Homework #3

The Cochrane Library and PubMed Clinical Queries as your first search options.
These two resources provide high quality information quickly, and they have done some of the work of filtering and appraising for you.

Clinical Practice Guidelines Sites, such as


National Health and Medical Research Council
www.nhmrc.gov.au/publications/subjects/clinical.htm


National Institute for Health and Care Excellence
www.nice.org.uk


Scottish Intercollegiate Guidelines Network
www.sign.ac.uk/guidelines


U.S. Government Guideline Clearinghouse
www.guideline.gov


New Zealand Guideline Group
www.nzgg.org.nz


Other Sources of Evidence Reviews, such as


The Centre for Clinical Effectiveness (that’s us!)
www.monashhealth.org/cce


Clinical Evidence
www.clinicalevidence.com


Bandolier
www.jr2.ox.ac.uk/bandolier


Best Bets
www.bestbets.org


Centre for Evidence Based Medicine
www.cebm.net


Netting the evidence
www.shef.ac.uk/scharr/ir/netting/


TRIP Database
www.tripdatabase.com


Other Sources of Journal Articles, such as


If you’re interested in further resources have a look at some of the Citation Databases in the Health Library at the Clinicians Health Channel. These include MEDLINE, CINAHL, AustHealth & Meditext, PsycINFO, PEDro via the Clinicians Health Channel at www.health.vic.gov.au/clinicians

Clinical relevance on metabolic syndrome (obesity) and lipoprotein metabolism (dyslipidemia).

Sources of information:

Books & Media in library catalogue
- not readily accessible

Index & Databases
- Subject-specific article search engines
- Article citations

accessmedicine.mhmedical.com/

www.medicinescomplete.com/

www.medline.com/

www.ncbi.nlm.nih.gov/pubmed

AccessMedicine
· Current - Written and continually updated by a team of leading primary-care physicians
· Authoritative - Endorsed by the American College of Physicians
· Evidence-based, peer-reviewed
· Fast - Consistent organization, writing style and search logic gets you to answers fast, with over 1,100 illustrations to guide you through complex explanations
· Comprehensive - Patient-care reference covering the 11 subspecialties of internal medicine, plus key topics in Women's Health, Preventative Medicine, Psychiatry and more.

MedicinesComplete
A full-text collection that provides online access to drug reference material. Produced by Pharmaceutical Press, the publishing division of the Royal Pharmaceutical Society of Great Britain. MedicinesComplete supports both searching within a title and an integrated search across all titles, bringing together evidence based, unbiased and regularly updated information.

MEDLINE
Premier biomedical database with over 25 million journal articles in the life sciences. This premier medical database covers articles from 1946 in over 5000 journals. Similar in content to Pubmed, this Ovid interface facilitates structured searching and editing of saved searches.

PubMed
PubMed.gov is the U.S. National Library of Medicine's free, web searchable database which includes MEDLINE - the premier international index to biomedical research covering nearly 6000 peer-reviewed, scholarly journals and indexing over 24 million citations from 1946 to present. This link takes you to the version with links to UBC Library's fulltext.

Some websites that would be useful in obtaining information about different drugs for strep and their trials would be:

www.nlm.nih.gov/
This website talks about different trials and drugs that are being tested. It is current and updated. This can give suggestions as to new procedures that have given proven results to a certain circumstance or it can give suggestions in what to do if a substitution was needed for a drug or a procedure. The reviews not only talk about suggestions that can be made and the benefits of them but if their is any known disadvantages that is also discusses (such as allergy, or unwanted side effects that the practitioner and patient should be made aware of)

www.fda.gov/Drugs/InformationOnDrugs/default.htm
This website talks about drugs that have been currently approved for use and that are safe to give to a patient. So even if the other website does give a suggestion that a drug could be given as a substitute for something, the FDA website would tell if the drug was approved to be tried in that kind of circumstance or not because the FDA takes a comprehensive look at all trials and then makes their decision.
The FDA is a perfect guide for choosing a medicine and to use in what circumstance because their approval is not based on bias it is based on clinical trials that have been looked at multiple times.

www.ncbi.nlm.nih.gov/
The website is current and currently edited as new findings are being made and adjusted.
This website gives information about tests that have been conducted by other professionals and their testimony about those tests. In the testimony they talk about advantages and disadvantages to the trial as well as talk about costs and other benefits or non benefits that the patient may receive from using this trial.


2 specific issues related to convenience:

These websites that offer their information are free not only for the practitioner but for anyone. This is information that is readily available as it is written in journals and posted online, there is no lag time in waiting to see if the trial was tested or not and what is the results because they would not publish the information until everything was completed to give all of the facts. The ease of getting the information from these sites is very easy and it is concise and updated as new facts are being found.

2 issues related to validity:

These sites and their information have proven to have peer review, not just peer review and comments to them but also in some cases peer and board review to make them more valid. The information is not outdated, as it is continuously updated and it is also mentioned if new trials are being done to check on certain criteria so a practitioner can decide if it would be best to wait on that new information or if what information on hand is sufficient for the current case.

Pertaining to the case that was made for homework these issues pertaining to validity are very good as a practitioner could easily look for other peer reviews on what they have done in a certain situation like this and with updated and proven facts what are their suggestions.

Issues related to relevance:

The information that has been found is relevant to the fact that it is specific for clinical outcome and they discuss results along with and disadvantages. Some of the information is generalized to the specific category (for example instead of talking about a specific virus it talks about effect on viruses on a whole) which may leave some questions unanswered, but there is also information pertaining to the specific questions that someone would want answered. The only disadvantage is the topic of time that a practitioner may have to reword their search to find anything specifically related.

Some sources that I would go to find answer my question of the drug interactions between theophylline and macrolides are:



1)Pubmed Health:

www.ncbi.nlm.nih.gov/pubmedhealth/

-This is personally one of the best databases to get current research literature on my subject

-The issue is that it is not free and you need a subscription to enter the website, unless the school already subscribed for the students

-It is readily accessible and fast to navigate through

-The search needs to be specific and more narrowed down. Giving vague searches will not yield effective results in this database

-The papers on this database has more of a clinical basis and it's not just giving general information.

-It is more specific to a specific trial or study for example, rather than providing information on a broad scale (like a textbook would provide).

-The research papers are very up to date and recent, and the date of literature can be filtered on the site

-The papers in all three of these databases provide an evidence based approach to the information they are providing. By evidence based I mean the papers prove their statements by illustrating a study pertaining to the information they are providing. They all provide references at the end of their papers as well.

-The most important advantage to this database is that it gives up to date, relevant, and edited papers that I can use as a reliable source

-The most important disadvantage is that it is not free and the search needs to be narrowed down to get good results.





2)National Library of Medicine Databases & Resources:

www.nlm.nih.gov/

-Also a very reliable source to find recent, up to date literature on scientific topics

-It is also not free and a subscription must be attained in order to have access. The only database that is free in our circumstances is EBSCO.

-It is not very comprehensive. For example, it will not give general information to your question. You need to know exactly what to search for and narrow your search to yield an appropriate paper

-It is very reliable in that the papers have been edited and reviewed, and the information is up to date

-It is also written for more of a clinical setting as opposed to just providing general information on the topic of interest. The introduction or abstracts of the papers do provide good general information on the topic for all three of these sources.

-Also very fast to navigate, but again the searches need to be narrowed down to obtain good results.





3)Electronic Database of original Literature

-This database includes Medline, Embase, CINAHL and more.

-In terms of cost, it is free for our school which makes it a very efficient source to use.

-It helps narrow down articles in terms of date of publication, so we can get very up to date articles for our topic

-It is a database for people who know what to specifically look for, so it is not a source to find answers to general questions. It must be narrowed down to get the answer in question.

-It is a reliable source because the papers that get published on this database has been reviewed and edited.

-The biggest advantage is the fact that this database is payed for and already subscribed to us, which makes it extremely efficient to use.

-The disadvantage is the fact that you need to fully know what you are searching. If you don't have a good background and give a narrow search, the papers might not give what you are looking for.



4) www.wikipedia.com

-This is a good source to find general information on the topic before going into research databases.

-Again this is a free website and the search do not have to be narrowed down. For example if I just type macrolides, a whole set of information on macrolides will be provided.

-The literature is not valid because you do not know if it has been peer reviewed or edited. It does however provide references at the end .

-This is not a reliable resource to rely on for research based literature or investigations. It was simply my first step in getting a broad spectrum of information on the subject before continuing with my research

-Main advantage:Free, provides general information, fast to navigate, don't need to give a narrow search

-Main disadvantage:Not reliable in terms of validity of the information and the being properly edited, not clinically based; it is mostly general information that the literature provides.

Regarding the effective management of Lassa fever; the following resources are available for further guidelines.

- Centers for disease control and prevention
www.cdc.gov/vhf/lassa/
- Viral hemorrhagic fever consortium
vhfc.org/lassa_fever
CDC and vhfc provide basic information on the general public health in regards to lassa fever

Useful databases for the review of lassa fever can be viewed at.
PubMed Health, NIH: NLM
www.ncbi.nlm.nih.gov/pubmedhealth/

Virus pathogen database and analysis recource
www.viprbrc.org/brc/externalContent.spg?method=readNews&decorator=arena
Pubmed provides concise clinical data review while VPDAR is a forum for informational purposes. Therefore pubmed will be a better option when it comes to database results.


Online textbooks
Merck Manual Professional Version
www.merckmanuals.com/professional
This site has information to the clinical management of lassa fever, mostly targeted to physicians with a wide range of information about the prevalence of the disease

Springer link
www.springer.com/?SGWID=0-102-24-0-0&searchType=EASY_CDA&queryText=lassa+fever&submit=Submit
This site provided online textbook that can be used. However payment membership is required.

Offline textbooks
Review of Medical microbiology and immunology; Warren Levinson
This textbook provides a direct knowledge to the current diagnosis of lassa fever.


For current drug use in regards to Lassa fever:
FDA Drug Approvals and Databases
www.fda.gov/Drugs/InformationOnDrugs/default.htm
MedlinePlus: Drug and Medical Device Safety, NIH: NLM
www.nlm.nih.gov/medlineplus/drugsafety.html

Evidence Based Medicine Review
Cochrane
www.cochrane.org/evidence

Wikipedia
en.wikipedia.org/wiki/Lassa_fever
This site provides general knowledge in regards to lassa fever and it is easy to navigate. It also provides references to other sites that can be helpful. However anyone can update this page with false information, so it is advisable to have alternate clinical sources to fall back on.

As lassa fever is mostly concentrated to the western part of Africa, the disease outbreak occurs with resistance to treatment at each interval of outbreak. So scientist are continuously working to fix a treatment plan.

On drug interaction between Coumadin and Aspirin below are some source of information

www.ncbi.nlm.nih.gov/pubmed
www.rxlist.com/script/main/hp.asp
www.drugs.com/
www.medscape.com/
www.australianprescriber.com/
www.clevelandclinicmeded.com/
www.webmd.com/

While being very good sources of information, some are outdated and can be very slow and random. For high yield information they wouldn’t be a very good source. But despite that they are very fairly reliable and concise, easy to assess and understand. Also there is no subscription restriction. Very good for basic research just like my case.