MDConsult & FirstConsult Presented By: 王信傑 Ricky Wang Date:2008/7/23

Slide 2 Leading medical reference books (51) Full-text journals and Clinics of North America with MEDLINE (87) Nearly 10,000 customizable patient handouts Drug Database provided by Gold Standard The latest medical news More than 1,000 peer-reviewed practice guidelines Over 50,000 images that can be downloaded or printed POCKET Consult – free for your PDA

Slide 3 十大主題 First Consult Books Journals The Clinics Patient Education Drugs Guidelines Images News CME

Slide 4 Books 可針對整個書庫中的書籍 進行搜尋 提供索引及目次，方便您 的點閱及搜尋 可儲存最近的搜尋記錄及 搜尋結果 ( 個人化功能 ) * 需先註冊個人帳密功能

Slide 5 51 Reference Books

Slide 6 Journals 收錄 87 種期刊 包括著名的 《 The Clinics of North America 》及 《 Yearbook 》 同時搜尋 Medline 資料庫 每篇全文文章均包括 書目資料及目錄

Slide 7 Journal Search 簡單而靈活的搜尋選項方便進行精確檢索 年限設定 文章類別 受試者年齡 按全文 / 相關性、相關性或出版日期排序 年鑑的文章附於原著期刊文章 評論性文章 (REVIEW) 在搜尋結果中以旗標識別

Slide 8 全文期刊 HTML Elservier 所出版的期刊 和 Clinics 均提供全文內 容 包含超過 30,000 篇文章 Back Issue 可回溯至 1996 年

Slide 9 Journal PDFs 允許使用者瀏覽、下 載和列印 PDF 文章

Slide 10 Over 80 full-text journals and Clinics of North America Titles Overlap with 2006 JCR Journals5340 Clinics3425 Total8765 Journal Resources

Slide 11 Critical Care Medicine 2/18 Journal of Allergy and Clinical Immunology 1/16 Anesthesiology 2/22 The Lancet Infectious Diseases 1/47 Annals of Emergency Medicine 1/11 Journal of Pediatrics 4/74 The Lancet Neurology 1/146 Journal of the American Academy of Child and Adolescent Psychiatry 2/74 The Top 8 Journal Titles

Slide 12 Across 32 medical subjects 1.EMERGENCY MEDICINE 2.UROLOGY & NEPHROLOGY 3.GERIATRICS & GERONTOLOGY 4.MEDICINE, GENERAL & INTERNAL 5.CRITICAL CARE MEDICINE 6.ALLERGY 7.ANESTHESIOLOGY 8.CARDIAC & CARDIOVASCULAR SYSTEMS 9.INFECTIOUS DISEASES 10.DERMATOLOGY 11.ENDOCRINOLOGY & METABOLISM 12.GASTROENTEROLOGY & HEPATOLOGY 13.OBSTETRICS & GYNECOLOGY 14.ONCOLOGY 15.OPHTHALMOLOGY 16.EMERGENCY MEDICINE 17.HEMATOLOGY 18.IMMUNOLOGY 19.MEDICAL LABORATORY TECHNOLOGY 20.ORTHOPEDICS 21.OTORHINOLARYNGOLOGY 22.RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING 23.RHEUMATOLOGY 24.PEDIATRICS 25.CLINICAL NEUROLOGY 26.PSYCHIATRY 27.RESPIRATORY SYSTEM 28.SPORT SCIENCES 29.SURGERY 30.UROLOGY & NEPHROLOGY 31.PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH 32.NUTRITION & DIETETICS Note: According to JCR report category

Slide 13 The Clinics 提供 34 種最具權威的 北美臨床雜誌 每篇全文文章均包括 書目資料及目錄 簡單而靈活的搜尋選 項方便進行精確檢索 回溯至 2002 年

Slide 14 Top Clinics Series

Slide 15 Title 2006IF 1Adolescent Medicine Clinics#N/A 2Anesthesiology Clinics of North America#N/A 3Cardiology Clinics Clinics in Chest Medicine Clinics in Family Practice#N/A 6Clinics in Geriatric Medicine Clinics in Laboratory Medicine Clinics in Liver Disease#N/A 9Clinics in Perinatology Clinics in Sports Medicine Critical Care Clinics Dermatologic Clinics Emergency Medicine Clinics of North America Endocrinology and Metabolism Clinics Gastroenterology Clinics Hematology/oncology Clinics of North America Immunology and Allergy Clinics of North America Title2006IF 18 Infectious Disease Clinics of North America Medical Clinics of North America Neurologic Clinics1.1 21Obstetrics and Gynecology Clinics Ophthalmology Clinics of North America#N/A 23Orthopedic Clinics of North America2.5 24Otolaryngologic Clinics of North America Pediatric Clinics of North America PET Clinics#N/A 27Primary Care; Clinics in Office Practice Psychiatric Clinics of North America#N/A 29Radiologic Clinics of North America Rheumatic Diseases Clinics of North America Sleep Medicine Clinics#N/A 32Surgical Clinics of North America Ultrasound Clinics#N/A 34Urologic Clinics of North America1.819 Clinics in MDC

Slide 16 Patient Education 超過 10,000 篇衛教 可供印列及修訂 每篇長度為 1 ~ 2 頁 允許加註訊息給病患

Slide 17 Drugs 提供藥物商品的圖片 藥物資訊包含： 藥物分類、別名、學名 副作用 交互作用 藥物動力學、機轉 分子結構 … 等相關藥物 資訊

Slide 18 Drug Look-Up ( 藥物搜尋 ) 通過以下四大類別搜尋指定藥物： 商品名 + 適應症 商品名 適應症 禁忌

Slide 19 Drugs Safety Notices FDA Approvals

Slide 20 Guidelines ( 診療指南 ) 超過 1,000 份同儕評鑑 臨床診療指南 (Peer- Review Articles) 按照作者、機構、專 科及主題方式分類 每篇全文文章均包括 書目資料及目錄

Slide 21 Medical Images ( 圖片 ) 超過 50,000 張圖片 可供查詢 及 圖片比對 來源：資料庫中的 Books

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Slide 23 News ( 新聞 ) 每日更新 提供最新醫學發展新知 當週新聞

Slide 24 Global Search ( 整合搜尋 ) 同時檢索整個資料 庫內容 提供下拉式選單進 行快速檢索

Slide 25 Recommended Results ( 建議結果 ) Recommended Results 是根據過去 點閱記錄而整理出來 的結果

Slide 26 Top Search Results ( 檢索結果 ) 檢索結果會顯示出 每一主題當中的前 三筆資料 顯示檢索結果筆數

Slide 27 Refine Your Search ( 精確檢索 ) 畫面右方提供建議的 精確檢索

Slide 28 Searching First Consult 提供最新 的鑑別診斷 、 評估 、 結 果 、 預後等資訊

Slide 29 瀏覽 Medical Topics

Slide 30 閱讀 Medical Topics

Slide 31 Differential Diagnosis

Slide 32 Viewing Search Results

Slide 33 Search Results

Slide 34 Case Study

Slide 35 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 clinical expertisepatient values 4.Integrate with our clinical expertise and patient 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 實證醫學的五大進行步驟 Five Steps to Practice EBM

Slide 36 Case PICO 對於 慢性蕁麻疹 (chronic urticaria) ， Zyrtec 與 Allegra 的那一種治療效果比較好呢？ P Urticaria Urticaria I Zyrtec (Cetirizine, 驅特異膜衣錠 ) Zyrtec (Cetirizine, 驅特異膜衣錠 ) C Allegra (Fexofenadine, 艾來錠 ) Allegra (Fexofenadine, 艾來錠 ) O Which one is better?

Slide 37 Acquire / Search Chronic Urticaria Cetirizine Fexofenadine

Slide 38 Search Resules

Slide 39 Books

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Slide 41 Medical Topic

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Slide 46 Lifestyle Level of Evidence

Slide 47 Case PICO 慢性蕁麻疹 (chronic urticaria) ， Xyzal 與 Allegra 的那一種效果比較好呢？ PUrticaria I Xyzal (Ceterizine, 驅異樂膜衣錠 ) C Allegra (Fexofenadine, 艾來錠 ) O Xyzal is better !

Slide 48 My Folder Personal filing tool Save and organize information Save searches for easy reuse Set Search Alerts Access folders from any computer

Slide 49 Add to Folder Bookmark information to My Folder Easy to access for future use Title the bookmark any way you choose

Slide 50 My Folder Search Alerts Click on magnifying glass to set search alert Setup daily, weekly or monthly notification can include: New results with summary New results without summary All results with summary All results without summary Folder link to new results Folder link to all results

Slide 51 News Customization Select the specialty areas of interest to you News stories in these areas will appear first

Slide 52 to Colleague From any of the content, you can a colleague a link with a personalized note * The colleague must be a subscriber to access the article/information

Slide 53 Log Off Located in the upper right corner Click once you have finished your time on the service MD Consult will automatically log users off after 15 minutes of inactivity

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