Answering Clinical Questions at the Point of Care

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Answering Clinical Questions at the Point of Care
???ccheng_at_uptodate.com
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Outline

• About UpToDate
• Evidence Grading
• How to search
• Q A

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About UpToDate

• You dont need more information
• You need the right information

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Synthesize current literature and best practices,
then make specific clinical recommendations
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UpToDate enables

• Access the most current information within your
  specialty
• Recognize the clinical manifestations of a wide
  variety of disorders and describe current
  options for diagnosis, management and therapy,
  including the efficacy, doses, and interactions
  of individual drugs
• Identify optimal screening and prevention
  strategies

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Quick Facts about UpToDate

• Topic reviews
• Patient information
• Drug Information
• Guideline
• Written by Physicians for Physicians

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Quick Facts about UpToDate

• 3,300 world-renowned physician authors
  (international)
• 7,000 clinical topics in 13 specialties
• 4,100 unique drug entries in adult, pediatrics,
  international, and natural drugs (Lexi-Comp)
• 70,000 pages of text
• 21,000 graphics
• 230,000 references (Medline)
• Updated every 4 months

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Evidence Grading
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Evidence Grading

• UTD-GRADE

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How to search
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How to search

• New search
• search ? display result ? output
• Others
• Evidence grading
• SUMMARY AND RECOMMENDATIONS
• Drug interaction
• Calculator
• Movies

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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

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How to use UpToDate based on a Clinical Scenario

• A 60-year-old man comes in for a routine exam and
  mentions that two months earlier he lost vision
  in his right eye for 10 minutes.
• Send him for carotid duplex and find a 60 percent
  right carotid stenosis.
• Given that the TIA occurred more than two months
  ago.
• Is he an appropriate candidate for carotid
  endarterectomy ?

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Q A
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Citing an UpToDate topic review

• ??Carotid endarterectomy in symptomatic
  patients.
• ??James P Greelish, MD
• Greelish, JP. Carotid endarterectomy in
  symptomatic patients. In UpToDate, Rose, BD
  (Ed), UpToDate, Waltham, MA, 2007.

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How to use UpToDate based on a Clinical Scenario

• A patient for whom you have prescribed
  atorvastatin comes in saying he has been reading
  that atorvastatin can cause muscle pain and that
  taking coenzyme Q10 supplements may be helpful in
  preventing this.
• Is there any evidence to support taking coQ10?

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Thank you for your attention
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Specialties

• Cardiovascular Medicine
• Endocrinology
• Family Medicine
• Gastroenterology Hepatology
• Hematology
• Infectious Diseases
• Internal Medicine
• Nephrology
• Obstetrics Gynecology
• Oncology
• Pediatrics
• Pulmonary Medicine
• Rheumatology