Clinical Practice Guidelines and Reliability

Dr. Hall on Science Based Medicine has a post about CPGs that discusses how they are created, problems with the existing process, and standards to improve the process.

The American Academy of Family Physicians journal American Family Physician (AFP) has a feature called Journal Club thatI’ve mentioned before.  Three physicians examine a published article, critique it, discuss whether to believe it or not, and put it into perspective. In the September 15 issue  the journal club analyzed an article that critiqued the process for developing clinical practice guidelines. It discussed how two reputable organizations, the United States Preventive Services Task Force (USPSTF) and the American Academy of Pediatrics (AAP) looked at the same evidence on lipid screening in children and came to completely different conclusions and recommendations.

DynaMed Trial and Demonstrations

Everyone in the Saskatoon Health Region has access to the complete DynaMed evidence based clinical reference tool for the month of October.

DynaMed covers over 3,200 clinical topics, and is updated daily with evidence that has been evaluated for its relevance and validity.  Currently, physicians have access to a limited version through the Canadian Medical Association, and nurses can access DynaMed through NurseONE.

Easy to search and navigate, DynaMed articles are organized into headings and bullet points so that you can quickly find exactly what you are looking for.

All DynaMed recommendations include citations as well as links to the research. They also indicate how reliable the evidence supporting each recommendation is to help you to decide if and how the recommendation should impact your clinical decisions. 

DynaMed is accessible via the web and as an app that is compatible with most mobile devices; it can also be integrated with electronic health records. They also have a number of helpful current awareness features, including alerts for new content on a topic.

Try it out and let us know what you think!

SHR employees can access the trial from the Medical Library's InfoNet site.

Demonstration Sessions:
There will be three half-hour demonstrations run by a DynaMed representative who will show all of its features and will be happy to answer any questions you may have.

Ocotober 10, 2012

• 8:00 to 8:30 in SCH 1911
• 11:30 to 12:00 in SCH 1911
• 3:30 to 4:00 in SPH 0G30

Sessions will also be accessible online; If you would be interested in participating online, please contact the library to sign up!

Communicating with Patients on Health Care Evidence

A discussion paper from the Institute of Medicine.  Excerpt from the first page:

A continuously learning health system can deliver truly patient-centered care only when patient preferences—informed by medical evidence and provider expertise—are elicited, integrated, and honored. Shared decision making is the process of integrating patients’ goals and concerns with medical evidence to achieve high-quality medical decisions.  A 2011 Cochrane systematic review of 86 clinical trials found that patients’ use of evidence-based decision aids led to a) improved knowledge of options; b) more accurate expectations of possible benefits and harms; c) choices more consistent with informed values; and d) greater articipation  in decision making.  Providing patients with clearly-presented evidence  has been shown to impact choices, resulting in better understanding of treatment options and screening recommendations, higher satisfaction, and choices resulting in lower costs. Simply stated, engaging patients in their own medical decisions leads to better health outcomes.