Problem-based Learning & Finding the Evidence: Case 11: Monica Johnson

Medscape or Up to Date or Micromedex?  Each Has its Advantages

You will find similar information in all 3 of these resources; however, how they present the information is very different.  Up to Date has an encyclopedic format where they try to use their outline to help you navigate.  Medscape uses a chapter - sectional approach to help organize the information.  

A couple things I noticed:

• Medscape has a nice overview of the medicine used with MI - including separating the different types of drugs with an overview of each class.
• Up to Date's outline format on the results page can sometimes help you jump right to what you need - like reperfusion. 
• Micromedex might just be the best place for details on antiplatelet agents in MI. 

Organizations Providing Heart Disease Information & Calculators

The national organizations this week highlight a few organizations and a unique item them have to contribute towards understanding this week's case.

National Guidelines

When it comes to heart disease, there are many organizations that have produced guidelines about the various cardiac conditions.  Where can you find them?  One of my favorite places to look is the TRIP database.  Simply put in your terms - perhaps coronary artery disease and look for the limit for guidelines on the right side of the results.

PubMed Search -- Finding the Evidence About Therapy

-- PICO Style

This week's case lends itself to another PICO style question about treatment.  For example, perhaps you want to see some literature comparing stents to angioplasty (or better yet, balloon angioplasty). 

A few things to remember,

• Be sure to spell out CAD - PubMed does not do well with abbreviations, but is getting better
• Be more efficient -- specify the outcome of interest.  Is it survival? Or perhaps, heart attack?  Or something else?
• Adjust that Publication setting to the highest level of evidence you think you might find - RCT? Systematic Review? Meta-Analysis? Practice Guideline?

This week, I've linked you to a mobile friendly version of PubMed that asks you to enter your search terms in the PICO format.  Give it a shot and see what you can find.  It is a plain text format, but don't let that throw you.

PubMed & AEDs

Just a quick reminder about searching -- abbreviations can be confusing, so it helps to spell out the full name of what you want.  For example, AEDs.  Use automated external defibrillators instead of AEDs so you can get past the dermatology articles.  Want the evidence on using these?  Use the clinical trial (or more specific type of trial).  Or, do you want an opinion?  Use the editorial filter.

Looking up information about the results of lab tests are mostly background questions.  The following resources are easy to use tools to find very reliable information about the normal values, reference ranges, and more.