UpToDate ???????????? ??????????

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UpToDate ???????????? ??????????

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• ccheng_at_uptodate.com
• ??152-1075-5192

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• ???UpToDate
• Quick Facts about UpToDate
• Evidence Grading ????
• ??UpToDate
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???UpToDate?
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???UpToDate?

• UpToDate is an electronic evidence-based clinical
  decision support tool written by physicians to
  help clinicians
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  ??????????
• answer their clinical questions
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• increase their clinical knowledge
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• improve patient care
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Quick Facts about UpToDate

• Topic reviews ??????
• Patient Information ??????
• Drug Information ????

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Quick Facts about UpToDate

• 5,100 world-renowned physician authors
  (international) ????
• 9,500 clinical topic in 20 specialties ????
• 5,100 unique drug entries in adult, pediatrics,
  international and natural drugs (Lexi-Comp)
• ????
• 25,000 graphics ????
• 347,000 references (Medline) ??????
• Updated every month ????

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Specialties

• Adult and Pediatric Emergency Medicine ?????????
• Adult Primary Care Internal Medicine ??????????
• Allergy and Immunology ????????
• Cardiovascular Medicine ?????
• Endocrinology Diabetes????????
• Family Medicine ????
• Gastroenterology Hepatology?????????
• General Surgery ???
• Geriatrics ????
• Hematology ???
• Hospital Medicine ????
• Infectious Diseases ????
• Nephrology Hypertension ???????
• Neurology????
• Obstetrics, Gynecology Womens Health
  ??????????
• Oncology ???
• Pediatrics ??
• Pulmonary, Critical Care Sleep Medicine
  ????????????
• Psychiatry ????

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Specialties in Development

• Dermatology ???
• Palliative Care ?????

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Evidence Grading ????

• 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 ????
RECOMMENDATION GRADES ????? (???????) RECOMMENDATION GRADES ????? (???????) RECOMMENDATION GRADES ????? (???????)
Grade 1 1 ??? Strong Recommendation ??? Benefits clearly outweigh the risks and burdens (or vice versa) for most, if not all, patients
Grade 1 1 ??? We recommend Benefits clearly outweigh the risks and burdens (or vice versa) for most, if not all, patients
Grade 2 2 ??? Weaker Recommendation??? Benefits and risks closely balanced and/or uncertain
Grade 2 2 ??? We suggest Benefits and risks closely balanced and/or uncertain
EVIDENCE GRADES ????? (?????) EVIDENCE GRADES ????? (?????) EVIDENCE GRADES ????? (?????)
Grade A A ??? High Quality Evidence ????? Consistent evidence from randomized trials, or overwhelming evidence of some other form
Grade B B ??? Moderate Quality Evidence ?????? Evidence from randomized trials with important limitations, or very strong evidence of some other form
Grade C C ??? Low Quality Evidence ????? Evidence from observational studies, unsystematic clinical observations, or from randomized trials with serious flaws
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??UpToDate

• New Search ??????
• Search ? display results ? topic review ? output
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• Others ????
• Evidence grading ????????
• RECOMMENDATIONS
• Patient Information ?????? (1000)
• Whats new ????
• 135 Calculators ?????? (100)
• Drug Interactions ??????
• ECG Test

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How to use UpToDate based on a Clinical scenario

• A 65 year old man comes to see you with
  moderately symptomatic heart failure. He has a
  remote history of a large anterior wall MI and an
  echocardiogram shows an ejection fraction of 30.
  His LDL cholesterol is 150 mg/dL, currently
  untreated. Should he be started on a statin ?
• ??65??????,? moderately ? Heart Failure
  ???????????????,???????30??????????????150 mg/dL
  ,???????????
• ???????????? ?

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How to use UpToDate based on a Clinical scenario

• A 50 year old woman is obese (BMI32) 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.
• ???50????,BMI?32, ?????? ???????????????, ?????
  ?????????????????? ????????????????????????? ?
• Keyword
• Obesity drug

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Q A

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