循证搜索引擎：SUMSearch与TRIP database

SUMSearch与TRIP database是查询循证医学临床证据的元搜索引擎。本文系统介绍SUMSearch与TRIP database的主要内容和检索方法,旨在为临床循证实践提供快捷检索资源和技术帮助。     

证据的来源与检索

循证医学是指认真、明确和明智地应用现有的最好证据,同时结合医生的个人专业技能和临床经验,考虑病人的愿望,对患者做出医疗决策.因此证据及其质量是循证医学的关键.本文旨在系统介绍证据的来源和如何检索证据,为卫生健康工作者的循证医学实践提供服务和帮助.     

循证医学数据库:现状与趋势

循证医学数据库是基于循证医学理念,以临床证据为核心的资源检索系统.本文针对临床实践指南、系统评价、临床试验等不同类型循证数据库,整理分析了其各自功能和特点,以期为国内研究者了解循证数据库发展现状及未来趋势提供参考.     

药品标示外使用的循证医学评价方法探讨

目的介绍国内外药品标示外使用的循证医学评价情况,探讨药品标示外使用的循证医学评价方法。方法综合国内外相关文献,从证据来源、证据分级及推荐强度三个方面探讨药品标示外使用的循证医学评价方法。结果药品标示外使用的证据来源包括临床药理学、药品咨询系统(DRUGDEX?System)、肿瘤药典及手工检索补充的证据;证据分级及推荐强度可参考2009年牛津证据分级与推荐意见强度(治疗部分)和药品咨询系统的推荐强度和证据强度。结论本研究初步建立了一种系统的药品标示外使用的循证医学评价方法。     

证据的来源与检索

循证医学是指认真、明确和明智地应用现有的最好证据，同时结合医生的个人专业技能和临床经验，考虑病人的愿望，对患做出医疗决策。因此证据及其质量是循证医学的关键。本旨在系统介绍证据的来源和如何检索证据，为卫生健康工作的循证医学实践提供服务和帮助。     

提高护士文献信息检索技能以适应循证环境

循证医学和循证护理的开展临床上已形成了“遵循证据”的行医环境，然而循证护理的开展关键是证据及其质量，其核心是证据的有效性、可靠性、临床适用性等进行系统评价。因此，证据的检索是必不可少的，一切循证活动的开展都离不开文献信息检索，现代化图书馆及网络已成为联系现代医学和循证护理实践的一个重要媒介。目前由于种种     

Cochrane图书馆检索方法

循证医学实践的基本过程就是结合临床经验与最好证据对患者进行处理。这个过程包括提出问题、检索证据、评价证据、结合临床经验与最好证据对患者作出处理、效果评价5个步骤。进行临床循证实践的重要步骤之一是寻找最佳证据。Cochrane图书馆是获取高质量证据的重要来源之一,通过光盘和因特网均可对CochraneLibrary进行检索。介绍Cochrane图书馆的内容,Cochrane图书馆光盘检索方法及Cochrane图书馆因特网检索方法,并举例说明。     

循证医学的定义、发展、基础及实践

循证医学是结合医生的个人专业技能和临床经验,考虑患者的愿望,对患者作出医疗决策而发展起来的新兴临床学科。高质量的证据是指尽可能保证结果真实性的、以患者为中心的临床研究数据。证据及其质量是循证医学的关键。研究人员应该尽量提供高质量的证据,临床医生应尽可能使用现有的最佳证据。循证医学在进行诊断和治疗决策时,考虑患者的愿望,从而体现以患者为中心的医疗服务宗旨。高素质的临床医生、最佳的研究证据、临床流行病学的基本方法和知识及患者的参与是循证医学的基础。循证医学实践包括提出问题,检索证据,评价证据,结合临床经验与最好证据对患者进行处理和效果评价5个步骤。     

Cochrane图书馆检索方法

循证医学实践的基本过程就是结合临床经验与最好证据对患进行处理。这个过程包括提出问题、检索证据、评价证据、结合临床经验与最好证据对患作出处理、效果评价5个步骤。进行临床循证实践的重要步骤之一是寻找最佳证据。Cochrane图书馆是获取高质量证据的重要来源之一，通过光盘和因特网均可对Cochrane Library进行检索。介绍Cochrane图书馆的内容，Cochrane图书馆光盘检索方法及Cochrane图书馆因特网检索方法，并举例说明。     

循证医学的定义、发展、基础及实践

循证医学是结合医生的个人专业技能和临床经验，考虑患的愿望，对患作出医疗决策而发展起来的新兴临床学科。高质量的证据是指尽可能保证结果真实性的、以患为中心的临床研究数据。证据及其质量是循证医学的关键。研究人员应该尽量提供高质量的证据，临床医生尽可能使用现有的最佳证据。循证医学在进行诊断和治疗决策时，考虑患的愿望，从而体现以患为中心的医疗服务宗旨。高素质的临床医生、最佳的研究证据、临床流行病学的基本方法和知识及患的参与是循证医学的基础。循证医学实践包括提出问题，检索证据，评价证据，结合临床经验与最好证据对患进行处理和效果评价5个步骤。     

循证护理信息资源的获取

在简单回顾循证护理产生与发展历史的基础上,从生物医学文献数据库、搜索引擎、元搜索引擎、电子期刊、重要网站等方面获取网络循证护理信息资源。提出了循证护理网络信息资源的检索方法与检索策略。得出加强护理人员与医学图书情报人员的合作将有利于推动循证护理实践的开展。     

Decision making in family medicine: Randomized trial of the effects of the InfoClinique and Trip database search engines

Objective

To compare the ability of users of 2 medical search engines, InfoClinique and the Trip database, to provide correct answers to clinical questions and to explore the perceived effects of the tools on the clinical decision-making process.

Design

Randomized trial.

Setting

Three family medicine units of the family medicine program of the Faculty of Medicine at Laval University in Quebec city, Que.

Participants

Fifteen second-year family medicine residents.

Intervention

Residents generated 30 structured questions about therapy or preventive treatment (2 questions per resident) based on clinical encounters. Using an Internet platform designed for the trial, each resident answered 20 of these questions (their own 2, plus 18 of the questions formulated by other residents, selected randomly) before and after searching for information with 1 of the 2 search engines. For each question, 5 residents were randomly assigned to begin their search with InfoClinique and 5 with the Trip database.

Main outcome measures

The ability of residents to provide correct answers to clinical questions using the search engines, as determined by third-party evaluation. After answering each question, participants completed a questionnaire to assess their perception of the engine’s effect on the decision-making process in clinical practice.

Results

Of 300 possible pairs of answers (1 answer before and 1 after the initial search), 254 (85%) were produced by 14 residents. Of these, 132 (52%) and 122 (48%) pairs of answers concerned questions that had been assigned an initial search with InfoClinique and the Trip database, respectively. Both engines produced an important and similar absolute increase in the proportion of correct answers after searching (26% to 62% for InfoClinique, for an increase of 36%; 24% to 63% for the Trip database, for an increase of 39%; P = .68). For all 30 clinical questions, at least 1 resident produced the correct answer after searching with either search engine. The mean (SD) time of the initial search for each question was 23.5 (7.6) minutes with InfoClinique and 22.3 (7.8) minutes with the Trip database (P = .30). Participants’ perceptions of each engine’s effect on the decision-making process were very positive and similar for both search engines.

Conclusion

Family medicine residents’ ability to provide correct answers to clinical questions increased dramatically and similarly with the use of both InfoClinique and the Trip database. These tools have strong potential to increase the quality of medical care.     

循证医学与电子信息资源

随着医学文献的与日俱增，如何在浩瀚的信息和文献海洋中筛选出最优的证据已成为实践循证医学所要解决的核心问题。随着计算机的日益普及，全球信息高速公路的发展，查找最佳证据不再仅停留在以手工操作咪主的印刷型资源中，电子信息资源成为查找医生证据的主要来源。本文介绍了电子信息资源在收集循证医学证据中的运用。     

Giddyup! or Whoa Nelly! Making Sense of Benefit Claims on Websites of Equine Programs for Children with Disabilities

Programs offering horseback riding or other equine related experiences for children with disabilities are commonplace throughout the United States as well as other parts of the world. However, there is a dearth of research findings demonstrating the benefits of these programs. Four Internet search engines were used to identify 115 websites associated with equine programs that people with disabilities and their family members in the United States would likely encounter if searching the Web for information. Content analysis methodology was used to review websites for information related to program characteristics and benefit claims. Findings are summarized and the importance of establishing the validity of benefit claims through means other than anecdotal and testimonial evidence is discussed.     

A descriptive analysis of internet information regarding music therapy

The purpose of the two studies reported here was to investigate and describe information available about music therapy that is likely to be found on the Internet. The top 20 Internet search engines were surveyed using the term "Music Therapy." Information concerning the first 25 sites listed per engine was collected. The following categories of information were described: the frequency of mention across the search engine sites, the type of site, whether the site gave a definition of music therapy, the orientation of that definition, the number of links, orientation of links, and the number of hits shown on the main page. A rank order was then compiled of the 267 sites listed across all searches. Results showed that American Music Therapy Association (AMTA) web page was the most frequent and highest ranked site across the 20 search engine sites. Sites from educational institutions were frequent, as were commercial sites. Most of the highest ranked sites gave traditional definitions (as defined by AMTA) for music therapy and associated links were conventional as well. These procedures were replicated one year later, although the question "What is Music Therapy?" was used as the search term. Results from this second search revealed only 145 sites. Of those, American Music Therapy Association web page was again the most frequent and highest ranked site across the search engines. Sites from educational institutions were frequent, as were commercial sites, however, only half of the highest ranked sites gave traditional definitions for music therapy.     

How to search and harvest the medical literature: let the citations come to you,and how to proceed when they do

Background: There is a virtual avalanche of medical information available to clinicians and researchers. The traditional ‘search’ can be substantially augmented by proactive ‘harvesting.’ Aims: To describe how to search and harvest the medical literature. Materials & Methods: Survey of selected resources available on the internet. Results: PubMed remains the backbone of the traditional literature search. The availability of automated delivery of electronic tables of contents (‘eTOCs’), electronic feeds of targeted search results, and workflow tools allows relevant articles to find the reader. Electronic storage and retrieval tools make it possible to manage this information and make day‐to‐day clinical and research activities more efficient. Discussion: Searching and harvesting the medical literature is made easier with the advent of the internet and email. In addition, there are internet resources that screen and filter potential articles of interest. Managing one’s electronic library of PDF documents requires attention to appropriately naming files and the use of indexing programs. Conclusion: In addition to readers searching for relevant citations, these citations themselves can be searching for readers. Clinicians and researchers can take advantage of this and efficiently harvest the medical literature with a modest investment of time.     

The effective use of search engines on the Internet

This article explains how nurses can get the most out of researching information on the internet using the search engine Google. It also explores some of the other types of search engines that are available. Internet users are shown how to find text, images and reports and search within sites. Copyright issues are also discussed.     

Informational content of official pharmaceutical industry web sites about treatments for erectile dysfunction

BACKGROUND: In the last 5 years, several treatments have become available for erectile dysfunction (ED). During this same period, consumer use of the Internet for health information has increased rapidly. In traditional direct-to-consumer advertisements, viewers are often referred to a pharmaceutical company Web site for further information. OBJECTIVE: To evaluate the accessibility and informational content of 5 pharmaceutical company Web sites about ED treatments. METHODS: Using 10 popular search engines and 1 specialized search engine, the accessibility of the official pharmaceutical company-sponsored Web site was determined by searching under brand and generic names. One company also manufactures an ED device; this site was also included. A structured, explicit review of information found on these sites was conducted. RESULTS: Of 110 searches (1 for each treatment, including corresponding generic drug name, using each search engine), 68 yielded the official pharmaceutical company Web site within the first 10 links. Removal of outliers (for both brand and generic name searches) resulted in 68 of 77 searches producing the pharmaceutical company Web site for the brand-name drug in the top 10 links. Although all pharmaceutical company Web sites contained general information on adverse effects and contraindications to use, only 2 sites gave actual percentages. Three sites provided references for their materials or discussed other treatment or drug options, while 4 of the sites contained profound advertising or emotive content. None mentioned cost of the therapy. CONCLUSIONS: The information contained on pharmaceutical company Web sites for ED treatments is superficial and aimed primarily at consumers. It is largely promotional and provides only limited information needed to effectively compare treatment options.     

FOAMSearch.net: A custom search engine for emergency medicine and critical care

The number of online resources read by and pertinent to clinicians has increased dramatically. However, most healthcare professionals still use mainstream search engines as their primary port of entry to the resources on the Internet. These search engines use algorithms that do not make it easy to find clinician‐oriented resources. FOAMSearch, a custom search engine (CSE), was developed to find relevant, high‐quality online resources for emergency medicine and critical care (EMCC) clinicians. Using Google^TM algorithms, it searches a vetted list of >300 blogs, podcasts, wikis, knowledge translation tools, clinical decision support tools and medical journals. Utilisation has increased progressively to >3000 users/month since its launch in 2011. Further study of the role of CSEs to find medical resources is needed, and it might be possible to develop similar CSEs for other areas of medicine.