EBM and related resources tzchiutmu edu tw tzchiuncl

實證醫學與其相關資源介紹 EBM and related resources 邱子恒 tzchiu@tmu. edu. tw tzchiu@ncl. edu. tw 2014. 12. 01

實證醫學核心內容 – 三大要素(3 E) Best research evidences EBM Clinical expertise Patient expectations

5 S Levels Systems Prefiltered Evidence-based textbooks: Summaries Up. To. Date, Clinical Evidence Synopses Syntheses Unfiltered Studies Evidence-based journal abstracts: ACP Journal Club…. Systematic Reviews: The Cochrane Library Original journal article: Pub. Med Modified from R Brain Haynes et al. : ACP Journal Club Nov/Dec 2006 | Vol 145 • Number 34; A 8 -A 9.

常用的網站和資料庫 n n n Guidelines Health Technology Assessment (HTA) Up. To. Date The Cochrane Library Pub. Med Ovid Medline

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醫學界重要的出版品 The Lancet、 New England Journal of Medicine、 British Medical Journal and the Journal of the American Medical Association 一致推崇 Cochrane Reviews 是目前最具參考價值的系 統評論 (“gold standard” )，同樣的 評價也出現在其他不同領域地醫 學專業期刊中

WHAT IS THE COCHRANE LIBRARY? The Cochrane Library is a collection of Evidence-Based Medicine databases: n n n The Cochrane Database of Systematic Reviews (Cochrane Reviews) The Cochrane Database of Reviews of Effects (Other Reviews) The Cochrane Central Register of Controlled Trials (Clinical Trials) The Cochrane Methodology Register (Methods Studies) Health Technology Assessment Database (Technology Assessments) NHS Economic Evaluation Database (Economic Evaluations) It also contains information about The Cochrane Collaboration and the Cochrane Collaborative Review Groups

Cochrane Review Groups (CRGs) Cochrane Acute Respiratory Infections Group Cochrane Airways Group Cochrane Anaesthesia Group Cochrane Back Group Cochrane Bone, Joint and Muscle Trauma Group Cochrane Breast Cancer Group Cochrane Childhood Cancer Group Cochrane Colorectal Cancer Group Cochrane Consumers and Communication Group Cochrane Cystic Fibrosis and Genetic Disorders Group Cochrane Dementia and Cognitive Improvement Group Cochrane Depression, Anxiety and Neurosis Group Cochrane Developmental, Psychosocial and Learning Problems Group Cochrane Drugs and Alcohol Group Cochrane Ear, Nose and Throat Disorders Group Cochrane Effective Practice and Organisation of Care Group Cochrane Epilepsy Group Cochrane Eyes and Vision Group Cochrane Fertility Regulation Group Cochrane Gynaecological Cancer Group Cochrane Haematological Malignancies Group Cochrane Heart Group Cochrane Hepato-Biliary Group Cochrane HIV/AIDS Group Cochrane Hypertension Group Cochrane Incontinence Group Cochrane Infectious Diseases Group Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Group Cochrane Injuries Group Cochrane Lung Cancer Group Cochrane Menstrual Disorders and Subfertility Group Cochrane Metabolic and Endocrine Disorders Group Cochrane Methodology Review Group Cochrane Movement Disorders Group Cochrane Multiple Sclerosis Group Cochrane Musculoskeletal Group Cochrane Neonatal Group Cochrane Neuromuscular Disease Group Cochrane Oral Health Group Cochrane Pain, Palliative and Supportive Care Group Cochrane Peripheral Vascular Diseases Group Cochrane Pregnancy and Childbirth Group Cochrane Prostatic Diseases and Urologic Cancers Group Cochrane Public Health Group Cochrane Renal Group Cochrane Schizophrenia Group Cochrane Sexually Transmitted Diseases Group Cochrane Skin Group Cochrane Stroke Group Cochrane Tobacco Addiction Group Cochrane Upper Gastrointestinal and Pancreatic Diseases Group Cochrane Wounds Group

問題 n 利用hypothermia方式治療comatose cardiac arrest患者，是否會比standard normothermic方法降低腦神經的受損或降 低死亡率？

問題類型：therapy n P: cardiac arrest n I: hypothermia n C: standard normothermic management n O: more favorable neurological outcome, reduction in mortality

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The Cochrane Library 分別有在reviews 及clinical trials中 找到相關文獻。

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The Cochrane Library Clinical trials中 找到NEJM中有 相關文獻。

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The necessary of surgery for asymptomatic intestinal malrotation n n 小朋友因其他病因住院 檢查時照 X光發現有腸亂轉的情形 但沒有吃不下，嘔吐…等臨床症狀 想知道這樣的情形是否需要開刀? 問問題原則: PICO - Population - Intervention - Comparison - Outcome

Advanced Search – Example (Me. SH Search) 利用 Go To Me. SH Tree 可以瀏覽相關詞彙 的樹狀結構 利用 Thesaurus 可以查尋 Me. SH 同義詞

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Antibiotics for acute otitis media in children (The Cochrane Database of Systematic Reviews 2004, Issue 1. ) l Cochrane Review Objective: to assess the effects of antibiotics for children with acute otitis media l Dr Chris Cates Project: Given antibiotics prescription, but advised to wait 1 -2 days, use only if symptoms remain l In 2004, the American Academy of Pediatrics and the American Academy of Family Physicians’ guideline revised to include deferring antibiotics for children with ear infections who are not unduly ill

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