医学课件uptodate 循证医学数据库内容说明以及使用操作

UpToDate 循证医学 数据库 内容说明以及使用操作 鄭如雅 大纲 什么是 UpToDate UpToDate主要特点 Evidence Grading 证据等级 检索 UpToDate 问题与讨论 2 什么是 UpToDate? 3 填补空白 4 UpToDate的主要特点 5 使用 UpToDate的医院 United States 美国 Johns Hopkins Hospital Mayo Foundation UCLC Medical Center Massachusetts General Hospital University of California, San Francisco Medical Center Australia 澳大利亚 Queensland Health Northern Sydney Health Royal Perth Hospital 6 亚洲使用 UpToDate的医院 Singapore General Hospital National University Hospital, Singapore National Taiwan University Hospital Chang Gung Memorial Hospital Seoul National University Hospital, Korea Yonsei University Medical Center, Korea University of Malaya Medical Center, Malaysia Penang Adventist Hospital, Malaysia King Chulalongkorn Memorial Hospital, Thailand Angkor Hospital for Children, Cambodia 7 UpToDate的主要特点 8 Evidence Grading 循 据等级 In 2001, we 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 recommendations 9 Evidence Grading 循 据等级 10 RECOMMENDATION GRADES 医嘱的强度 Grade 1 Strong Recommendation Benefits clearly outweigh the risks and burdens (or vice versa) for most, if not all, patients “We recommend” Grade 2 Weaker Recommendation Benefits and risks closely balanced and/or uncertain “We suggest” EVIDENCE GRADES 证据的品质 Grade A High Quality Evidence Consistent evidence from randomized trials, or overwhelming evidence of some other form Grade B Moderate Quality Evidence Evidence from randomized trials with important limitations, or very strong evidence of some other form Grade C Low Quality Evidence Evidence from observational studies, unsystematic clinical observations, or from randomized trials with serious flaws 检索 UpToDate 11 New Search 单一检索方式 Search display results topic review output 检索 浏览检索结果 如何使用内容 输出 Others 其它功能 Evidence grading 如何找到证据等级 RECOMMENDATIONS Patient Information 卫教资料 Whats new 各科新知 125 Calculators 医学电子表格 Drug Interactions 药物交互作用 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 obesity. 有一位 50岁的女性， BMI是 32, 而且有高血压 ; 她透过节食和改变生活 习惯来减肥 , 但是失败了 ; 现在希望可以直接吃药来达到减肥的目的 ; 什么药物可以让她减肥又不会影响到她的高血压的症状呢 ? Keyword: Obesity drug 12 Q&A 13 Specialties Adult and Pediatric Emergency Medicine 急诊 Adult Primary Care & Internal Medicine 一般内科 Allergy and Immunology 过敏免疫 Cardiovascular Medicine 心脏内科 Endocrinology & Diabetes 内分泌及糖尿病 Family Medicine 家庭医学 Gastroenterology & Hepatology 肝胆肠胃科 Hematology 血液科 Hospital Medicine 医院医学 Infectious Diseases 感染科 Nephrology & Hypertension 肾脏科及高血压 Neurology 神经内科 Obstetrics, Gynecology & Womens Health 妇产科 Oncology 肿瘤科 Pediatrics 小儿科 Pulmonary,