The Pediatric Internet

1
The Pediatric Internet

• The Good
• The Bad
• The Ugly

2
Actually

• Less of the Bad and the Ugly
• More of the Good...
• Short Discussion
• Strategies
• Hands-on...

3
The Pediatric Internet

• Online resources
• Medical reference/journals/guidelines
• Advocacy federal/local
• Business commerce/regulatory
• Research data
• News medical, advocacy, business
• Family/child-related information

4
The Good

• Evidence-based Medicine (EBM)
• Definition The conscientious, explicit, and
  judicious use of current best evidence in making
  decisions about the care of individual patients.

5
The EBM Approach...

• Formulate an appropriate clinical question.
• Conduct a literature search.
• Select the key articles.
• Critically appraise the articles.
• Apply the results of the search to your patient.

6
Practical EBM

• Understand the kinds of questions you ask and
  want answered at the point-of-care.
• Select trusted EBM datasources that will most
  likely provide usable answers for you.
• Integrate them into your workflow.

7
Questions asked

• Drugs indications, dosages, interactions,
  adverse reactions, insurance coverage?
• Treatment effectiveness, compliance, guidelines?
• Diagnosis decision support, expertise, pictures?

8
What are resources?

• Drugs handbooks, formularies
• Treatment textbooks, review articles,
  guidelines/critical paths
• Diagnosis diagnostic aids, experts, decision
  algorithms, atlases...

9
Where are resources?

• Federal government
• NIH, CDC, FDA...
• Organizations
• AAP, AMA, APS-SPR...
• Universities
• Private organizations
• Merck, Thomson Healthcare/PDR...

10
How do I get to them?

• Have an Internet connection...
• Know some basic starting points
• Portals, Search engines, directories
• Organize them to access quickly
• Know how to ask questions to get the answers you
  need

11
Starting points

• If you are a medical school faculty member, you
  may be eligible for remote log-in privileges
• Ask and ask for help from a good medical
  librarian
• See what resources are available
• LEARN HOW TO BOOKMARK EFFECTIVELY
• Well show you how

12
Free resources

• Federal government
• NIH http//www.nih.gov
• Numerous institutes with up-to-date resources
• National Library of Medicine http//www.nlm.nih.g
  ov
• Medline Peer-reviewed, abstracted articles
• TOXLINE Toxicology information
• MEDLINEplus Consumer health information

13
Free resources

• Federal government
• CDC http//www.cdc.gov
• Up-to-date relevant clinical and surveillance
  information
• Numerous reports and databases for download
• MMWR free
• Electronic mailing lists

14
Free resources

• Federal government
• AHRQ http//www.ahrq.gov
• Agency for Healthcare Research and Quality
• Evidence-based practice guidelines
• NGC http//www.guideline.gov
• National Guideline Clearinghouse
• Searchable abstracted guideline repository

15
Organizational resources

• American Academy of Pediatrics
• AAP Policy Statements, Clinical/Technical
  Reports http//www.aap.org/policy/pprgtoc.cfm
• Pediatrics, Pediatrics in Review
• http//www.pediatrics.org
• http//www.pedsinreview.org

16
University resources

• GeneralPediatrics.com (U. Iowa)
• http//www.generalpediatrics.com
• Problem-based resources
• Harriet Lane Links (Johns Hopkins)
• http//www.harrietlane.org
• Reviewed resources from the WWW
• DermAtlas (Johns Hopkins)
• http//www.dermatlas.org
• Searchable pictorial atlas of skin disease

17
Commercial Resources

• Merck
• http//www.merck.com
• Merck Manual
• Merck Manual Home edition
• http//www.merckmedicus.com
• Theradoc Antibiotic assistant
• Medicine Harrisons, Cecils
• Drug reference, CME

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Portals

• Pedialink (AAP)
• http//www.pedialink.org
• Medical resources linking to CME
• Physicians Online
• http//www.pol.net
• E-mail, job board, CME, patient care/business news

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Portals

• eMedicine
• http//www.emedicine.com
• Free and premium versions
• Online medical text, formulary, patient
  information
• MDConsult
• http//www.mdconsult.com
• 200 per year
• Nelsons, AAP Red Book, full-text journals

20
PDA tools

• ePocrates
• http//www.epocrates.com
• Handheld drug formulary
• Hopkins Antibiotic Guide
• http//www.hopkins-abxguide.org
• Infectious disease management

21
Set up your search tools

• List the kinds of questions you ask frequently...
• See which resources provide answers for you
• Place the ones that work for you in a way you can
  use them (Browser bookmarks, PDA downloads)

22
Set up your search tools

• Bookmarks or Favorites
• This browser function marks locations on the
  Internet you want to remember
• BOOKMARK search pages
• DOWNLOAD documents
• Bookmarks can be organized for easy access

23
Set up your search tools

• Exercise/Practice
• Pick a clinical question
• Select resources you think will provide you with
  a usable answer
• Organize your resources
• BOOKMARK search sites
• DOWNLOAD articles
• Evaluate your results

24
and Explore

• Have fun! Were here to help...
• Start here