit for the first 5 conferences submitted, administered by the Cyberounds Committee at the Albert Einstein College of Medicine, for up to 50 hours of Category 1 credit. Personal login to MD Consult required to access Cyberounds.
First Consult
Searching First Consult 提供最新的鑑別診斷 評估 結果 預後等資訊
Medical Topics
Differential Diagnosis
Procedures
Evaluation of Evidence In this rating system, in order to indicate the strength of the supporting evidence, each summary evidence statement is accorded one of three levels, or uncategorized: Level A Cochrane Reviews of randomized controlled trials (RCTs) where adequate data are found for analysis Other good quality systematic reviews or meta-analyses of RCTs where adequate data are found for analysis Good-quality RCTs Level B Other RCTs not included in Level A Other systematic reviews or meta-analyses not included in Level A Rarely, good-quality nonrandomized clinical trials, and very occasionally other types of study such as case-control studies, clinical cohort studies, cross-sectional studies, retrospective studies, or uncontrolled studies Level C Evidence-based consensus statements and expert guidelines Uncategorized Where a Cochrane Review or other systematic review or meta-analysis reviews a clinical problem but finds no adequate trials upon which to base a conclusion.
Case Study
問題與臨床經驗
實證醫學的五大進行步驟 Five Steps to Practice EBM 1. Formulate an answerable question. (PICO) 由個案的臨床資料形成可回答的臨床問題 2. Track down the best evidence. (Search database) 尋找最佳的實證 各種文獻及資料庫, 包括發表及未發表資料 3. Critically appraise the evidence for validity, impact, and applicability. (VIP) 評估各種醫學報告的可信度 臨床重要性, 以及可應用性 4. Integrate with our clinical expertise and patient values. 整合並應用於實際患者的治療決策 臨床應用 5. Evaluate our effectiveness and efficacy. 效果評估
Case 對於慢性蕁麻疹 (chronic urticaria), Zytec 與 Allegra 的那一種治療效果比較好呢? PICO P Urticaria I Zytec (Ceterizine, 驅特異膜衣錠 ) C Allegra (Fexofenadine, 艾來錠 ) O Which one is better?
MD Consult 臨床醫學資料庫 專題講習課程 2012-05-10 ( 四 ) 12:30~13:30 今日臨時帳號密碼 帳號 :medrefclass1 密碼 :class1 ( 最後一碼為阿拉伯數字 )
使用時登入個人借閱查詢帳密 校外連線設定說明 電子資源講習課程
MD Consult MD Consult e 資料庫查找路徑 1: 查詢
MD Consult MD Consult 資料庫查找路徑 2 : 瀏覽 實證醫學
電子資源利用指引 1. 講習課程報名 : 醫分館講習課程清單 2. 教材下載 : 課程講義 上課錄影畫面
講習課程授課評量
Acquire / Search Chronic Urticaria Cetirizine Fexofenadine
52:cetirizine 45:fexofenadine symptom free 27(51.9%) 2(4.4%) partial improvement 19(36.5%) 19(42.2%) no improvement 6(11.5%) 24(53.3%)
Case 慢性蕁麻疹 (chronic urticaria), Zytec 與 Allegra 的那一種效果比較好呢? PICO P Urticaria I Zytec (Ceterizine, 驅特異膜衣錠 ) C Allegra (Fexofenadine, 艾來錠 ) O Zytec is better!
Thanks for your attention!