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Problem-based Learning & Finding the Evidence: Retired - Case 8: Alvin Hardy -- Little Blue Pills

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Dr. Kallenberg's Tip: Quantifying Urinary Symptoms Annoyance Factor

Have you heard about the International Prostate Symptom Score (IPSS) for men?  Developed by the American Urological Association, this validated and widely used questionnaire can help quantify how problematic the symptoms related to prostate changes are for the patient.  

A quick Google search for this organization and BPH or urinary symptoms will also retrieve a few other valuable resources produced by this organization.  (Don't forget to add site:org to the Google search.)

Alvin Hardy -- Little Blue Pills

If you need to check out the medications for treating hypertension or what the possible side-effects of atenolol might be, don't forget to use one of the drug databases listed on the Drug Info Resources tab.  Either Clinical Pharmacology or Micromedex would be good choices. 

 

Resources for this Case

Textbooks (look left)

Dr. Kallenberg's Tip:  Quantifying Urinary Symptoms Annoyance Factor

Featured Resources : Natural Medicines

National Organizations :  Guidelines, FDA Drug Info, & ePSS

What's the Evidence on PSA? - Cochrane Library

Patient Information Resources

Natural Standard & Natural Medicines Database

Sometimes, an internet search will help you understand what your patients are finding out on the web.  But when it comes time for finding good evidence about those items, we have a really great resource for you on alternative, complementary, or integrative medicine: Natural Medicines.  

Natural Medicines

Natural Medicines Comprehensive Database the information aims for evidence-based practice principles and uses as many references as they can find on their topics.  Links to the references allows you to put your EBMI skills to good use in evaluating that component - typed of study and levels of evidence.  The interface does a good job at calling attention to possible interactions and the possible strength of the interactions.  Search or browse the resource.

 

 Search for yohimbine or look for the information they have on erectile dysfunction.  For example, see below for the categories of info they have available.

Plus, look at their recent news section for this item. (Scroll down on the first page - it is "below the fold."

National Resources

Screening Guidelines

How many organizations have an opinion on prostate screening?  Which national organization would have what you need?  What would be the best one to check out?  What is the latest information?

Not sure?  Let the Guidelines Clearinghouse help.  It contains the practice guidelines for many different organizations so you don't have to try to figure out the best one to investigate.  A handy comparison tool lets you compare side-by-side possible guides.  

Two specific organizations that you may think about are the US Preventive Task Force (USPTF) which would be a good one for the general practitioner doing general screening tests and then there is the American Urologic Association (AUA) which provides info for a slightly different audience of urologic specialists.

 

Drug Information

The FDA has several consumer related publications along with their health professional information.  Check out a few of the publications they have related to this case.  I also added the national standard organization's information (from the US PDI) regarding drug quality & information.. 

 

Certification for Supplements

A number of organizations exist as third-parties to supplement companies to verify the ingredients of dietary supplements.

 

A Cool App - Put it on Your Phone/Tablet 

The federal group AHRQ which produces a lot of information on prevention and screening (along with lots of other info too) has created a helpful app where you can enter patient specific details and get recommended screening tools for them.

What's the Evidence on PSA?

Cochrane Library - Database of Systematic Reviews

One of the more confusing points for this week's case is the difference of opinion about PSA.  Sometimes, it helps to head for the evidence to see what it says without the agenda driven advice from various organizations.  A PubMed search would be very messy because you would need to synthesize all those reports yourself.  What you need is a resource that can boil down the facts to more concise data that you can use for decision making.  Cochrane Library does that.  

Try either prostate specific antigen or screening for prostate cancer.  What you want is just the systematic reviews.

MedlinePlus: Information Tool for Patients

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 for erectile dysfunction or PSA.

Search MedlinePlus: