Problem-based Learning & Finding the Evidence: Case 1: Danni Crane: Lost to Follow Up

Finding Reliable Videos

In last Spring's survey, several people asked for resources regarding reliable videos.  So, when possible, I will be adding links to related videos or to our video platforms where you can search for what you need.

Resources for this Case

Textbooks  (look left)

Cervical Cancer Guidelines

Videos (including the NEJM one)

Vaccine Recommendations

National Organizations

E-Books Refresher

Clinical Tools Refresher

Patient Information Resources

Cervical Cancer Screening Recommendations

One of the confusing factors about guidelines for cervical cancer screening is not only the number of organizations making recommendations but also the differences between some of their statements.  Some have very recently updated their recommendations which may complicate things a bit for a while.  For example, some of the organizations that have practice guidelines includes:

• American College of Obstetricians and Gynecologists
• American Cancer Society
• American Society for Colposcopy and Cervical Pathology
• Centers for Disease Control and Prevention 
• US Preventive Services Task Force  (USPSTF)

While it is a little dated now, the CDC has a nice comparison chart between several of these organization's guidelines.

If you are at a large health-care organization, then the guidelines to follow may be spelled out for you.  But what about the doctors in private practice?  You need to discern the most appropriate for your practice - this is where your analytical skills from epidemiology come into play as well as your background with evidence-based medicine.   Which one will you choose?  

A few questions to consider are:

• How recent is it?  
• Does the organization have any specific bias that might impact their conclusions?  
• How thorough and systematic was the research that helped to make these conclusions?  
• Many other questions might come to mind -- what else do you need to consider that is specific to the topic at hand? 

Where Else Can You Go for Guidelines

There are several places to search for guidelines.  Try one or all of them to see what they have to offer.

HPV Vaccinations

Just like with the cancer screening guidelines, there may be multiple voices providing guidance on who and when to administer the vaccines.

Cancer Organizations

National organizations, both government and private organizations, often have very useful information for patients as well as physicians. 

Guidelines and concensus statements, while not a systematic review, review the existing literature and are considered a high level of evidence.

EBooks Refresher

Don't forget you can search across multiple texts for the information you seek.  You have a couple of options from which to choose.

Where Else to Search for EBooks?

We have a large collection of online books, handbooks, and textbooks.  While our catalog will show you everything we have, some folks prefer to do some full-text searching at some of their favorite publishers sites.  The following ones have a great deal of health science resources.

Some of your topics may be ones for which the clinical tools might be helpful.  Just remember, we have several of these tools, not just Up to Date. 

MedlinePlus is a great place to find consumer-friendly materials along with directories, a dictionary & encyclopedia, and more.  Take a look and see what you find - try HPV.