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Internet Medical Databases Presented by: Hongie Wang, MLS, AHIP Lyman Maynard Stowe Library University of Connecticut Health Center The goals of this activity were to identify for the clinician/ educator/ researcher effective database search strategies and to introduce newly available databases through the Lyman Maynard Stowe library. As with any endeavor requiring database searches, one needs to clearly delineate the topic of interest. Overview: Define the clinical problem or searchable idea. Utilize Medical Subject Headings (MeSH) as "key words." Determine the most appropriate resource (eg.): Medline Pubmed Cochrane Database of Systematic Reviews MDconsult UpTo Date InfoRetriever Design a search strategy based upon key words AND modifiers Each database provides individual variables some of which can be modified to limit the search strategy (eg. years to search, language, ages of subjects, types of manuscripts etc.) Summarize the results and synthesize the evidence. There may be a need to re-search through an alternate database for what you need. FYI: Medline: Indexes 3,900 biomedical journals with over 10 million citations and growing. It incorporates journals from 1966 to present, where ~67% of citations obtained include an abstract. PubMed: Most up-to-date database for biomedical citations. Updated weekly. Includes all that is incorporated within Medline with broader search capabilities and search filters. Cochrane Database: An international group of individuals and institutions, which prepare, maintain and disseminate systematic reviews of randomized clinical trials pertaining to health care. These are full text and updated quarterly. Reviews are available from 1991 to present. MDConsult: This is a peer review summary of available data within 35 full-text medical books, 45 full-text journals and >600 peer review practice guidelines. Available material includes patient education material and health care news. UpToDate: A clinician review and summary of selected clinical topics within Internal Medicine, Family Practice, Obstetrics and Gynecology, and Pediatrics. The review material includes ~270 journals. Topics are updated by the authors "when new information is published" and the last update date is given. Summaries follow a similar format; definition, epidemiology, pathology, physiology, treatment, references. Links to references are provided. InfoRetriever: The premier source of evidence-based information. Each citation is a formatted review "POEM" which summarizes in journal-club style a specific clinical question based on a particular relevant study. POEM stands for Patient-Oriented Evidence that Matters. POEMs have to meet three criteria: they address a question that we face as physicians, they measure outcomes that our patients and we care about (symptoms, morbidity, quality of life, and mortality), and they have the potential to change the way we practice. Internet sites of interest: HSTAT-Health Services/Technology Assessment Text http://hstat.nlm.nih.gov/hq/Hquest Full text AHCPR Clinical Practice Guidelines and Evidence-based Clinical information, NIH clinical studies and Consensus Development Program, SAMHSA/CSAT Treatment Improvement Protocols. National Guideline Clearinghouse http://www.guideline.gov/ ~75 national organizations list their guidelines with appropriate summaries and recommendations or position statements. Full-text links are available. Summarized by F. DiMario