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Answering clinical questions

Published on Jan 06, 2016

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PRESENTATION OUTLINE

Answering clinical questions

with evidence-based practice methods
Photo by Junnn

The question:
The patient is a 65 year old male with a long history of type 2 diabetes and obesity. Otherwise his medical history is unremarkable. He does not smoke. Over the years he has tried numerous diets and exercise programs to reduce his weight but has not been very successful. He understands that his diabetes puts him at a high risk for heart disease and is frustrated that he cannot lose the necessary weight. His neighbor told him about a colleague at work who had his stomach stapled and as a result not only lost over 100 lbs. but also "cured" his diabetes. He wants to know if this procedure really works.

Reference Interview

  • Clarify desired patient outcomes
  • Clarify desired patient procedure
  • EBM is the intersection between the best available evidence based on research, individual patient care, and patient values.
  • Information provided will provide sound medical evidence, but should consult with a medical professional.

Reference Interview Assumptions

  • Outcomes: decrease weight, lower risk of heart disease, control diabetes.
  • Gastroplasty procedure

Databases

  • MeSH terms: Diabetes Mellitus AND gastroplasty
  • Demonstrate to patient that that I have located the best possible information.
  • Open PubMed, MEDLINE, Trip

Start with systematic reviews

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Fill in gaps

  • Review references for possible leads
  • Published in 2011; anything more current?

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Consumer-based resources

can help clarify procedures for patients

Check with patient

  • Satisfied with amount of information?
  • Reassure that more specific resources can be obtained
  • Provide keywords and tips for database searching.
  • ILL, Virtual Library, Research Guides, contact information

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