Transcript DynaMed Plus

MISSION
Committed to improving
patient care by providing the most
CURRENT CLINICAL
EVIDENCE TO CLINICIANS
so they can make the best decisions
for their patients.
The Next Generation Clinical
Information Resource
• Re-created from
the ground up
• New search
algorithm
• New physician
leadership
• New interface
• New platform
• New content
• New features
Created by
physicians who are
A TOOL
…Not a textbook
EXPERTS
in their
respective fields
who provide
OBJECTIVE ANALYSIS
of the evidence &
recommendations
in an easily
digestible format
with access anytime,
anywhere from any
device or system
TOP FIVE OBJECTIONS
to DynaMed vs. UpToDate
• It doesn’t tell me what to do
• Lack of expert reviewers
• Lack of specialty content
• There are no images
• It’s hard to get an answer quickly
It doesn’t tell me
what to do
OVERVIEWS AND
RECOMMENDATIONS
• Overviews and Recommendations provide
clinicians with concise, accurate overviews
for highly relevant topics and evidencebased recommendations for action.
• Topics have been re-written from scratch to
provide immediate context and direction
New Overviews and
Recommendations at the top
DynaMed Plus offers many
examples of strong and weak
recommendations
Clicking on a link provides the
user with levels of evidence
and guidelines behind each
recommendation
DynaMed Plus provides links to
the levels of evidence and the
guidelines behind each
recommendation
The GRADE (Grading of Recommendations Assessment,
Development and Evaluation) system was created in 2000
by a dedicated group of guideline developers.
What is GRADE?
RECOMMENDATIONS
are graded as Strong or Weak
EVIDENCE
is graded for the body of evidence as High, Moderate, Low or Very low
quality (A, B, C, or D).
QUALITY
grading for evidence is based on the risk of bias introduced by study
methodology, the precision the consistency of studies, the directness to the
conclusion being made, and the likelihood of publication bias.
GRADE is now the standard
GUIDELINE GROUPS
More than 80 of the world’s leading organizations which
produce guidelines formally use GRADE:
SYSTEMATIC REVIEWS
Independent systematic
review organizations such
as Cochrane have
incorporated GRADE
•
WHO
•
CDC
•
The Endocrine Society
•
AGA
•
ACCP
•
AASLD
•
ACP
•
ICSI
•
American Thoracic Society
•
NICE
•
NKF/KDOQI
•
SIGN
•
KDIGO
•
NHS
•
Norwegian Knowledge Center /
Norwegian Directorate of Health
•
Kaiser Permanente
•
Dutch College of GPs
•
Canadian Cardiovascular Society
•
Multiple Red Cross groups
•
IDSA
DynaMed Plus
EVIDENCE-BASED
METHODOLOGY
Lack of
expert reviewers
Editorial
LEADERSHIP
BRIAN S. ALPER, MD,
MSPH, FAAFP
Founder of DynaMed, VP of EBM
Research & Development, Policy
and Content Quality, EBSCO
Information Services, Clinical
Research Assistant Professor
Department of Family and
Community Medicine, University
of Missouri School of Medicine
Columbia, MO
ALAN EHRLICH, MD
SHEILA BOND, MD
Executive Deputy Editor
Assistant Clinical Professor in
Family Medicine, University of
Massachusetts Medical School
Worcester, MA
Deputy Editor of Infectious
Disease, Clinical Instructor in
Medicine
Harvard Medical School
Boston, MA
PETER OETTGEN, MD, FACC
KEVIN LOUGHLIN, MD, MBA,
MA(HON)
Deputy Editor of Cardiology
Director of Preventative Cardiology,
Beth Israel Deaconess Medical
Center, Associate Professor
Harvard Medical School
Boston, MA
Deputy Editor of Oncology and
Hematology, Senior Surgeon
Brigham & Women's Hospital
Professor of Surgery, Harvard
Medical School, Boston, MA
FULLY INTEGRATED
EXPERTS
• An extensive
network of physicians
• Experts in their particular fields
• Select the best and most appropriate evidence
• Confirm the clinical applicability of content
• Peer-review topics
Matthew Coggins, MD
Michelle Lin, MD
Instructor of Cardiology
Harvard Medical School
Beth Israel Deaconess Medical Center
Associate Professor of Clinical Emergency Medicine
Academy Endowed Chair for Emergency Medicine
Education
University of California San Francisco
Kevin Ard, MD
Instructor of Medicine
Harvard Medical School
Assistant in Medicine
Division of Infectious Diseases
Massachusetts General Hospital
Jennifer Nan-Wah Wu, MD
Instructor of Pediatric Oncology
Dana-Farber Cancer Institute
Boston Children's Hospital
Dawn Abbott, MD, FACC, FSCAI
Jennifer Johnson, MD
Instructor in Medicine
Division of Infectious Diseases
Harvard Medical School
Brigham and Women's Hospital
Muhammad Mir, MD, FACP
Assistant Professor of Hematology and Blood/
Marrow Transplant
Penn State University
Milton S. Hershey Medical Center
Obinna O. Adibe, MD
Assistant Professor of Pediatric Surgery
Duke University Medical Center
Associate Professor of Medicine, Brown University
Director of Interventional Cardiology Fellowship
Rhode Island and Miriam Hospitals
Christian Jackson, MD
Assistant Professor of Gastroenterology
Loma Linda University
Chief of Gastroenterology
Loma Linda VA Healthcare System
Kenneth Weiss, MD, FACP
Professor of Medicine
Cleveland Clinic Lerner College of Medicine
Physician Executive Board
We have established an
EXECUTIVE BOARD
charged with advising on editorial, EBM, and
editorial policy
Members represent JAMA, McMaster,
Penn, Emory, MGH, ACP and other
healthcare organizations.
Betsy Jones
Ilkka Kunnamo, MD, PhD
Vice President of Medical Product
Management and Chief Content Officer,
EBSCO Health
Founder and Editor-in-Chief of EBM Guidelines
and EBMeDS decision support program
Amir Qaseem, MD, PhD, MHA, FACP
Michael Berkwits, MD, MSCE
Deputy Editor for JAMA
Director of the Department of Clinical Policy at
the American College of Physicians
Robert M. Centor, MD, MACP
Dr. Surendra K. Sharma, MBBS, MD, PhD
Chair of the Board of Regents for the
American College of Physicians
Chief of the Division of Pulmonary, Critical
Care, and Sleep Medicine at the All India
Institute of Medical Sciences
Julie Hollberg, MD
CMIO for Emory Healthcare
Craig Umscheid, MD, MSCE
William A. Kormos, MD, MPH
Assistant Professor of Medicine and
Epidemiology at the University of Pennsylvania
School of Medicine
Chief of Medicine at the James Howard
Means Firm, Department of Medicine
Holger Schünemann, MD, MSc, PhD
Professor and Chair of the Department of
Clinical Epidemiology & Biostatistics
Lack of
specialty content
Editorial team structure
SPECIALTY PUBLISHING GROUPS:
• General Internal Medicine
• Cardiology/Pulmonology/Critical Care
• ID/Immunology
• Oncology/Hematology
• Emergency Medicine
Editorial team structure
EXPERTS RECRUITED FROM:
• Harvard University
• Massachusetts General Hospital
• Beth Israel Deaconess Hospital
• Yale
• Brigham and Women’s Hospital
• Dana Farber Cancer Institute
• University of California San Francisco
• Cleveland Clinic
AND MORE…
ROBUST SPECIALTY
CONTENT
•
Allergy
•
Obstetrics and Gynecology
•
Cardiology
•
Oncology
•
Critical Care
•
Orthopedics
•
Dermatology
•
Pediatrics
•
Infectious Disease
•
Primary Care
•
Emergency Medicine
•
Psychiatry
•
Endocrinology
•
Rheumatology
•
Gastroenterology
•
Sports Medicine
•
Hematology
•
Surgery
•
Nephrology
•
Urology
There are
no images
DynaMed Plus includes more
Selecting
imagewith
provides
than 4,000animages
more
the
user
a
larger
view
than 2000 from ACP. Images
are searchable as well as
embedded in relevant topics
It’s hard to get an
answer quickly
Precise Search Results
Search
employs a brand-new, proprietary, semanticallypowered search engine, significantly improving
discoverability and speed-to-answer
DynaMed Plus employs
intelligent auto-suggest, which
identifies the user’s query and
allows direct navigation to
highly-accessed areas within
topics
Convenient filters allow quick
access to images and
calculators that are relevant to
the user’s query
DynaMed Plus offers superb
navigation within the results
display
With exact-match queries,
DynaMed Plus displays a
medical information placard,
offering topic-specific links,
images, and information
By understanding the user’s intent,
DynaMed Plus’ intelligent search is able
to identify queries that yield robust
image results and display them in a
time-saving image carousel
This same technology
presents the user with
query-specific
calculators
Grouped results allow the clinician
to quickly understand the context
of the result
EXAMPLE: Result shows
Pulmonary embolism within the
Heart failure with reduced
Relevant
results
ejection fraction
topic,
and will
the
navigate
userstodirectly
path provides
the context
thethe
specific
understandto
that
result section
refers
DynaMed Plus’
to treatmentwithin
medications
clinically relevant
outline-based structure
Topic view offers nextgeneration navigation,
Location
within the topic
providing
immediate
is dynamically
context
to the userupdated
both in the navigation
bar, as well as within the
breadcrumb trail at the
top of the screen
DynaMed Plus offers all
of the same quickaccess features users
have come to expect,
including search within
and highlighting
DynaMed Plus employs a
FULLY RESPONSIVE DESIGN,
which means it renders ideally for
any device or orientation
iPhone
Small Tablet
iPad - Portrait
iPad - Landscape
iPhone
Small Tablet
iPad - Portrait
iPad - Landscape
EHR Integration
EBSCO Health listens to the needs of our customers
and users which helps us build better products
DynaMed Plus has….
overviews and recommendations
well-known expert reviewers
increased breadth/depth of specialty content
multimedia content
better search & discovery
MICROMEDEX DRUG CONTENT
Micromedex evidence-based content is presented in concise,
sourced, and referenced blocks of information to help you get
answers quickly when the situation demands.
• Medication Management Standard Drug Information
• Drug Information for Medication Safety
• IV Compatibility for Reduced Complications
• Lab Recommendations
ACP Partnership
• ACP clinical leadership
develops and maintains
DynaMed Plus internal
medicine topics
• Multiple members of ACP
are part of the DynaMed
Plus Executive Board
Access anywhere, anytime
SUMMARY OF NEW FEATURES
Graphics & Images
Access thousands of graphics
and images
Overviews &
Recommendations
Precise Search
Results
Read concise overviews
and detailed
recommendations
Get precise search results
every time
Specialty Content
DynaMed Plus includes robust
specialty content
Expert Reviewers
Mobile App
Drug Content
Deputy Editors are
supported by an extensive
network of clinical experts
The mobile app is
complimentary with every
subscription, at no extra
cost
Drug content to help with
diagnosis with Micromedex®
Clinical Knowledge Suite
GRAZIE
Fabio Di Bello | Regional Manager Italy & Israel
[email protected]
349.4157827
Resources to Consider:
ACP Pier
BMJ Point of Care
Cochrane Library
DynaMed
Up-to-Date
Who can find the answer most
quickly? Use any resource.
Round 1, Question 1
• Is glatiramer acetate effective for relapsingremitting multiple sclerosis? How does it
compare to interferon beta?
Round 1, Question 2
What antibiotic should you use for a
pregnant woman with acute cystitis?
Round 1, Question 3
• What is the dose of famciclovir for treating
zoster in an immunocompetent patient?
Round 1, Question 4
• Are graduated compression stockings effective
for reducing the risk for venous
thromboembolism after acute stroke?
Round 1, Question 5
• You have a new patient who is an adolescent
with obsessive-compulsive disorder. Her
parents state this is due to a strep throat. What
are the criteria for Pediatric Autoimmune
Neuropsychiatric Disorders Associated with
Streptococcal infection (PANDAS)?
Round 1, Question 6
• How do you diagnose chronic fatigue
syndrome?
Round 1, Question 7
• A 45-year-old man complains of shortness of
breath for two hours and there was a sudden
onset. Two days ago he traveled 12 hours by
airplane. He has no history of prior
thromboembolism, cancer, or other medical
conditions. He has tachycardia (pulse 106
beats/minute) but otherwise normal findings on
physical examination. Would you classify his
risk for pulmonary embolism as high,
Round 1, Question 8
• For the man with an intermediate risk of
pulmonary embolism, what testing should you
do? Consider the resources available for
testing in your setting.
Round 1, Question 9
• How do triflusal and cilostazol compare to
aspirin for secondary prevention of stroke in a
patient with a history of transient ischemic
attacks (TIAs)?
Round 1, Question 10
• What is the most effective antibiotic for
uncomplicated symptomatic urinary tract
infection in women?
Round 2
• Check different resources to see if the
answers are consistent. If not, why not?
Round 2, Question 1
• A 3 year-old girl weighing 13.3 kg (30 lbs) has
rotaviral gastroenteritis and moderate
dehydration. How do you start fluid
replacement?
Round 2, Question 2
• A man complains of sudden sensorineural
hearing loss. You prescribe steroids. Should
you also include antiviral therapy as part of your
treatment plan?
Round 2, Question 3
• You are establishing a protocol for response to
patients who develop anaphylaxis in your
medical practice. The nurse asks if epinephrine
administration can be given subcutaneously
instead of intramuscularly. Is there a difference
in efficacy between the subcutaneous and
intramuscular routes?
Round 2, Question 4
• You are seeing a 22-month-old boy in follow-up
after treatment for a urinary tract infection (UTI).
He was found to have grade II vesicoureteral
reflux (VUR). You wonder if you should start an
antibiotic for prophylaxis, and if so, which
antibiotic?
Round 2, Question 5
• How do you diagnose irritable bowel syndrome
(IBS)? What evaluation is indicated?
Round 2, Question 6
• You diagnosed irritable bowel syndrome. Is fiber
an effective treatment?
Round 2, Question 7
• Do antihypertensive medications reduce
cardiovascular events in a patient with mild
hypertension (blood pressure 145/95 mmHg)
and no other cardiovascular risk factors?