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Presented By: Andy Chuang 莊俊彥
Elsevier Taiwan LLC
Date: Dec 27, 2007
Systematically Review
SUMSearch (http://sumsearch.uthscsa.edu/)
TRIP (www.tripdatabase.com)
Entrez PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi)
Cochrane Database of Systematic reviews
National Guidelines Clearinghouse (www.guidelines.gov)
1. Medical Topic – including
drug doses, risks & benefits written by professional
medical writer
2A. Content Editors check style,
consistency, omissions
2B Drugs Editors (PharmD’s)
check doses provided by med
writer and write all other drugs info
by customizing data in FC drugs
dbase
10. Content Editors and Drugs
Editors (PharmD’s) undertake
final check prior to publication
to live site
FIRSTConsult:
editorial workflow
for Medical Topics
9. Evidence-Based Medicine
Editors (MD’s) insert evidence
references and links to
guidelines
Pink box = medical writer (work for hire)
8. Generalist Editor (e.g.
internist or family
physician) review Medical
Topic to ensure relevance
to target audience
Blue box = in-house check
3. Topic Editor (Attending
Physician in US) edits Medical
Topic to ensure clinical
relevance and accuracy, and
answers queries
4. Content Editors & Drugs
Editors (PharmD’s) check
Topic Ed work
Green box = external review by Ed
Board member
5. CAM Editor
(complementary/alternative
medicine) review (optional)
7. Content Editors & Drugs
Editors (PharmD’s) check
Specialty Editor’s work
6. Specialty Editor (e.g.
cardiologist or hematologist)
reviews Medical Topic for
clinical accuracy & currency,
and writes Clinical Pearls etc.
Evidence-Based Medicine
Evidence-based medicine (EBM) has been defined as 'the conscientious, explicit and
judicious use of current best evidence in making decisions about the care of individual
patients' (Sackett DL, Rosenberg WMC, Gray JAM, et al. BMJ 1996;312:71-2).
Look for the
icon in the text
Evidence is summarized by our team of experts, principally from three
critically evaluated, very highly regarded sources:
Cochrane Systematic Reviews
Clinical Evidence
The National Guideline Clearinghouse™
Within the Medical Topics, the best available evidence and guidelines are integrated
into the content. You can find evidence and guidelines in the following sections:
Diagnosis - for diagnostic guidelines
Treatment - for guidelines relating to management; and summaries of evidence from
primary research articles and systematic reviews relevant to your treatment plan
Prevention - for evidence and guidelines relating to prevention
Level of Evidence
Resource from: http://www.mdconsult.com/php/about/82479328-4/pm_FC_EBM.html
What is FIRSTConsult?
FIRSTConsult is a revolutionary web and PDA-based clinical
information system that provides continuously-updated,
evidence-based guidance on the latest in patient evaluation,
diagnosis, and management — all written and designed for
rapid access at the point of care!
FIRSTConsult offers:
Covering Specialty: 23
Medical Topic: 684
Patient Education: 360
Procedure: 70
DDX: 320
Diagnosis: 1800
Synthesized
Sources of Evidence…
Cochrane
Database
Clinical
Evidence
(ACP/BMJ)
National
Guidelines
Clearinghouse
…are synthesized under the
supervision of expert
faculty…
Editorial Advisory
Board
Leaders and well-known
authors in IM, FP, Peds
Ob-gyn, emergency and
specialty medicine.
Clinical Reviewers
MD Consult
Practicing clinicians and
regional experts.
Medical Writers
Consensus
Statements
Reference
Texts and
PeerReviewed
Articles
Assist in categorizing
information and creating
a consistency of style
from diverse sources
…delivered via web/PDA
Evidence-Based Medicine
Look for the
icon in the text
Evidence is summarized by our team of experts, principally
from three critically evaluated, very highly regarded sources:
Cochrane Systematic Reviews
Clinical Evidence
The National Guideline Clearinghouse™
Once summarized, Evidence is only then included if clinically
actionable
All evidence is based on a rating system published by the AAFP
Evidence and guidelines are regularly updated
Differential Diagnosis
Based on the patient’s
chief complaint
Start by choosing from
over 320 signs &
symptoms
Search options include:
Enter chief complaint
in search box
Scroll the list to find
the complaint
Click on A-Z to jump
to the chief complaint
Differential Diagnosis
Work from the chief
complaint to the
diagnostic tables
Over 1,800 possible
diagnoses available
Sorted by age and
prevalence
Emergency
conditions are
marked in red *
Differential Diagnosis
Clinical Benchmarks
provided for each
diagnosis
Click on diagnosis to
view
Differential Diagnosis
To compare multiple
disorders, select the
check boxes and
click ‘Compare’
Differential Diagnosis
Show all of the
characteristics for
this diagnose.
Medical Topics
684 medical topics
Browse by
alphabetical on AZ or search in the
up blank field
Medical Topics
Use left site
navigation to
access in-depth
information
3-9 subcategories
in each menu
Content is updated
weekly
Medical Topics
Background Menu includes:
Cardinal features
Causes
Epidemiology
Codes
Diagnosis Menu includes:
Clinical presentation
Differential diagnosis
Clinical pearls
Consider consult
Workup
Diagnostic decision
Questions to ask
Examination
Tests
Treatment Menu includes:
Immediate action
Therapeutic options
Summary of therapies
Medications and other therapies [EBM]
Summary of evidence Clinical pearls
Follow-up
Outcomes Menu includes:
Prognosis
Clinical complications
Consider consult
Prevention Menu includes:
Primary prevention
Modifiable risk factors
Secondary prevention
Screening
Guidelines
Resources Menu includes:
References
Guidelines
Associations
Patient and caregiver information
Related topics
Contributors
Procedures
Systematic guidance on
surgical and diagnostic
procedures commonly
performed
70 available
Video clips or animations
included with each file
Full Text Search Feature
Full Text Search function will take your keywords and present
ranked, targeted results, from all of the FIRSTConsult content.
Enter search term(s) in the Full Text Search box on the left-hand panel
Search terms can contain Boolean terms, such as AND, OR, NOT.
Header describes
the details of the
current search
Results include an
ordered list of
search hits, the
most relevant
appearing first
and also provide
Recommended
Results
Thank You!