UpToDate 循证医学数据库内容说明以及使用操作案例实例.ppt

UpToDate 循证医学数据库内容说明以及使用操作 鄭如雅 ccheng@ 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 * 什么是UpToDate? * 填补空白 * UpToDate的主要特点 * 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 * Evidence Grading 循据等级 * 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 * 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 What’s 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 * QA * * * * * * *