Janet G Schnall, MS, AHIP

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Improving Patient Care Through Locating and
Using Library and Internet Resources

• Janet G Schnall, MS, AHIP
• Information Management Librarian
• Health Sciences Libraries
• University of Washington, Seattle, WA
• schnall_at_u.washington.edu

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Objectives

• Identify 10 ways to improve patient care using
  library and internet resources
• Describe different tools to navigate the web to
  find pediatric resources
• Describe web resources for evidence-based practice

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1Bookmark the HealthLinks Care Provider Toolkit

• http//healthlinks.washington.edu/care_provider/

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2Use the New UW Proxy Service
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New Proxy Servicehttp//healthlinks.washington
.edu/howto/connect/

• Allows off-campus access to UW restricted online
  e-texts, e-journals, databases
• Click on the Off-Campus Access link at the top
  right of any HealthLinks page
• Enter your UW NetID name and password

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3Explore e-Textbooks
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e-TextbooksAccess from HealthLinks Care Provider
Toolkit

• UptoDate
• Concise comprehensive uptodate reviews of
  clinical topics in multiple specialties
• MD Consult
• Continuously updated online medical information
  system that includes textbooks, journals, drug
  information, patient ed materials, practice
  guidelines

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Textbooks
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Textbook
otitis media
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Patient Handout
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4Search a Database to find Journal Articles
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Databases

• PubMedSearch PubMed through the UW HealthLinks
  web page so you can connect to full-text articles
• Web of Science
• PsycInfo

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PubMedAccess PubMed from HealthLinks

• Includes MEDLINE (mid 1950s to present) and
  PREMEDLINE
• Indexes 4,800 biomedical journals
• Covers all aspects of biosciences and healthcare
• 75 of citations have abstracts
• Updated DAILY

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Advantages of PubMed

• Free
• Links to publishers sites for full-text journals
• Or, can order full-text journal articles
• Can easily find related articles
• Clinical Queries and Systematic Reviews sections
  limit retrieval using research filters

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More Advantages of PubMed

• Can easily limit your search to
• Age groups
• Human or Animal studies
• Language
• Review articles
• Subsets, such as Core Clinical Journals or CAM
• Clipboard allows you to save citations from one
  search or several searches that you may want to
  print, save, email or order.
• Cubby allows you to store and update searches.

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http//healthlinks.washington.edu/howto/pubme
d/
Try
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E-Journals

• For UW Affiliates use the Proxy service to
  access full-text e-journals from off-campus
• For non-UW affiliates Check with your library
  for access to full-text

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Open Access Journal Sites

• BioMed Central
• http//www.biomedcentral.com/
• Independent publishing house providing immediate
  free access to peer-reviewed biomedical research
• PubMed Central
• http//pubmedcentral.gov/
• National Library of Medicine's free digital
  archive of biomedical and life sciences journal
  literature

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Order Articles Online for a Fee

• Document Services/University of Washington
  https//healthlinks.washington.edu/hsl/docservices
  /services.html
• Loansome Doc
• https//healthlinks.washington.edu/hsl/docservice
  s/lds-na.html
• Allows you to order full-text articles after
  searching PubMed

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5Search for Evidence
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What is evidence-based practice?

• Evidence based medicine is the conscientious,
  explicit, and judicious use of current best
  evidence in making decisions about the care of
  individual patients.
• The practice of evidence based medicine means
  integrating individual clinical expertise with
  the best available external clinical evidence
  from systematic research.
• Sackett DL et al. Evidence based medicine what
  it is and what it isn't. BMJ 1996 Jan 13
  312 (7023) 71-2.

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EBP and Guidelines Resourceshttp//healthlinks.wa
shington.edu/ebp

• PubMed Clinical Queries/Systematic Reviews
• Cochrane Library gold standard for EBP
• National Guideline Clearinghouse
• http//www.guideline.gov/
• Trip Database

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PubMed Stategies for Evidence-Based Citations

• PubMed Limits
• Randomized Controlled Trial
• Meta-Analysis
• Practice Guideline
• Clinical Trial
• PubMed Clinical Queries and Systematic Reviews
  

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Cochrane Library
recurrent abdominal pain
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6Keep up with Drug Resources
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Drug Resources

• Micromedex
• Clinical information on toxicology, drugs, drug
  interactions, and reproductive risks
• eFacts
• Drug Facts Comparisons, Drug Interaction Facts,
  Herbal Interaction Facts, The Review of Natural
  Products and MedFact Patient Information

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Natural Medicines/Herbals

• Natural Medicines Comprehensive Database
• Scientific summaries for 1000 medicinal herbs and
  dietary supplements. Rates safety and
  effectiveness. Interactions with condition, drug,
  food, lab test and nutrient levels
• Natural Standard Online
• Database of evidence-based monographs on herbs,
  supplements, and complementary therapies

New
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Natural Standard Online
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Drug Information for PDAs

• MobileMICROMEDEX
• Abridged version of Micromedex
• PocketConsult
• Mosbys Drug Consult from MD Consult
• ePocrates Rx
• http//www.epocrates.com/
• monographs for the most prescribed meds
• Free download after registration
• http//healthlinks.washington.edu/howto/pda/

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7Keep Current with Email Alert Services
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Information Overload!

• 2 million articles published in biomedical
  journals each year
• If a physician attempted keep up with the
  literature by reading 2 articles a day, at the
  end of year would be 60 centuries behind.
• Lundberg GD. Perspective from the editor of JAMA,
  The Journal of the American Medical Association.
  Bull Med Libr Assoc. 1992 Apr80(2)110-4.

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What are Email Alert Services?

• Deliver current citations or the tables of
  contents of selected journals into your email
• Based on a search strategy you create
• In most cases, abstracts of the articles are
  provided
• Many provide links to PubMed and full-text
  articles

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Email Alert Services http//healthlinks.washington
.edu/howto/alerts.html
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Journal Watch Pediatrics and Adolescent Medicine

• Summarizes articles from more than 28 medical and
  scientific journals
• Includes commentaries to put the latest clinical
  research into perspective for the practicing
  clinician
• Bruder Stapleton,MD, editor-in-chief

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PubMed Cubby

• Your personal space on the NLM computer system
  for storing search strategies
• Free registration required
• Onus on you to return at frequent intervals to
  update your searches
• Near future new PubMed citations sent
  automatically to your email

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Health News

• CNN Health http//www.cnn.com/HEALTH/
• New York Times Health
• http//www.nytimes.com/pages/health/
• USA Today Health http//www.usatoday.com/news/he
  alth/front.htm
• Yahoo! News http//news.yahoo.com/

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8Explore Patient Ed Sites
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Patient Education

• MEDLINEplus Health Information
• http//medlineplus.gov/
• 1 SOURCE for quality consumer/patient
  information
• Includes drug information
• Spanish version
• Predesigned PubMed searches
• Interactive tutorials
• News

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Do you need

• Articles or research studies
• Go to PubMed
• Information written for patients
• Start with MEDLINEplus

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Additional Patient Ed Resources

• Healthfinder
• http//healthfinder.gov/
• MD Consult Patient Handouts
• Micromedex Patient Leaflets

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Cross-Cultural Healthcare Resources

• EthnoMed
• http//ethnomed.org/
• A cross-cultural medicine database containing
  information about cultural beliefs and medical
  issues pertinent to healthcare of ethnic groups
  in Seattle area
• Culture Clues http//depts.washington.edu/pfes/cul
  tureclues.html
• Tip sheets designed to increase awareness about
  concepts and preferences of patients from diverse
  cultures

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Somali Health and Illness
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• 9
• Navigate the Web Beyond Google

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Navigation Difficulties

• Size of the Web
• Lack of control or review
• Lack of quality standards

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Google Special Features http//www.google.com/

• View cached page to resurrect dead pages
• Includes similar pages feature
• Search for images
• Includes pdf and other file types
• Search within results

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Google Advanced Search Features

• File Format, i.e. pdf
• Date, i.e. pages updated in last 3 months
• Occurrences, i.e. terms appear in title
• Domain, i.e. .gov, .edu
• Links, i.e. pages that link to the page

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Meta-Search Engines
Allow you to send searches to more than one
search engine at a time
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Meta -Search Engines
Vivisimo
http//www.vivisimo.com/
DogPile
http//www.dogpile.com/
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Vivisimohttp//www.vivisimo.com/

• All the speed and functionality of Google, with
  clustering added
• Clustered results in left margin
• Why use clustering?
• Learn at a glance types of information available
• Uncover results that are otherwise buried

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10Contact Your Ultimate Search Engine your
librarian!
UW Health Sciences Libraries
Childrens Hospital Library
Library Liaisons to the Dept of Pediatrics
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Improving Patient Care Through Locating and Using
Library and Internet Resources

• http//healthlinks.washington.edu/hsl/liaisons/sch
  nall/improvingpatientcare