Influence Impact Knowledge Authority BMJ Publishing Group: Your gateway to essential clinical research and knowledge Pauline Dilworth Library Sales Executive

BMJ PG Today’s presentation… Current online products: –Clinical Evidence –Best Treatments –BMJ Journals Online Collection –bmj.com New developments at BMJ PG BMJ PG consortium offer to ANKOS members

An international ‘digest’ of the best available evidence for effective health care Covers 200+ clinical conditions and over 2000 treatments Gathers good quality evidence Provides detailed background on each condition and summaries of the best evidence on the benefits and harms of interventions Gives a list of key outcomes that matter to patients What is Clinical Evidence?

How is Clinical Evidence put together? Addresses common questions on conditions raised by clinicians In response to each question the major medical databases and websites are searched Results are appraised following recognised criteria Good quality evidence is combined into structured summaries Peer reviewed before publication Process is repeated every twelve months

How does Clinical Evidence overcome many of the barriers to practice of Evidenced-Based Medicine? Time - Easily accessible information on your desk Information Overload - We trawl all the relevant research so you don’t have to Up to Date - Online edition updated and expanded monthly Clinical Evidence

Rating the research in Clinical Evidence Beneficial Likely to be beneficial Trade off between benefits and harms Unknown effectiveness Unlikely to be beneficial Likely to be ineffective or harmful

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Lipodystrophy syndrome: There is increasing concern about the association between antiretroviral treatment and lipodystrophy syndrome.[28] This syndrome consists of elevated serum lipid levels, redistribution of fat storage in the body leading to changes in body shape (morphological lipodystrophy), and insulin resistance. One systematic review (search date 2002, 14 RCTs, 57 observational studies, narrative synthesis only) concluded that there was evidence that use of protease inhibitor based regimens was associated with increased serum levels of total cholesterol, triglycerides, and low density lipoprotein, and with morphological changes in vasculature known to be associated with increased cardiovascular risk (carotid intima thickening or presence of atherosclerotic lesions).[29] Preliminary evidence from long term observational studies suggested that protease inhibitor use may increase the risk of myocardial infarction.[29] Morphological lipodystrophy is often a cause of psychological distress, loss of quality of life, and treatment non- adherence in people on.[28] [30] There is considerable variability in the definition of syndromes involving body fat distribution anomalies.[31] Therefore, estimates of the prevalence of morphological lipodystrophy differ. Prospective observational studies suggest that some patterns of adipose tissue maldistribution may be associated with high adherence to treatment, increasing age, and female gender.[30] [32] [33] Although morphological lipodystrophy was initially thought to be associated with protease inhibitor use, some NRTIs (notably stavudine) have also been suggested to play a role in their development.[21] [32][33][34] Observational studies have estimated that in people receiving protease inhibitor based antiretroviral treatment the prevalence of diabetes is about 6 7%, whereas 16 18% have impaired glucose tolerance.[35] [36] Further studies are needed on the issue of glucose intolerance New Harms

What is Best Treatments? Evidence based website explaining 60 of the commonest medical conditions and 20 surgical procedures Designed to help patients make informed treatment decisions about their care in consultation with doctors and nurses “Translation” into jargon free, language that the patient can understand

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BMJ Journals Online Collection 22 BMJ specialist Journals published by BMJ Publishing Group Ltd in conjunction with other professional bodies such as the British Cardiac Society and EULAR. Includes 3 evidence based medicine journals Leaders in their field covering a wide range of specialities e.g. Heart, Gut, Thorax All BMJ Journals available online hosted by HighWire Press: search across 340 journals!

BMJ Journals Online Collection Full text in html and pdf formats Fully searchable archive Additional material not included in print versions Toll free links from references to full text of more than 340 journals hosted by HighWire Cross-journal searching Direct access to Medline

BMJ Journals Online Collection Online First publishes ahead of print a friend facility to send the abstract of an article directly to a colleague Previews of future issues TOC alerts CiteTrack service Submission and review of manuscripts online eLetters - comment on articles online

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bmj.com The British Medical Journal is published weekly in print and online rigorous and accessible material, including: original scientific studies, review and educational articles, and papers commenting on the clinical, scientific, social, political, and economic factors affecting health articles submitted, only around 10% are selected after rigorous peer review Over a million visitors a month to the web-site Original research papers are freely available and deposited in PubMed Central Backfiles will be freely available after 12 months

bmj.com Online features similar to Journals Online Collection: Inter-journal links, Cross-journal searching, alerts, Cite track, citation manager, usage statistics, printing and PDFs, news alerts Electronic Long, Print Short (ELPS) Rapid responses “…probably the place to debate a hot medical issue.” Topic collections Theme issues and series

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New Developments: BMJ Learning A service to help doctors meet their revalidation requirement for continuous professional development. Offers a mix of clinical and professional modules Currently offered free of charge!

Collaboration between BMJ PG and McMaster University’s Health Information Research Unit Searchable database of the best evidence from over 100 premier clinical journals alerting system bringing the best medical evidence straight to your inbox Register for free access at bmjupdates.com New Developments: BMJ Updates

Future Developments: Clinical Evidence Diagnosis

Deeply-discounted prices available to ANKOS members participating in the BMJ PG consortium offer Online-only access: GBP £3000 for BMJ Journals Online Collection GBP £315 for bmj.com GBP £2100 for Clinical Evidence BMJ PG: ANKOS Consortium Offer

For more information contact: Pauline Dilworth at Or Gussun Gunes at Thank you!