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• About UpToDate
• How to Search
• Q & A
Synthesizes the medical literature, incorporates the
latest evidence, and provides specific recommendations for
patient care
About UpToDate
Evidence is derived from a number of Sources
• Journals: 440+ peer viewed journals• Databases:
– MEDLINE, The Cochrane Database, Clinical Evidence and ACP Journal Club
• Guidelines• Clinical trials
– FDA, CDC, NIH• Proceedings• Clinical experience and observations
Including but not limited
The editorial process
Leading and Evidence Based Literature and Resources
UpToDate Topic Review
Read ..... Analyze ..... Summarize .....
..... Synthesize .....
..... Expert Comments .....
..... Expert Opinion .....
..... Recommendations .....
..... Grade the Evidence .....
..... Editorial Peer Review .....
Quick Facts about UpToDate
• Topic reviews
• Patient Information
• Drug Information – Lexi-Comp
Quick Facts about UpToDate
• 4,400+ world-renowned physician authors (international)
• 7,775 clinical topics in 16 specialties
• 4,619 unique drug entries in adult, pediatrics, international, and natural drugs (Lexi-Comp)
• 24,637 graphics
• 262,209 references (Medline)
• Update every 4 months (March, July, November)
Specialties• Adult and Pediatric Emergency Medicine • Dermatology
• Adult Primary Care & Internal Medicine • Psychiatry
• Allergy and Immunology • Surgery
• Cardiovascular Medicine
• Endocrinology & Diabetes
• Family Medicine
• Gastroenterology & Hepatology
• Hematology
• Infectious Diseases
• Nephrology & Hypertension
• Neurology
• Obstetrics , Gynecology & Women’s Health
• Oncology
• Pediatrics
• Pulmonary, Critical Care & Sleep Medicine
• Rheumatology
To Access UpToDate
• Please go to library homepage
• Just “Accept” the license agreement and you are brought to the search page, ready for your use; within a few seconds
How to Search
How to Search
• New Search– search display result output
• Others– Patient Information– What’s new– Calculators– Evidence grading
• RECOMMENDATIONS– Drug interactions– ECG Test– Movies
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
• Keyword : – obesity drugs
Patient Information
What’s New
Calculators
此為主畫面除此以外另有三個頁面可以選點-Patient Info-What’s New-Calculators
我們以 obesity drug 來做查詢
當我們把關鍵字鍵入後系統會跳出相關的詞以供選擇
關鍵字可以是- 病名 , 藥名 , 症狀- 大小寫皆可- 可同時輸入二個字以上- 接受布林邏輯裡的 and 以及 or- 系統亦提供拼錯檢查- 單複數不會影響檢索結果
輸入完畢直接選點 Go
此為檢索結果另外有三個選項可以改變檢索結果的順序-Prioritize adult topics-Prioritize pediatric topics-Prioritize patient topics
可以預覽文章的 Outline-只要滑鼠移到文章篇名的上面， 即可在右邊出現該篇文章的 outline- 若要進入本文，直接點選篇名- 若只針對有興趣的段落， 可直接點選右邊段落的裡的文字
建議：-This topic last update 這篇文章被更新的日期-Introduction 這個議題的簡介-Recommendations 提供及時的答案
Drug information : 藥物資訊由 Lexi-Comp 提供，若想要得到更詳細的資料， 可以點選具有超連結的藥名
此為另開一視窗以供瀏覽
-Reference 參考書目
圖表部份點選後則另開啟一個視窗以供瀏覽
- Export TO PowerPoint 直接將圖表轉入 PowerPoint- Print- Email- 亦可滑鼠移到圖片上方 , 按滑鼠右鍵 , 選擇”複製”
OutputPrint, Email, Save
-Print 若要列印請選擇此功能 可以完整的列出整篇文章 包括圖表在內 ( 若文章有附 )-Email 可以 email 文章內容 不包括圖表在內
- Save 直接點選 [ 檔案 ] [ 另存新檔 ]
帶出另存新檔的視窗檔名 : 直接帶入篇名存檔類型 : 網頁封存 , 單一檔案 , *mht
-Print 若要列印請選擇此功能 可以完整的列出整篇文章 包括圖表在內 ( 若文章有附 )-Email 可以 email 文章內容 不包括圖表在內
-星號欄位必填-Your name 為寄件人的名字-Your e-mail 為寄件人的帳號-E-mail address of recipient 為收件人的帳號- 填寫完畢後，點選 Send
cc
Patient Information
What’s New
提供各科別的新訊為重點式的說明
Calculators
輸入身高和體重切換成我們常用的單位 ( 公分和公斤 )
輸入完畢後BMI 值就呈現出來
Evidence Grading
Evidence Grading – UTD GRADE
RECOMMENDATION GRADES
Grade 1
Strong RecommendationBenefits clearly outweigh the risks and burdens (or vice versa) for most, if not all, patients “ We recommend…”
Grade 2Weaker Recommendation Benefits and risks closely
balanced and/or uncertain “ We suggest…”
EVIDENCE GRADES
Grade A High Quality Evidence
Consistent evidence from randomized trials, or overwhelming evidence of some other form
Grade BModerate 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
會放在特定的段落 : Recommendations
-點選 Evidence Grading 的超連結-會有說明的視窗出現
Others:Drug Interactions
ECGMovies
Feedback
Drug Interactions
-提供二種以上的藥物執行藥物交互作用-目前以美國藥品為主-來源 : Lexi-Comp
-一次輸入一種藥名-可輸入多種藥品-以以下藥品為例 aspirin grape seed lasix olistat
-輸入完畢-Analyze
-Risk rating 藥物交互作用的說明-點選超連結有藥物交互作結果的說明
若想知道單一藥品已知藥物交互作用的種類輸入藥名後再直接點選藥名即會出現
ECG test
-關鍵字 : ecg test -檢索結果第一至第三個為 ECG test 分為初級 Basic ，中級 Intermediate ，高級 Advanced
Movies in Graphics
-會依據文章內容所提及部份輔以圖表做說明-圖表的大標題為 : Graphics-之下再細分屬性，例如 echocardiograms, table, figure
-Movies 為影像檔-播放的軟體為： Apple Quick Time 此軟體為免費下載
-系統會先偵測電腦有無安裝 Apple Quick Time 有 : 會出現以下畫面 無 : 會出現請至網頁下載並安裝 Apple Quick Time 提示畫面
-右邊 為左邊心臟的定格，再加上文字說明-左邊 為影像檔 ，會跳動並自動重複播放
Feedback
-歡迎並感謝給予任何意見-Email 內容直接至美國主編群，並由主編群直接回覆
Q & A
Thank you for your attention
