Presented By: 王信傑 Ricky Wang Date:2010/10/6 Ri.wang@elsevier.com That’s a quick preview of what we’re doing to make MD Consult smarter, easier, and better. We’ll be posting more information to our website SmarterEasierBetter.com, so sign up for our email list or check back regularly for updates. We want your feedback as well – there’s a Contact Us page on the website SmarterEasierBetter.com so you can tell us what you think about the new enhancements! Thanks again for your time and we look forward to telling you more about these exciting enhancements coming this spring. Presented By: 王信傑 Ricky Wang Date:2010/10/6 Ri.wang@elsevier.com 02-25225927

Over 80 full-text journals and Clinics of North America with MEDLINE MD Consult is designed to help physicians answer clinical questions and stay current with new developments in medicine. Over 80 full-text journals and Clinics of North America with MEDLINE About 50 leading medical reference books Drug Database provided by Gold Standard The latest medical news More than 1,000 peer-reviewed practice guidelines Over 50,000 images that can be downloaded or printed POCKET Consult – free for your PDA

MD Consult操作 Not only is MD Consult going to have smarter search, but it’s going to be easy to use. We’ve streamlined and simplified the interface to make it easier to navigate and access all of this great medical reference content.

瀏覽十大主題 First Consult Books Journals The Clinics Patient Education Drugs Guidelines Images News CME

MD Consult操作 主題搜尋 Not only is MD Consult going to have smarter search, but it’s going to be easy to use. We’ve streamlined and simplified the interface to make it easier to navigate and access all of this great medical reference content.

何謂實證醫學? 以流行病學和統計學的方法，從龐大的醫學資料中嚴格評讀、綜合分析並找出值得信賴的部分，並將所能獲得的最佳文獻證據，應用於臨床工作中，使病人獲得最佳的照顧。

實證醫學五大步驟 提出問題 (Question Formulation) 將資訊需求轉變成可以回答的臨床問題 搜尋證據 (Evidence Search) 實證醫學資料庫 嚴格評讀 (Critical Appraisal) 以批判的方法檢驗證據的可信度 恰當運用 (Evidence Application) 結論是否能應用於我的病人? 衡量結果 (Outcome Evaluation) 評估執行實證醫學的效用和效率

Patient character or Problem Intervention Comparison intervention 問題的結構(PICO或PICOT) Patient character or Problem Intervention Comparison intervention Clinical Outcome Time

背景問題 vs 前景問題 Background question (背景問題) Foreground question (前景問題) 有關某種疾病的基本知識 A question root (who, when, what, where, why, how...) Foreground question (前景問題) 有關病人處置的特殊問題（PICO格式）

問題與臨床經驗

Case PICO 對於 慢性蕁麻疹(chronic urticaria)， Xyzal與Allegra的那一種治療效果比較好呢？ P Xyzal (Cetirizine, 驅異樂膜衣錠) C Allegra (Fexofenadine, 艾來錠 ) O Which one is better?

Thank You!