2. MDConsult & FirstConsult Presented By: Lydia Lu Date:2008/4/30

3. Slide 2 MD Consult is designed to help physicians answer clinical questions and stay current with new developments in medicine. 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

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

5. 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

6. Slide 5 51 Reference Books

7. 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

8. 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

9. 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

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

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

12. 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

13. 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

14. 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

15. Slide 14 Top Clinics Series

16. Slide 15 Title 2006IF 1Adolescent Medicine Clinics#N/A 2Anesthesiology Clinics of North America#N/A 3Cardiology Clinics1.433 4Clinics in Chest Medicine1.991 5Clinics in Family Practice#N/A 6Clinics in Geriatric Medicine1.129 7Clinics in Laboratory Medicine1.904 8Clinics in Liver Disease#N/A 9Clinics in Perinatology1.405 10Clinics in Sports Medicine0.832 11Critical Care Clinics1.845 12Dermatologic Clinics1.179 13 Emergency Medicine Clinics of North America 0.672 14Endocrinology and Metabolism Clinics2.845 15Gastroenterology Clinics2.019 16 Hematology/oncology Clinics of North America 1.468 17 Immunology and Allergy Clinics of North America 3.178 Title2006IF 18 Infectious Disease Clinics of North America 1.642 19Medical Clinics of North America2.054 20Neurologic Clinics1.1 21Obstetrics and Gynecology Clinics0.825 22Ophthalmology Clinics of North America#N/A 23Orthopedic Clinics of North America2.5 24Otolaryngologic Clinics of North America0.911 25Pediatric Clinics of North America1.048 26PET Clinics#N/A 27Primary Care; Clinics in Office Practice0.588 28Psychiatric Clinics of North America#N/A 29Radiologic Clinics of North America2.533 30 Rheumatic Diseases Clinics of North America 2.568 31Sleep Medicine Clinics#N/A 32Surgical Clinics of North America1.656 33Ultrasound Clinics#N/A 34Urologic Clinics of North America1.819 Clinics in MDC

17. 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

18. 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

19. 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

20. Slide 19 Drugs Safety Notices FDA Approvals

21. 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

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

25. 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

26. 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

27. 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

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

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

30. Slide 29 瀏覽 Medical Topics

31. Slide 30 閱讀 Medical Topics

32. Slide 31 Differential Diagnosis

33. Slide 32 Viewing Search Results

34. Slide 33 Search Results

35. Slide 34 Case Study

36. 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

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

38. Slide 37 Acquire / Search Chronic Urticaria Cetirizine Fexofenadine

39. Slide 38 Search Resules

40. Slide 39 Books

41. Slide 40 1 Journals 2

42. Slide 41 Medical Topic

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44. Slide 43

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47. Slide 46 Lifestyle Level of Evidence

48. 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 !

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

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

51. Slide 50 My Folder Search Alerts Click on magnifying glass to set search alert Setup daily, weekly or monthly email notification Email 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

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

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

54. 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

55. Slide 54 Available now RSS Feed for News Allow customers to access news headlines from outside MD Consult Improvements to Journal / Book searching APIs Journal / Clinic searching via ISSN Improvements to book full text searching

56. Slide 55 Updated Content List http://eresourcesonline.com/resources

57. PubMed and MDC Elsevier HS B&J, Taiwan

58. 57 Milestones in NLM History http://www.nlm.nih.gov/about/nlmhistory.html 1836 Library of the Office of the Surgeon General of the Army established. 1879 First volume of Index Medicus published. 1956 October 1 Act of Congress moved Armed Forces Medical Library to Public Health Service (PHS) and rechristened it the National Library of Medicine (NLM). 1971 October MEDLINE was initiated to provide online access. 1993 October NLM's Internet World Wide Web site (www.nlm.nih.gov) appeared.www.nlm.nih.gov 1997 June 26 Web-based access to NLM's MEDLINE became available free of charge.MEDLINE 1998 October MedlinePlus created to provide access to consumer health information.MedlinePlus 2000 February 29 ClinicalTrials.gov, an online resource designed to give the public easy access to information about research studies, was launched.ClinicalTrials.gov

59. 58 美國醫學索引 （ Index Medicus ， 簡稱 IM ） MEDLINE 的前身為美國《醫學索引》 是當前世界上最著名的大型生物醫學文 獻檢索刊物， 1879 年創刊，由美國國立 醫學圖書館 (The National Library of Medicine) 編輯出版。

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62. 61 MEDLINE Database NLM 為迅捷地提供索引服務，自 1965 年開始以 IM 為基礎，利用電腦來處理資料，而建立了 MEDLARS 系統（醫學文獻分析與檢索系統）； 截至目前為止該系統約有 36 個資料庫，而其中使 用最頻繁且最重要的資料庫則為 MEDLINE 。 MEDLINE 資料庫自 1966 至現在，一億六千多萬 書目資料，且每個月以 20000 筆的速度增加。收 錄數千種全世界著名且各學科權威之期刊。

63. 62 What is PubMed? PubMed is a service of the U.S. National Library of Medicine that includes over 16 million citations from MEDLINE and other life science journals for biomedical articles back to the 1950s. PubMed includes links to full text articles and other related resources.U.S. National Library of Medicine PubMed 是美國國家醫學圖書館對全球所提供的服務， 其中 MEDLINE 提供了一億六千多萬筆期刊的引用與 索引，最久遠至 1950 年，當然 PubMed 也提供了使用 者快速方便的可以連結至全文的服務。

64. 63 What function does PubMed have? Online Demo Browse Searching Relative article Linkout Limit Combine MeSH Individual account setting Clinical Query PubMed® Online Training

65. 64 Clinical Pharmacology 3.0 Elsevier Taiwan LLC 程世仁 2008

66. 65 What is Clinical Pharmacology  CP is designed to provide timely, concise drug information and clinical tools for medical professionals and health care consumers. -- produced by Gold Standard

67. 66 Peer-reviewed Articles 評估 撰寫審查 發表 References FDA drugwatch Pharmacology Journals Text books 藥劑師 藥學專家 毒理學專家 臨床醫師 EBM 專家

68. 67 Features 友善界面友善界面 功 能 導 向 內 文 簡 潔 即時更新即時更新

69. 68 Clinical Pharmacology Content

70. 69 Drug Monograph Content (2713)  US centric  Prescription, Over-the-Counter, Herbal, Nutritional, Investigational  “Off-Label” Uses: A term used in the U.S> for non-FDA approved uses of the drug Drug Product Content  US centric  Ingredients, Dosage Forms, Images, Descriptors Searching Capabilities  Brand or Generic Name  Global Drug Name Directory: global drug names, brand and generic  Indication  Drug Classification  Adverse Reaction Report Features  Drug Interaction  Adverse Reaction  IV Compatibility  Product Identification Drug Comparison Features Drug Calculators Patient Education (US Centric: English and Spanish) Clinical Pharmacology - Content

71. 70 藥物專題 (Drug Monograph) Aspirin Rx OTC Herbal Nutritional Investigational By drug name By indication By precaution By adverse reaction By NDC By manufacturer

72. 71 General Search  Key word: Drug name CI/Precaution Adverse Reaction Indication  Tips: Type the first 2 characters, e.g. “as” Type 3 or more characters, e.g. ”olol”

73. 72 MedGuides from FDA

74. 73 Patient Education  MedCounselor Sheet

75. 74 Report  Drug Interaction Reports  Product Comparison Report  IV Compatibility Report  Adverse Reaction Report  Clinical Comparison Report  Patent Peport

76. 75 Drug Interaction Reports

77. 76 Drug Interaction for consumer

78. 77 Product Comparison Report

79. 78 IV Compatibility Report

80. 79 Adverse Reaction Report

81. 80 Clinical Comparison Report Indication Adverse reaction contraindication Drugs

82. 81 Patent Report

83. 82 FIND/LIST - By Multiple Criteria

84. 83 Resource Center  Calculators  Lab Reference  Drug Class Overviews  Manufacturer contact info  ToxED History Mechanism of Action Distinguish features Adverse Reaction

85. 84 Clinical Pharmacology Additional Function

86. 85 Drug Identifier

87. 86 Global Drug Names

88. 87 Online Demo CP URL http://cp3.clinicalpharmacology-ip.com Thanks for your attention