MD Consult First Consult By Ken Lin Mobile

MD Consult + First Consult By: Ken Lin 林揚凱 Mobile: 0972117807 Mail: k. lin@elsevier. com

Agenda § § § Elsevier Overview MD Consult Overview First Consult Overview Demonstration Reference

Specialties § § § § § Allergy, Asthma & Immunology Alternative Medicine Anesthesiology & Pain Management Basic Science Cardiology Critical Care Dentistry Dermatology Emergency Medicine Endocrinology & Metabolism Family Medicine Gastroenterology Geriatric Medicine Hematology Hospice & Palliative Care Hospital Medicine Infectious Disease Internal Medicine § § § § § Neonatalogy Nephrology Neurology Obstetrics & Gynecology Oncology Ophthalmology Orthopedic Surgery Otolaryngology Pathology Pediatrics Physical Medicine & Rehabilitation Psychiatry Pulmonary Medicine Radiology Rheumatology Sleep Medicine Sports Medicine Surgery, General Urology

實證期刊（EBM Related Journals） § Evidence-based Cardiovascular Medicine Full text available from April 1997 - June 2006 § Evidence-based Health Policy & Management Full text available from March 1997 - December 1998 § Evidence-based Healthcare and Public Health Full text available from October 2004 - December 2005 § Evidence-based Healthcare: A Scientific Approach to Health Policy Full text available from March 1999 - August 2004 § Evidence-based Obstetrics & Gynecology Full text available from March 1999 - September 2006 § Evidence-based Oncology Full text available from March 2000 - December 2002

The Lancet Infectious Diseases Journal of Pediatrics Anesthesiology Journal of the American Academy Annals of Critical Care Medicine Emergency Medicine of Child and Adolescent Psychiatry The Lancet Neurology Journal of Allergy and Clinical Immunology

Mobile § i. Phone, Blackberry…等智慧型手機或i. Pad, HTC Flyer…等平板 電腦 § 快速瀏覽臨床醫學主題相關資源 § 檢索books, Clinics, journals, MEDLINE®, 以及practice guidelines § 觀看book chapters, journals, and Clinics 等全文內容，包含 圖片資源 § 利用Email分享相關資源內容的連結

4 Easy steps to get started 1. Access www. mdconsult. com from a computer within the institution 2. Click on "Create an Account" in the top right 3. Complete the registration form, create a username and password, click "Submit" and log out 4. Log into MD Consult Mobile by visitinghttp: //mobile. mdconsult. com from a mobile browser

Level of Evidence § Level A § Cochrane Reviews of randomized controlled trials (RCTs) where adequate data are found for analysis § Other good quality systematic reviews or meta-analyses of RCTs where adequate data are found for analysis § Good-quality RCTs § Level B § Other RCTs not included in Level A § Other systematic reviews or meta-analyses not included in Level A § Rarely, good-quality nonrandomized clinical trials, and very occasionally other types of study such as case-control studies, clinical cohort studies, cross-sectional studies, retrospective studies, or uncontrolled studies § Level C § Evidence-based consensus statements and expert guidelines § Uncategorized § Where a Cochrane Review or other systematic review or meta-analysis reviews a clinical problem but finds no adequate trials upon which to base a conclusion. § From AAFP (American Academy of Family Physicians) & US Agency for Healthcare Policy and Research Classification

Demonstration WWW. MDCONSULT. COM

實證醫學的五大進行步驟 1. Formulate an answerable question. (PICO) 由個案的臨床資料形成可回答的臨床問題 2. Track down the best evidence. (Search database) 尋找最佳的實證� 各種文獻及資料庫，包括發表及未發表資料 � 3. Critically appraise the evidence for validity, impact, and applicability. (VIP) 評估各種醫學報告的可信度、臨床重要性，以及可應用性 4. Integrate with our clinical expertise and patient values. expertise values 整合並應用於實際患者的治療決策� 臨床應用� 5. Evaluate our effectiveness and efficacy. 效果評估

Case Study § 對於 慢性蕁麻疹(chronic urticaria)，Zytec與Allegra的 那一種治療效果比較好呢？ P Chronic Urticaria I Zytec (Cetirizine, 驅特異膜衣錠) C Allegra (Fexofenadine, 艾來錠 ) O Which one is better?

Reference § MD Consult: http: //info. mdconsult. com/ § MD Consult for Mobile: http: //info. mdconsult. com/about/content/md-consultmobile/ § Elsevier線上書城: http: //www. elsevier. tw

www. MDConsult. com Questions: Ken Lin 林揚凱 0972117807 k. lin@elsevier. com