UpToDate 循证医学数据库内容说明以及使用操作

鄭如雅ccheng@uptodate.com

大纲

什么是 UpToDate

UpToDate 主要特点 Evidence Grading 证据等级 检索 UpToDate

问题与讨论

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什么是 UpToDate?

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填补空白

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UpToDate 的主要特点

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使用 UpToDate 的医院

United States 美国 Johns Hopkins Hospital Mayo Foundation UCLC Medical Center Massachusetts General Hospital University of California, San Francisco Medical

Center Australia 澳大利亚

Queensland Health Northern Sydney Health Royal Perth Hospital

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亚洲使用 UpToDate 的医院

Singapore General Hospital National University Hospital, Singapore National Taiwan University Hospital Chang Gung Memorial Hospital Seoul National University Hospital, Korea Yonsei University Medical Center, Korea University of Malaya Medical Center, Malaysia Penang Adventist Hospital, Malaysia King Chulalongkorn Memorial Hospital, Thailand Angkor Hospital for Children, Cambodia

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UpToDate 的主要特点

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Evidence Grading 循据等级

In 2001, we began a collaboration with Gordon Guyatt, a world leader in EBM, and his colleagues in the international GRADE collaborative to implement a grading system for recommendations

UpToDate grades specific treatment and screening recommendations

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Evidence Grading 循据等级

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RECOMMENDATION GRADES 医嘱的强度 Grade 1

Strong Recommendation Benefits clearly outweigh the risks and burdens (or vice versa) for most, if not all, patients “ We recommend…”

Grade 2Weaker Recommendation Benefits and risks closely balanced

and/or uncertain “ We suggest…”

EVIDENCE GRADES 证据的品质Grade A High Quality Evidence

Consistent evidence from randomized trials, or overwhelming evidence of some other form

Grade B Moderate Quality Evidence Evidence from randomized trials with important limitations, or very strong evidence of some other form

Grade C Low Quality Evidence

Evidence from observational studies, unsystematic clinical observations, or from randomized trials with serious flaws

检索 UpToDate

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New Search 单一检索方式 Search display results topic review

output

检索 浏览检索结果 如何使用内容 输出 Others 其它功能

Evidence grading 如何找到证据等级 RECOMMENDATIONS

Patient Information 卫教资料 What’s new 各科新知 125 Calculators 医学电子表格 Drug Interactions 药物交互作用

How to use UpToDate based on a Clinical scenario

A 50 year old woman is obese (BMI=32) and has hypertension. She has not achieved weight loss despite counseling for diet and lifestyle changes. What is the best medication for pharmacologic management of her obesity.

有一位 50 岁的女性， BMI 是 32, 而且有高血压 ; 她透过节食和改变生活习惯来减肥 , 但是失败了 ; 现在希望可以直接吃药来达到减肥的目的 ; 什么药物可以让她减肥又不会影响到她的高血压的症状呢 ?

Keyword:

Obesity drug12

Q&A

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Specialties

• Adult and Pediatric Emergency Medicine 急诊• Adult Primary Care & Internal Medicine 一般内科• Allergy and Immunology 过敏免疫• Cardiovascular Medicine 心脏内科 • Endocrinology & Diabetes 内分泌及糖尿病• Family Medicine 家庭医学• Gastroenterology & Hepatology 肝胆肠胃科• Hematology 血液科• Hospital Medicine 医院医学• Infectious Diseases 感染科• Nephrology & Hypertension 肾脏科及高血压• Neurology 神经内科• Obstetrics, Gynecology & Women’s Health 妇产科• Oncology 肿瘤科• Pediatrics 小儿科• Pulmonary, Critical Care & Sleep Medicine 胸腔内科以及重症医学• Rheumatology 风湿科14

Specialties in Development

• Dermatology 皮肤科• Psychiatry 精神病学• Surgery 外科 – Release just now

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