EBSCO Information Services + 이용 매뉴얼 EBSCO Information Services 곽단미/과장

Changing Rule Decision making is based on training and experience Current Approach New Rule Care is based primarily on visits Care is based on continuous healing relationships Professional autonomy drives variability Care is customized according to patient needs and values Professionals control care The patient is the source of control Information is a record Knowledge is shared and information flows freely Decision making is based on training and experience Decision making is evidence-based Do no harm is an individual responsibility Safety is a system property Secrecy is necessary Transparency is necessary The system reacts to needs Needs are anticipated Preference is given to professional roles rather than the system Cooperation among clinicians is a priority

New medical information is changing rapidly Problem of End User New medical information is changing rapidly Doctors and patients need reliable guidance

Problem of End User 환자 진료에 있어 효과적이고, 포괄적인 최신의 객관성이 확보된 임상의학 정보 필요 그러나 현실적으로는 어떤 임상의학 정보원이 가장 신뢰성을 근거로 객관정인 정보를 제공하는지에 대한 제시가 제대로 이루어 지지 않고 있음 Evidence-Based Medicine and Primary Care: Keeping Up Is Hard to Do. MOUNT SINAI JOURNAL OF MEDICINE 2012

DynaMed Plus EBM Resource 서비스 절대적 필요 점점 다양해 지는 정보원 EBM 정보원의 절대적인 평가 필요 정확한/최신의 임상의학 정보원 서비스 필요

Medical Specialty 임상 토픽 Recommendation & Overview 기관 EMR 시스템과 연동 Medical Specialty 임상 토픽 모바일서비스 제공 관심 임상 Topic Alert 서비스 매일 업데이트 최적 최신의 근거중심 임상의학 정보원 약물 정보 Reference 원문 링크 Medical Image 제공 Recommendation & Overview

What is “DynaMed Plus”? 환자 진료 시 실무에 바로 적용할 수 있는 임상의학 정보원 임상질의에 적용할 수 있는 최적의 근거자료 및 가이드라인 제공 약 30가지 Medical Specialty의 임상 토픽 제공 약물정보(Drug Information) 수록 임상토픽과 관련된 Medical Image 수록 Medical Calculator 제공

“DynaMed Plus” Conents 각 질병 토픽에 대한 임상 요약 정보 제공 Topic Summaries are based on -일반 및 희귀질병 -증상 -임상적으로 중요한 다른 토픽 (e.g., breastfeeding, cardiac stress testing) -특정 인기 관심 정보 (e.g., West Nile virus, anthrax, SARS, avian influenza) -새로운 연구개발에 기반한 정보 (e.g., include metabolic syndrome and D-dimer testing) -DynaMed Plus이용자가 제안한 정보

DynaMed Plus Overviews and Recommendations Redesigned DynaMed and focused on time-to-answer: GRADE에 기반한 Overviews & Recommendations는 임상의들의 Evidence-Based Recommendation에 근거한 간결하고 정확한 정보 전달 이용률이 높은 약 750건의 토픽에 Overviews & Recommendations 추가 - 매주 타 토픽에 추가 예정 Mention: We haven’t just added Overviews and Recommendations, we’ve re-written the entire topic to support them (show this in next slide) We started with the most-used 750 topics, and we’ll continue to update topics as we move forward.

What is GRADE? GRADE (Grading of Recommendations Assessment, Development and Evaluation) 는 2000년에 Guideline 연구자 그룹에 의해 고안 Recommendations 는 “Strong 또는 Week”으로 등급 구분 Strong recommendations는 임상의들이 해당 진단/치료/가이드라인 정보의 편익이 위험요소나 책임요인보다 월등히 앞선다고 확신할 때 부여 Weak recommendations는 편익과 위험요소가 비슷한 수준이거나 환자의 상태에 따라 진단, 예후가 달라질 경우라고 판단할 때 부여 Quality grading은 각 방법연구에서 언급된 편견에 따른 위험 요소에 기초하여 구분

GRADE is now the standard Guideline Groups More than 80 of the worlds leading organizations which produce guidelines formally use GRADE: WHO The Endocrine Society ACCP ACP American Thoracic Society NKF/KDOQI KDIGO Norwegian Knowledge Center/ Norwegian Directorate of Health Canadian Cardiovascular Society Systematic Reviews Independent systematic review organizations such as Cochrane’s have incorporated GRADE. IDSA CDC AGA AASLD ICSI NICE SIGN NHS Kaiser Permanente Dutch College of GPs Multiple Red Cross groups

Recommendations in DynaMed Plus DynaMed Plus는 쉽게 접근 할 수 있는 가장 간결하고 명확한 Recommendation 제공 Topic 상단에 “Key Points” 정보 수록 – 검색이나 Scroll Down 필요 없음 투약 정보는 질병Topic 약물 정보 섹션에 – 더 이상의 검색 필요 없음 특정 학회의 Grading System은 각각의 Topic에 링크와 함께 제공 DynaMed Plus는 미국 주요 학회 및 전세계 대륙별 가이드라인 제공 각 학회의 가이드라인은 Full Text 링크 및 원 정보에 대한 링크 함께 제공

DynaMed Plus Images DynaMed Plus의 Topic에 관련 이미지 추가 Over 2000 images from ACP Specifically requested images from editors for DynaMed topics 각 Topic에 수록 및 별도 이미지 검색기능 제공 We’ll be starting out with about 2500 images, many from the ACP, as well as specifically targeted and licensed images that will be embedded right into DynaMed topics. All the images will be searchable, and we’ll show you how that will look in a few minutes

Topic 검색 시 관련 이미지 상단에 출력 We’ll be starting out with about 2500 images, many from the ACP, as well as specifically targeted and licensed images that will be embedded right into DynaMed topics. All the images will be searchable, and we’ll show you how that will look in a few minutes

각 토픽 상세 페이지에 이미지 및 설명 제공 We’ll be starting out with about 2500 images, many from the ACP, as well as specifically targeted and licensed images that will be embedded right into DynaMed topics. All the images will be searchable, and we’ll show you how that will look in a few minutes

DynaMed+ Time to answer 원하는 정보접근까지의 시간 단축을 위한 기능 제공 Easy to Access, Easy to Search, 즉문즉답을 위한 기능 강화 이용자 질의에 대한 정보검색 시간 단축: Intelligent auto-suggest Direct-to-section search results Exact-match summary display Quick access to relevant images and calculators There are a number of ways that we’ve solved the problem of accessing content quickly, and we’ve categorized these under this idea of “Time to answer”. One of these we’ve already seen with overviews and recommendations – adding recommendations right at the top of a topic decreases the time to answer for the clinician. We’ve also tackled this problem from a technological standpoint as well.

There are a number of ways that we’ve solved the problem of accessing content quickly, and we’ve categorized these under this idea of “Time to answer”. One of these we’ve already seen with overviews and recommendations – adding recommendations right at the top of a topic decreases the time to answer for the clinician. We’ve also tackled this problem from a technological standpoint as well. 추천 검색어와 키워드 자동완성 기능 제공

There are a number of ways that we’ve solved the problem of accessing content quickly, and we’ve categorized these under this idea of “Time to answer”. One of these we’ve already seen with overviews and recommendations – adding recommendations right at the top of a topic decreases the time to answer for the clinician. We’ve also tackled this problem from a technological standpoint as well.

DynaMed Plus Mobile DynaMed Plus 전용 모바일 서비스 제공 반응형 웹에서 어플리케이션까지 모바일 어플리케이션 이용통계 제공 이용자 접근점 확대!