Oct 03

The NNT

Just realized that I have not yet mentioned here that I don’t work in a medical library any longer.

A few months ago, I took a job as the geek (technologist-generalist?) for the Department of Emergency Medicine at SUNY Upstate. I love the job. Love it. The people are great and the work is both challenging and interesting.

While I have really enjoyed shifting more to the mechanics of health information than the content, I’ve found certain librarianish habits and interests haven’t faded.

For instance, TheNNT.com fascinates me.

http://www.thennt.com/

“There is a way of understanding how much modern medicine has to offer individual patients. It is a simple statistical concept called the “Number-Needed-to-Treat”, or for short the ‘NNT’. The NNT offers a measurement of the impact of a medicine or therapy by estimating the number of patients that need to be treated in order to have an impact on one person. The concept is statistical, but intuitive, for we know that not everyone is helped by a medicine or intervention — some benefit, some are harmed, and some are unaffected. The NNT tells us how many of each.”

Here’s a great example: Anticoagulation for Venous Thromboembolism

Or check out Mediterranean Diet for Secondary Prevention After Heart Attack.

Is it just me, or is this site crazy awesome? I’ve encountered a handful of physicians who like the site a lot, but I’ve heared next to nothing from medical librarians. Any thoughts?

Jan 24

Understanding Evidence-based Healthcare

Rachel Walden points (from both Women’s Health News and Our Bodies Our Blog) to a free online workshop titled “Understanding Evidence-based Healthcare: A Foundation for Action” , offered by the US Cochrane Center‘s Consumers United for Evidence-based Healthcare (CUE).

(Embedded below is a video about CUE. If you are reading this post via a feed reader, you may need to visit the site to view the video.)

Sep 22

Survey: Health Sciences Librarians and EBM

Posted by request from Lin Wu:

Dear Colleagues,

We are inviting all medical librarians to take this survey. The purpose of the survey is to explore the roles of health sciences librarians in enhancing and supporting evidence-based medicine (EBM) practice. Results will be reported only for research purposes. The survey will take no more than 10 minutes.

Take this link to the survey:
http://www.surveymonkey.com/s.aspx?sm=ghjbae2_2fJaeUMVJ_2bK7z0HA_3d_3d

Thank you for your time and participation!

If you have questions about the survey, please contact Lin Wu directly:

Lin Wu
Reference Services Librarian
Health Sciences Library
University of Tennessee Health Science Center
877 Madison Avenue; Memphis, TN 38163
Email: lwu5 [AT] utmem [DOT] edu
Toll-free: 877-747-0004; Local: 448-5404

Mar 20

EBLIP4 Keynote 5-9-07 Booth Plutchak Debate (Video)

Journal of the Medical Library Association and health sciences library director and Andrew Booth, a leader in EBLIP from the U.K., discuss whether the model of evidence based practice as it has evolved in other fields such as health sciences can be applied to the field of library and information science. Plutchak questions whether the “big questions” in the LIS field can ever be address by the currently available models and Booth counters with arguments in the affirmative. The speakers use the characteristic humor of the classical debating format to make their points.

Oct 20

Google CSE for “Netting the Evidence”

The Information Resources Section of the School of Health and Related Research (ScHARR) at the University of Sheffield has put together a Google Custom Search Engine of interest to medical libraryfolk. According to Andrew Booth, Director of Information Resources & Reader in Evidence Based Information Practice, the Netting the Evidence Google Search Engine “…searches over one hundred web sites (107) associated with the METHODOLOGY of evidence based practice.”

This CSE will replace the current Netting the Evidence site, which Booth indicates will shortly be removed.

Try it out and share your thoughts in the comments.

[Via]

Previous posts about Google CSEs

Aug 23

Reason vs. Superstition in Medicine (Richard Dawkins)

Although he is best-known as an outspoken atheist, Richard Dawkins is a respected biologist.

Really, if you read his work or hear him speak, you get the sense that he isn’t actually hostile towards religious people, he’s hostile towards attacks on reason. So it isn’t really surprising that in his Channel 4 special, The Enemies of Reason, he expresses strong views about superstition and the way it can impact medicine in the form of some “alternative” health therapies in the episode entitled The Irrational Health Service.

You can watch it in the embedded video below:

I particularly enjoy how Dawkins takes apart homeopathy.

Thanks for the heads-up, Graham!

Jun 25

More on NEJM’s “Clinical Decisions” Feature

The New England Journal of Medicine’s new social feature, Clinical Decisions, has closed its call for feedback and posted the results.


You can also view the results by country with this interactive map.

White coat Notes (a Boston Globe blog) notes that Journal voters stray from the evidence.

Readers were given three choices to vote on. When the 6,085 votes from 113 countries were counted, two of the three choices were almost a tie, with only eight votes separating them. But the winner, with 37.5 percent of the votes, was not the choice consistent with what the two studies concluded…

Jun 24

EBM Page Generator

Provided by the Dartmouth Biomedical Libraries, Dartmouth College and the Cushing/Whitney Medical Library, Yale School of Medicine, the EBM Page Generator looks like a wonderful tool to help a medical library create an EBM page on its intranet, even without extensive Web development skills.

Welcome to the EBM Page Generator!

Let us help you create your own EBM web page with your resources for your website. Once you’ve gone through the process, you’ll end up with the code to export to your own web site.

In five simple steps, your library can select the resources it has available and wishes to include, plug in the appropriate URLs, then copy and paste the code it generates into the appropriate intranet page.

Click here for an example of the kind of page you can make with this tool.

This is a great idea, implemented very nicely.

Hat tip: Ratcatcher’s del.icio.us favorites

May 21

Nursing EBP Presentation

Julie Smith (at Nursing Research: Show me the Evidence!) points to a PowerPoint presentation by Dana N. Rutledge, PhD, RN and Victoria Morrison BSN, RN of St. Joseph Hospital (Orange, California) on Evidence Based Practice and Nursing that I am tucking away for the next time someone asks what EBM/EBP is.

EBP Presentation

May 02

Sneak Preview: TRIP Enhancements

triplogo.png

Jon Brassey allowed me access so I could take some of the TRIP database’s upcoming enhancements for a test drive. They’re awesome. Here are just a few highlights:

RSS feeds (woohoo!) from searches:
triprss.png

Conclusion bubbles:
newconclusion.png

Just click the little icon in the list of search results for an article and get a quick look at the conclusion!
conclusionbubble.png

The Snippets feature is hard to illustrate with screen captures that will display properly here, so I’ll describe/simulate it in text instead.

Here’s a search result without the Snippets feature turned on:

Transdermal Nicotine for Ulcerative Colitis
Bandolier. 1997

Here’s the same search result with the Snippets feature turned on, giving a taste of the item’s content:

Transdermal Nicotine for Ulcerative Colitis
Bandolier. 1997
Nicotine for Ulcerative Colitis Case-control study Transdermal nicotine treatment Comment Ulcerative colitis has an…-control study One hundred patients with ulcerative colitis were matched for age and sex with community control subjects, and…

There’s other neat stuff on the way, too- so if you’d like to keep up with TRIP’s evolution, you may want to subscribe to its blog.

Thanks for letting me play with your new toys, Jon- they’re way cool. :)

Apr 16

Training the Learning Health Professional

Via User Education Resources for Librarians:

Evidence-based medicine resource, from the Institute of Medicine, has a chapter on training health professionals: http://books.nap.edu/openbook.php?record_id=11903&page=211. Title of resource – The Learning Healthcare System: Workshop Summary – Roundtable on Evidence-Based Medicine.

Mar 20

Medical Economics on Google for Doctors

Can Google make you a better doctor?
Tech Talk
Mar 2, 2007
By: Robert Lowes
Medical Economics

Includes interesting commentary on the BMJ article on “Googling for a Diagnosis” from last November.
(Previously mentioned here, here, here and here)

“The cases in the BMJ article deal with diagnoses so rare that most physicians will never make them in their lifetime,” Armstrong says. “Google is useful for them, but not for common conditions where presenting complaints are vague, like ‘nausea, fatigue, generalized muscle pain.’ Google would yield a morass of disorganized information with no built-in quality filter. I can’t think of a single person in the EBM field who would use Google on a regular basis.”

Armstrong says the BMJ study would have been more convincing had it compared Google with EBM search engines such as the TRIP Database (for more information, see “The best treatment? It’s at your fingertips,” in the March 4, 2005 issue). Interestingly enough, Jon Brassey, a co-founder and co-director of TRIP (www.tripdatabase.com), holds Google in higher regard. “Google isn’t anywhere near as good as TRIP,” Brassey wrote in a blog. “But it’s pretty fine.”

Read the rest.

Feb 20

TIME Magazine on EBM

time.png
Are Doctors Just Playing Hunches?

Nobody pretends medicine is easy, but if there’s one thing we ought to be able to rely on, it’s that the doctors looking out for us are doing more than playing hunches. We take certain medicines because they work, right? We go into the operating room for certain procedures because they’ll make us well, don’t we?

[via]

Also, check out the comments at Kevin, MD for very strong (and mostly negative) opinions on the nature, purpose and effects of EBM.

Jan 30

NHS adds DynaMed to CKS

I’ve mentioned previously that I really enjoyed my trial of DynaMed and wished I could get it into our library’s budget. It looks like the UK’s NHS likes it, too.

From today’s press release:

IPSWICH, Mass.–(BUSINESS WIRE)–As the result of a procurement undertaken by the National Health Service (NHS) of England, DynaMed™ is now offered as a key component of the new Clinical Knowledge Summaries (CKS) Service for the NHS community. As such, this evidence-based reference product created by physicians and made available by EBSCO Publishing (EBSCO), is now accessible at the primary point of care, for use by every physician and other health care professional across England.

NHS is the renowned government agency that manages and coordinates all aspects of the health care system in the UK. It is the largest single health care organization in Europe and often a model for all of the national health systems throughout the continent. Providing NHS physicians with unlimited usage of DynaMed, including via PDA, greatly expands their access to evidence-based materials.

About the Clinical Knowledge Summaries (CKS)

Jan 28

Presentation on EBM Databases


(Embedded slideshow presentation is above. If you are reading this in your feed aggregator, you may need to visit the blog in order to view the presentation)

By Lars Iselid, Librarian at the Medical Library, Umeå University Library, Sweden. Lars is pretty excited about SlideShare. Can’t say I blame him- I was pretty excited the first time I saw it, too.

Jan 09

Podcast: Evidence Based Practice

Eugene Barsky points out a podcast from the British Columbia Rehabilitation Sciences Research Network (BC RSRnet) by Alison Hoens and Maggie McIlwaine entitled “Appraising the Evidence: So how do I know that this article is any good?”

Says Eugene:

This session would be of particular interest to the folks interested in Quantitative part of the health research, Alison is a gifted presenter, it is worth spending those three hours listening – there is lots to learn!

Details including links to the podcast and a companion PDF can be found at the UBC Physio Info-blog.

Looks like good stuff that I hope to download to my mp3 player soon.

One nit-pick: If I can’t set a podcatcher (iTunes or something else) to subscribe to a feed and automatically download new audio files, is this really a “podcast?” …or did I just fail to find the feed?

Oct 24

New Blog: ‘EBM Librarians’ by Connie Schardt

Duke University’s Connie Schardt has started a new blog, EBM Librarians, “…for students and librarians who support the practice of evidence based medicine.”

When I asked MEDLIB-L subscribers to recommend resources for teaching EBM, multiple respondants recommended Connie’s work:

One respondant strongly praised a class she’d attended about EBM for librarians taught by Connie.

I’m really looking forward to Connie’s posts, and have subscribed to her blog’s feed.

Oct 13

Technology mediator: a new role for the reference librarian?

From Biomedical Digital Libraries:

Technology mediator: a new role for the reference librarian?
David K Howse, Paul J Bracke, Samuel M Keim
Biomedical Digital Libraries 2006, 3:10 (13 October 2006)
Direct link to provisional PDF

The Arizona Health Sciences Library has collaborated with clinical faculty to develop a federated search engine that is useful for meeting real-time clinical information needs. This article proposes a technology mediation role for the reference librarian that was inspired by the project, and describes the collaborative model used for developing technology-mediated services for targeted users.

NEAT.

The first obstacle to overcome is establishing a connection between the three parties with critical knowledge bases – systems, resources, and users. Identifying and enlisting these parties presents a challenge, especially for smaller organizations with limited resources. In the world of academic health sciences libraries, reference librarians are best suited to initiating and maintaining this relationship, as well as advocating for navigational tools that create added value and convenience for users.

(my italics).