醫(yī)學(xué)課件 UpToDate 循證醫(yī)學(xué)數(shù)據(jù)庫內(nèi)容說明以及使用操作

1、UpToDate 循證醫(yī)學(xué)循證醫(yī)學(xué)數(shù)據(jù)庫數(shù)據(jù)庫內(nèi)容說明以及使用操作內(nèi)容說明以及使用操作鄭如雅鄭如雅大綱大綱什么是什么是UpToDateUpToDateUpToDateUpToDate主要特點主要特點Evidence Grading Evidence Grading 證據(jù)等級證據(jù)等級 檢索檢索UpToDateUpToDate問題與討論問題與討論2什么是UpToDate?3填補空白4UpToDate的主要特點5使用UpToDate的醫(yī)院United States 美國美國 Johns Hopkins Hospital Mayo Foundation UCLC Medical Center Mass

2、achusetts General Hospital University of California, San Francisco Medical CenterAustralia 澳大利亞澳大利亞 Queensland Health Northern Sydney Health Royal Perth Hospital6亞洲使用UpToDate的醫(yī)院Singapore General HospitalNational University Hospital, SingaporeNational Taiwan University HospitalChang Gung Memorial Hos

3、pitalSeoul National University Hospital, KoreaYonsei University Medical Center, KoreaUniversity of Malaya Medical Center, MalaysiaPenang Adventist Hospital, MalaysiaKing Chulalongkorn Memorial Hospital, ThailandAngkor Hospital for Children, Cambodia7UpToDate的主要特點8Evidence Grading 循循據(jù)等級據(jù)等級 In 2001, w

4、e 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 recommendations9Evidence Grading 循循據(jù)等級據(jù)等級 10RECOMMENDATION GRADES 醫(yī)囑的強度醫(yī)囑的

5、強度 Grade 1Strong RecommendationBenefits clearly outweigh the risks and burdens (or vice versa) for most, if not all, patients “We recommend”Grade 2Weaker RecommendationBenefits and risks closely balanced and/or uncertain “We suggest”EVIDENCE GRADES 證據(jù)的品質(zhì)證據(jù)的品質(zhì)Grade AHigh Quality EvidenceConsistent ev

6、idence from randomized trials, or overwhelming evidence of some other formGrade BModerate Quality Evidence Evidence from randomized trials with important limitations, or very strong evidence of some other formGrade CLow Quality EvidenceEvidence from observational studies, unsystematic clinical obser

7、vations, or from randomized trials with serious flaws檢索UpToDate11 New Search 單一檢索方式單一檢索方式 Search display results topic review output 檢索檢索 瀏覽檢索結(jié)果瀏覽檢索結(jié)果 如何使用內(nèi)容如何使用內(nèi)容 輸出輸出 Others 其它功能其它功能 Evidence grading 如何找到證據(jù)等級如何找到證據(jù)等級 RECOMMENDATIONS Patient Information 衛(wèi)教資料衛(wèi)教資料 Whats new 各科新知各科新知 125 Calculators 醫(yī)

8、學(xué)電子表格醫(yī)學(xué)電子表格 Drug Interactions 藥物交互作用藥物交互作用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 o

9、besity. 有一位50歲的女性，BMI是32, 而且有高血壓; 她透過節(jié)食和改變生活習(xí)慣來減肥, 但是失敗了 ; 現(xiàn)在希望可以直接吃藥來達到減肥的目的; 什么藥物可以讓她減肥又不會影響到她的高血壓的癥狀呢 ? Keyword: Obesity drug12Q&A13Specialties Adult and Pediatric Emergency Medicine 急診急診 Adult Primary Care & Internal Medicine 一般內(nèi)科一般內(nèi)科 Allergy and Immunology 過敏免疫過敏免疫 Cardiovascular Medici

10、ne 心臟內(nèi)科心臟內(nèi)科 Endocrinology & Diabetes 內(nèi)分泌及糖尿病內(nèi)分泌及糖尿病 Family Medicine 家庭醫(yī)學(xué)家庭醫(yī)學(xué) Gastroenterology & Hepatology 肝膽腸胃科肝膽腸胃科 Hematology 血液科血液科 Hospital Medicine 醫(yī)院醫(yī)學(xué)醫(yī)院醫(yī)學(xué) Infectious Diseases 感染科感染科 Nephrology & Hypertension 腎臟科及高血壓腎臟科及高血壓 Neurology 神經(jīng)內(nèi)科神經(jīng)內(nèi)科 Obstetrics, Gynecology & Womens Health 婦產(chǎn)科婦產(chǎn)科 Oncology 腫瘤科腫瘤科 Pediatrics 小兒科小兒科 Pulmonary, Critical Care