Transcript Best Practice

来自BMJ的全新的循证医学在线资源
--帮助临床医生有效解决诊、治疑问的权威工具
王赫 BMJ Group
[email protected]
26th June 2008
Do you ever use it?
BMJ Clinical Evidence
“临床证据”
基于现有各种原始研究证据资源，针对重要的临床问题高度提炼后的总汇。
The evolution of Evidence-Based
information systems
Systems
Examples
Computerized decision
support
电子临床资讯系统
Summaries
Evidence-based textbooks
针对临床问题结合证据的概述
(Clinical Evidence)
Synopses
(Evidence Based Medicine)
Syntheses
(Cochrane Library / PubMed-Systematic Review)
Studies
(PubMed –Clinical study search)
Evidence-based journal
abstracts
单篇循证文献摘要性评述
Systematic reviews
系统性综述
Original journal articles
原始研究文献
What is new in Best Practice? 新在何处？
For each condition, Best Practice covers the following categories:
对每一种收录的疾病都提供了标准结构内容：
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Highlights 要点: Summary / Overview
Basics 基础: Definition / Epidemiology / Aetiology / Pathophysiology / Classification
Prevention 预防: Primary / Screening / Secondary
Diagnosis 诊断: History & Examination / Tests / Differential / Step by Step / Criteria
/Guidelines / Case History
Treatment 治疗: Details / Step by Step / Emerging / Guidelines / Evidence
Follow-up 随访: Recommendations / Complications / Prognosis
Resources 参考资料: References and Links / Images / Online resources / Patient
Leaflets/Credits
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Standard Monograph 标准界面
Comprehensive information on a specific condition or group of conditions.
显示单个或多个病症的综合信息
• It covers all aspects of the disease including: basic information, prevention,
diagnosis, follow up-recommendations and resources
A standard monograph for
Vitamin C deficiency
Standard Monograph 标准界面
Highlights要点
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Summary 总结: Key highlights
on the topic present the
essential facts.
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Overview 概览: History and
exam factors, diagnostic tests
and patient groups with
treatment types are listed to
provide a brief synopsis of
diagnosis and treatment.
Standard Monograph 标准界面
Basics基础
Prevention预防
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Fundamental information on the
topic is provided on the definition,
epidemiology, aetiology,
pathophysiology and classification.
Primary and secondary prevention
are discussed. Information on
population screening is provided for
applicable topics.
Standard Monograph 标准界面
Diagnosis诊断
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病史和检查 This section takes the user through the process of
diagnosis, addressing history and examination, diagnostic tests before
elaborating on any possible differential diagnosis.
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分步诊断 The Step-by-Step section guides the user through a verbal
algorithm of the approach to diagnosis.
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指南 Guidelines appropriate to diagnosis of the condition are listed from
international and regional organisations. The user can also upload
further guidelines from their local institutions.
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病例 Case history describes one or two patient vignettes and may also
discuss other less common presentations.
Standard Monograph 标准界面
Treatment治疗
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治疗内容 Details on treatment conditions are provided according to
recognised patient groups. Treatment is tiered according to primary, secondary
and tertiary treatments. Comments provide information regarding treatment
type, and medications are listed with dosing detail.
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分步治疗 The "Step-by-Step" section provides an overview of how to treat the
condition. It may also provide additional information on specific medications.
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新的方法 Emerging treatments are discussed and may include those that are
still undergoing trials or those that may have been approved but not yet in use.
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证据 Evidence, when available, is provided in the form of evidence pop-ups.
Users have the opportunity to link to discussion of the evidence on the Clinical
Evidence website or within specific articles or systematic reviews. Links to
evidence for all interventions for the same topic discussed in Clinical Evidence
are also provided
Standard Monograph 标准界面
Follow-up随访
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Recommendations, complications and prognosis are discussed.
Resources文献资源
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参考文献 References are listed; key references highlighted. Most references have
abstract and/or full text links.
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图片资料 Images are presented within the image library and can also be found as
image tags providing a pop-up image within the text of the monograph.
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在线资源 Online resources appropriate to the topic may be listed and link to
organisations providing further information on the condition and useful resources
used in diagnosis such as patient questionnaires
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患者教育 Patient leaflets from Best Health are provided for relevant and available
Best Health topics.
Assessment Monograph分析和评估界面
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Information on how to evaluate a symptom, clinical finding or diagnostic test
finding 提供关于如何分析症状、临床发现或诊断性检测发现的信息
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It is presented in the following format: overview, emergencies, diagnosis and
resources 包括概览，急诊，诊断和文献资源四个部分
An assessment monograph
for chronic cough
Assessment Monograph分析和评估界面
Overview 概览
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Summary may include
information on definition,
epidemiology, pathophysiology
and classification as well as
any additional pertinent
information on the topic.
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Aetiology discusses or lists the
various differentials causing
the symptom, clinical or test
finding
Assessment Monograph分析和评估界面
Emergencies 急诊
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列出可能的疾病以及紧急考虑给予
的治疗方法 Emergencies list
those conditions to which urgent
consideration of treatment should
be given
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Brief information on emergency
treatment may be given and users
can also click through to the
standard monograph on a topic
for further treatment information.
Assessment Monograph分析和评估界面
Diagnosis诊断
Step-by-step section 分步诊断
• This section guides the user through a
verbal algorithm of the approach to
diagnosis and assists them to arrive at
the differential diagnosis.
Differential diagnosis鉴别诊断
• Each individual differential diagnosis
is listed with details on history,
examination and tests.
Assessment Monograph分析和评估界面
Resources 文献资源
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文摘或全文链接 References are listed: key references highlighted.
Abstract and/or full text links.
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图片和影音资料 （下载保存）Images are presented within the image
library and can also be found as image tags providing a pop-up image
within sections of the monograph
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专业网站 Online resources appropriate to the topic may be listed and
link to organisations providing further information on the condition and
useful resources used in diagnosis such as patient questionnaires.
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患者教育信息 Patient leaflets from Best Health are provided for relevant
and available Best Health topics.
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作者和评审专家信息 Credits list the author and peer reviewer details.
Best Practice
Best Practice from the BMJ Evidence Centre is a new,
comprehensive online decision-support tool designed to be used at
the point of care.
Highlights 要点
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一万多种诊断方法
金标准同行评审
完全整合“临床证据”
实时更新 ；
每一疾病提供标准结构内容：总结，预
防，诊断（诊断步骤，鉴别诊断，指南），
治疗（方法，证据，指南）， 随访，参考
图片影音资料；
Features 特点：
• The BMJ Evidence Centre is a division of the BMJ
Group. Clinicians know they can trust us. Our expert
team search, appraise and summarise over 200,000 new
research articles, in some 8,000 journals, covering over
40 medical specialities, each year
BMJ的专家队伍每年检索评估筛选出自8000多种期刊的
超过200，000篇新发表的研究文章,涵盖40多个医学专业
领域。
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Features 特点：
• Best Practice is the best blend of expert opinion,
guidelines and research evidence that make it quick
and intuitive to use
整合了专家的观点、经验，诊、治指南和最新研究证
据，方便用户快捷地找到需要的信息。
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适合读者范围
Best Practice is designed
for…
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Institutions 机构
 Hospitals 医院
 Medical schools 医学院
 Large primary care practices
 Biotech companies
 Consumer-facing organisations
 System vendors
 Policy makers 政策治定者
 Medical publishers
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Individuals 个人
 Hospital doctors 医生
 Primary care physicians
 Academic/teaching staff 教学研究人员
 Student doctors
 Nurse practitioners 护理人员
 Pharmacists 药剂师
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Case 实例
Find the answers in 3 Clicks and 30 seconds
Question:
• A 56 year old man with diabetes is currently
taking lisinopril to control his essential
hypertension. Today at follow-up, his blood
pressure is 150/95, not at goal. How should
his therapy be modified?
• 56岁男性糖尿病患者，服用赖诺普利控制原发性高血
压。今天血压测试结果为150/95，如何调整其治疗？
Case 实例
Click 1: 检索 Hypertension
Case 实例
Click 2: 选择 Treatment
Find the answers in 3 Clicks and 30 seconds
Click 3: 找到患者群，评估治疗方法
Find the answers in 3 Clicks and 30 seconds
Click 3:
找到患者群，评估治疗方法
Other features 其它特点
Available in different languages 17种语言支持
• Best Practice is available in
17 other languages
including: Spanish;
Chinese; Turkish;
Japanese; German;
Portuguese; Greek; French
and Italian
Other features 其它特点
Online images 图片
• Best Practice aims to provide full colour images for conditions
when appropriate.
Images available for wrist fractures
Extra-articular fracture of the distal
radius--lateral view
(Complex) intra-articular fracture of the
distal radius--lateral view.
Online images 图片
Other features 其它特点
• 上传本国指南 Ability to upload local guidelines, and
web links
• 远程访问 Remote access for authorised users at no
additional cost
• 非常见疾病 Rare disease
• Demo Online:
http://bestpractice.bmj.com
检索： MI
• Question？
谢 谢！
王赫 BMJ Group
[email protected]