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全新 MD Consult 更聰明 更簡單 更好

2007 春季改版 更聰明的搜尋： 透過進化的聰明搜尋功能，能幫您更快、更精確找到您所需要的答案 Our new smart search doesn’t just find all of the documents on MD Consult that include your search terms — we understand more about what you’re really looking for, providing Recommended Results and Search Refinements to help you get better, more relevant search results.

2007 春季改版 更簡單的使用： 重新設計的界面減少了凌亂，帶來的是更簡潔的操作介面以及閱讀版面的增加 One of MD Consult’s strengths is that it provides access to a vast amount of high-quality clinical information. Our new user interface will make it even easier to find, access, and use that information to answer your clinical questions.

2007 春季改版 更好的連結： 更方便的方式連結到優質臨床醫學的電子資源 MD Consult has long been known as a premier resource for medical content, and these enhancements will make MD Consult even more valuable. You know that you can turn to MD Consult for the leading medical books, journals, The Clinics of North America, drug information, patient education materials, and other clinical medical information.

更聰明的 MD Consult 更聰明地搜尋到臨床相關資訊 We spent a lot of time really understanding how physicians search on MD Consult, and how they want to be able to search. We watched how physicians look for medical information, both on our site and on other sites. We identified things that MD Consult does well and areas where we can improve. What we came up with is a smarter way to search, where you will see results that are more clinically relevant, making it easier to access the best medical reference information to improve patient care. 更聰明地搜尋到臨床相關資訊

更聰明的搜尋 增加同義字搜尋 更好的檢索策略轉譯 增加搜尋精化-讓使用者能藉由進一步的分類快速篩選結果 新增檢索建議-讓使用者在一般搜尋結果頁面直接點選 呈現推薦結果-讓使用者可以看到最簡潔的結果呈現 Smarter search is really a combination of five significant enhancements. We’ll go through each of these individually so you can understand a bit more about how each of these will make it easier to find the right information on MD Consult.

增加同義字 能讓使用者找到一開始沒有考慮到的詞彙以增加搜尋內容的廣度 大部分的關鍵字詞在MD Consult中都解會被正確解讀並進一步查詢相關字彙 The first two enhancements to search are really things that are going on “behind the scenes” with MD Consult. When you search on MD Consult, you won’t need to do anything differently and may not notice anything specifically different right away, except that there will be significant improvements in your search results. By broadening the thesauri and vocabularies we are using, searches on MD Consult will uncover even more relevant and appropriate clinical content than before. We have always expanded terms using appropriate medical vocabularies, but these enhancements will further improve the recall of searches.

增加同義字 Examples： 藥物的學名與商品名稱 Coumadin vs. Warfarin 提供最佳的縮寫字詞判別 “DVT” or “Deep Vein Thrombosis” Here’s just a few examples of how improved synonymy will improve search results. People often come to MD Consult to search for medications. Often, they are not sure if the medication is a brand name or a generic name. Our improved synonymy will find all times the medication is referred to, regardless of whether the person searched with the generic name or the brand name. In this example, regardless of whether someone searches for a brand name like Coumadin® or the associated generic name (warfarin), we will provide the same search results. Another area where you will see improvements is with medical acronyms. We’ve made enhancements in recent years, but our smarter search will make it work even better. Now, regardless of whether your patrons type in a medical acronym or abbreviation like DVT, or the full phrase – in this case, deep vein thrombosis, we will show the same search results and find all of the cases where the medical condition is mentioned. After all, that’s why people turn to MD Consult – for clinical information on a specific topic. Medical professionals shouldn’t have to think about how to compose their query to get the right information out of the search engine – they should spend their time thinking about how to use the information they find to improve patient care.

更好的檢索策略轉譯 heart attack cancer heart AND (attack cancer) Search heart AND (attack cancer) (heart attack) AND cancer “(“heart attack” or “myocardial infarct” or “cardiac infarction” or “infarction of heart” or “myocardial infarction”)” AND cancer When you combine better query interpretation with the improved synonymy that were just described, what you get is a search engine that not only can interpret the query but find all of the related synonymous terms. In this example, you can see that we’re using medical vocabularies to find related terms for heart attack. This is a fairly straightforward example, but with more obscure terms, more complicated queries, and searches on things like abbreviations, acronyms, and drug names, you will notice significant improvements to the quality of search results.

更好的檢索策略轉譯 Examples： 標點符號的轉譯 “bell’s palsy” vs. “bells palsy” 針對特定問題的轉譯 ICD-9 code: 88.72 (echocardiography ) Better query interpretation isn’t just about recognizing phrases, it’s about making sure we’re interpreting the words correctly. We have lots of searches for bell’s palsy – some people include an apostrophe, some don’t, and when it does appear it can be different places. Regardless of where the punctuation is placed, we’ll find the same results, and find all of the relevant results. This should apply to any terms that include apostrophes, semi-colons, hyphens, and other punctuation marks. We can also better handle specific queries like ICD-9 codes. So, if you have an ICD-9 code and you’re not sure what procedure or diagnosis it relates to, you can just search on the code. We can also handle other codes like ISSNs and ISBNs. Now, it’s probably pretty unlikely a physician would go to MD Consult and type in the ISBN of Cecil’s Textbook of Medicine, but it’s an example of how we can recognize a whole range of different types of queries – in this case, even if it’s just numbers and dashes, we’ll know that the searcher is looking for a book. Our system is flexible and can accommodate and recognize different types of queries.

搜尋精化 將搜尋結果做進一步的精確分類 The first two enhancements were “behind the scenes” enhancements. You won’t notice anything significantly different other than that search results will be a lot more relevant and appropriate to your query. These next three enhancements are things that you will definitely notice right away. As shown here, we’ll be providing suggestions for refinining a search. You’ve probably seen things like this before, since there are a number of other sites that provide refinements like this. Alongside search results, these search refinements will be shown. If you select one of those refinements, we’ll add that term to your search query and run another search. One of the challenges we have is that we have hundreds of thousands of possible documents to display for broad and general searches. As I mentioned earlier, most of our searches are very short queries focused on a specific diagnosis or disease entity. The more information physicians can give us about what they are looking for, the better we can provide appropriate search results. Searches familiar with Boolean searching know how to structure their searches with different types of connectors, but this is a way of allowing searches of all levels to provide us with more specific information about what they’re looking for, which ultimately can help us provide better results. We also classify searches, so when someone searches, we can detect if they are searching on a diagnosis, a sign, a symptom, or any other type of term? Then, the refinements that we provide will be based on how we classify the search. As an example, the refinements that would be shown for a symptom like back pain would be different than for a disease like rabies.

搜尋精化 還能訂做最佳的檢索策略 That tailoring of refinements extends to not just classifying the searches and providing refinements based on the classification, but also to tailoring for specific searches. Instead of or in addition to the regular refinement terms, we can present more specific diagnoses, related medical concepts, combinations of different types of terms, or anything else related to the query. In this example, instead of the standard refinements that could be shown for hypertension, which we saw on the last slide, We’ve gotten extremely positive feedback on these refinements from the medical students, physicians, and librarians who have been involved throughout the development. This is an example of how the new search is smart and can anticipate what people might be looking for.

檢索建議 你能猜測下列關鍵字的搜尋結果嗎? Cecil Textbook of Medicine Anesthesiology Clinics of North America Head Trauma Handout Wellbutrin XL Before we discuss about our fourth enhancement, let’s take a look at an example of some of the types of searches we see on MD Consult. For these searches, we all probably have a pretty good idea of what the person is looking for. In the first two examples, someone is coming to MD Consult looking for a specific book or journal, and they type its name into our search box. In the third example, someone is looking for a specific type of content – a Patient Education handout – relating to a medical topic. In the last example, someone is searching on a specific drug name. They are likely looking for information on that medication – description, classification, dosage, contraindications, and other information about the drug and how it should be used. For these types of searches, searches where we have a pretty good idea of what a searcher is looking for, we will provide search recommendations along with the regular search results.

檢索建議 跟著檢索結果提供 ”建議結果” 商品名稱 書籍及期刊名稱 作者姓名、重要新聞,以及其他適當的內容 跟著檢索結果提供　”建議結果” 商品名稱 書籍及期刊名稱 作者姓名、重要新聞,以及其他適當的內容 The types of searches where we will provide recommendations along with search results are any searches that include a brand or generic drug name, the name of a book or journal, or the name of an author of one of the books on MD Consult. In those cases, we’ll provide a link directly to the appropriate content. In this example, someone has searched on the name of what happens to be a drug name. We have identified that it is not only a drug, but that it is a brand name drug, and we know the associated generic drug. We present a link to the appropriate monograph since it is likely that this is what the person may be looking for. If it’s not what they are looking for, or if they want additional information as well, that’s not a problem, because we also present all of the other search results. These search recommendations may also appear for important news – when a medication is recalled, when a significant journal article is published, or for other major medical or public health news that physicians and medical professionals need to know about. If there’s an e coli contamination in a certain type of food or at a certain restaurant, we could present a link to the relevant medical news article when people search on the name of that food or that restaurant. We have received very positive feedback about this feature because it can help people get to the right information quicker and easier. What we’ve done is build a search that doesn’t just bring back all of the documents that contain the word that you typed in, but instead it understands more about what you are looking for and provides clinically relevant results that can help you more easily get you to the right medical reference information.

推薦的結果 針對在診斷或疾病方面較為常用的字彙提供建議結果 acne asthma COPD diarrhea hepatitis lupus obesity Our last enhancement to search is something that we are very excited about and the medical students, physicians, and librarians who have been involved in helping to evaluate and provide feedback on are very excited about as well. It’s based around the idea that on MD Consult, as on most web sites and search engines, there are a small percentage of queries that make up a good portion of overall search volume. As an example, we get searches for things like “acne” and “peripheral vascular disease” but “acne” is searched on much more frequently than “peripheral vascular disease.” The most popular searches are these broad diseases and diagnosis like acne, asthma, and obesity. For these searches, there are literally hundreds of thousands of pieces of content on MD Consult that contain those terms and may be relevant. We know that it’s a challenge for physicians or really anyone to wade through that many search results – they need help getting them more quickly and easily to clinically applicable content.

推薦的結果 Recommended Results的面頁會提供最常被搜尋到的內容結果 包含最新、最相關以及最有用的臨床資訊的內容 What we’ve done is create what we call Recommended Results pages for a lot of these terms that are frequently searched on MD Consult. These pages are in addition to the regular search results, so you will still see your regular search results as always but you will also get this additional page that recommends current, relevant, and clinically useful content.

This is a sample page for anemia, which is a common query on MD Consult. There are tens of thousands of pieces of content on MD Consult that mention anemia, but a physician searching on that term definitely doesn’t have the time to sort through all of that information. These pages have been designed with a lot of input from medical students, residents, and physicians, and they are organized based on the way physicians think about medical information. The content is grouped the same way physicians are trained to think about patient care – there’s a section with links to overviews of the disease, sections for etiology, diagnosis, treatment, management, and other sections that vary depending on the search term. We’ve used many of our medical books as references to see how they organize medical information and use that common organization that physicians are familiar with as the basis for these Recommended Results pages. Within those sections, we’ve selected current, relevant, and clinically appropriate content. These may be sections of relevant reference books, summary articles from The Clinics of North America, review articles from leading journals, tables and graphs, even appropriate practice guidelines. Rather than being overwhelmed by search results, searchers can get a quick view of what relevant content is available on MD Consult. There’s also links to refine the search and to patient education handouts for that condition. If you want more information in a specific area, you can refine your search. For example, if you want more information on diagnosis, just click on the link that will refine your search to Anemia diagnosis. You can also access the standard search results page that shows the Top Results for All Sections, or the search results for each section, shown in the orange bar across the top.

更簡單的 MD Consult 簡明流線的界面使得它更容易瀏覽 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. 簡明流線的界面使得它更容易瀏覽

使得 MD Consult 更簡單 透過圖書館員, 醫師, 學生和其他相關人員協助進行問卷調查 藉由下列方式得知客戶反應、需求: 使用滿意度測試 訪問和觀察 調查 焦點團體 顧客的意見 This new design that you’ll see for MD Consult is really the culmination of extensive research. We’ve received an extensive amount of input about what people like about the site and what can be improved. We’ve watch students and physicians and librarians use our site and other sites. We’ve visited hospitals, medical schools, and private practices to talk with customers and non-customers. We’ve conducted surveys and focus groups to get answers on specific questions and ideas. We’ve also taken into consideration all of the comments and feedback we have received through customer service and technical support, through our sales representatives, and through you getting in touch with many of us directly. As you can see, we’ve spent a lot of time listening to what our customers are saying and identifying customer needs, and the changes that we’ve made are based on all of that research.

MDC的改版,進行了那些改變？ 更簡潔有力、清爽的操作介面 更簡單的瀏覽方式與互動 更多的閱讀空間 秉持著一致性的設計 有效率地簡化共同工作 Here is a quick overview of what we’ve changed. You’ll notice the cleaner, more streamlined look right away. The design of the site has been simplified to make it easier to navigate and interact with the content. We know that you come to MD Consult for our world class content, and we wanted to make sure that there was as much space on the screen as possible for viewing and reading content. As MD Consult has evolved over the years, new sections have been added and updated, and in some cases one section isn’t consistent with another. This new interface is much more consistent across the entire site, which should make it easier to quickly learn how to use MD Consult and take advantage of all of its capabilities. And throughout all of this, we identified common tasks that people perform on the site and have streamlined them to reduce the number of steps and clicks.

改版後除移的內容 移除的部分 Student Union What Patients Are Reading Clinical Topic Tours Case of the Week 透過聚焦，使我們能夠在內容上提供更好品質的臨床參考文獻 www.SmarterEasierBetter.com We will be removing some of the content areas as part of the new MD Consult coming out this spring. Student Union, What Patients Are Reading, Clinical Topic Tours, and Case of the Week have all been discontinued as of April 1. We have posted messages to the site notifying people of these changes, and we will be removing these content areas as part of our spring enhancements. When we talked with customers and analyzed why they were purchasing and using MD Consult, these were areas of the site that were noted to be less important, and when we analyzed usage we saw that they were not used nearly as frequently as other areas on the site. Removing these content areas from MD Consult will improve the service in several ways. - The fewer different areas we have on the site, the less clutter there will be in the interface and the easier it will be to access the most-used types of content. - Fewer areas in search results should simplify search results and make it quicker to find what you’re looking for. - With fewer different types of content on the site, it allows us to focus our efforts more on improving the most-used and most-valued content We’ve thought long and hard about these content changes and received input from customers all along the way. We believe that these changes will help us make MD Consult an even more valuable resource for clinical medical information.

更好的 MD Consult 更簡便的方式連結至優質的臨床醫學資源 You’ve seen how MD Consult’s search will be smarter, the interface easier to use, and overall create an MD Consult that provides better access to the best clinical medical reference information available. 更簡便的方式連結至優質的臨床醫學資源

產品內容 35本臨床為主的期刊 51部著名醫學參考書 53份全文醫學期刊加上MEDLINE 提供藥物資訊(Support by Gold Standard) 最新醫學新聞 同儕評鑑診療指引(Peer-Review Guidance) 超過10,000篇病患須知，並可按需要作出修訂 線上可取得繼續醫學教育學分(USA only) POCKET Consult – 專為PDA而設，免費的功能

九大主題 醫學用書（Books） 醫學期刊（Journals） 臨床期刊 (The Clinics) 病患須知（Patient Education） 藥物資訊（Drugs） 診療指南（Guidelines） 圖片（Image） 新聞（News） 本周醫藥新知（This Week in Medicine） 當週期刊（In This Week’s Journals） 持續醫學教育（CME）

參考書籍（Books） 備受推崇的參考書籍，如： Brenner & Rector's The Kidney Braunwald's Heart Disease 7e Sleisenger & Fordtran's Gastrointestinal and Liver Disease 8e Cecil Textbook of Medicine 22e Robbins and Cotran 7e Campbell's Urology 上下捲動檢視目錄或索引

參考書籍（Books） 查詢某本特定的書籍

參考書籍（Books） 可針對整個書庫中的書籍進行搜尋 提供索引及目次，方便您的點閱及搜尋 可儲存最近的搜尋記錄及搜尋結果(個人化功能)

期刊（Journals） 收錄88種期刊 包括最著名的《The Clinics of North America》及《年鑑》 同時搜尋 Medline 資料庫 每篇全文文章均包括書目資料及目錄

臨床期刊(The Clinics) 提供35種最具權威的 北美臨床雜誌 每篇全文文章均包括書目資料及目錄 簡單而靈活的搜尋選項方便進行精確檢索 專科按鈕 受試者年齡 按全文/相關性、相關性或出版日期排序

期刊搜尋（Journal Search） 簡單而靈活的搜尋選項方便進行精確檢索 年限設定 文章類別 受試者年齡 按全文/相關性、相關性或出版日期排序 年鑑的文章附於原著期刊文章 評論性文章(REVIEW)在搜尋結果中以旗標識別

期刊 HTML全文 Elservier所出版的期刊和Clinics均提供全文內容 包含超過30,000篇文章 Back Issue可回溯至1996年

期刊 PDF全文 允許使用者瀏覽、下載和列印PDF文章

病患須知（Patient Education） 超過10,000篇病患須知 可按需要作出修訂 內容淺顯易懂 – 只要具備美國6至8級閱讀水平 平均每篇1~2頁的長度 超過100篇綜合版病患須知 部分衛教資訊附有圖片

藥物資訊（Drugs） 由Clinical Pharmacology所提供的藥物資訊 提供藥物圖片及說明 提供FDA第一手訊息,包含： 剛核准上市的新藥 安全性通告 新核准的指示 Off-Label Use… 資料每天更新(最即時)

藥物資訊（Drugs） 提供藥物商品的圖片 藥物資訊包含： 藥物分類、別名、學名 副作用 交互作用 藥物動力學、機轉 分子結構 …等相關藥物資訊

藥物搜尋（Drug Look-up） 通過以下四大類別搜尋指定藥物： 商品名+ 適應症 商品名 適應症 禁忌

診療指南（Guidelines） 超過1,000份同儕評鑑臨床診療指南(Peer-Review Articles) 按照作者、機構、專科及主題方式分類 每篇全文文章均包括書目資料及目錄

圖片(Image) 超過50,000張的圖片 可供查詢 及 圖片比對 來源：資料庫中的Books

新聞報導（News） 獲取美國醫學界的最新發展 服務涵蓋以下兩方面： 本週醫藥新知 當週期刊

本週醫藥新知（This Week In Medicine） 簡介 資料每天更新 自訂有興趣的專科領域 （個人化功能）

當週期刊（In This Week’s Journals ） 提供目前最具影響力醫學期刊主要文章的摘要精華 迅速概覽主要醫學期刊的內容 專題期刊，每月不同 每週更新（與最新發行的期刊同步）

當週期刊（In This Week’s Journals） 收錄的期刊包括： JAMA New England Journal of Medicine The Lancet British Medical Journal Annals of Internal Medicine Archives of Internal Medicine Canadian Medical Association Journal Pediatrics

訂閱電子報 提供MDC的最新訊息 包含期刊、醫藥、圖書等相關訊息 並可藉由上方連結快速回到MD Consult使用相關資源

FIRSTConsult FIRSTConsult Overview Differential Diagnosis Medical Topics Procedures Patient Education Full Text Search Feature Links to MD Consult FIRSTConsult Handheld Benefits of FIRSTConsult

What is FIRSTConsult? FIRSTConsult 一個革命性的臨床資訊系統服務，同時提供網路和PDA版本。具有持續更新 (continuously-updated) 的特性，提供最新的病患評量、論斷、處置資的實證醫學 (evidence-based) 訊息 — 設計成快速讀取的格式以解決臨床 (point of care) 遭遇的問題 。 FIRSTConsult 提供： 1,800 種診斷選項 超過 800 個臨床主題 (medical topics) 300 份以上可客製的衛教單張 (patient handouts) 外科和診斷流程 (procedures)

FIRSTConsult Editorial

Evidence-Based Medicine 文獻中的 圖示代表實證醫學資訊 這些臨床實證資訊，經由專業編輯群，參考受到高度推崇的文獻而成： Cochrane Systematic Reviews Clinical Evidence The National Guideline Clearinghouse™ 選錄的文獻，考量臨床工作可行性後才加上實證醫學標示 所有的證據評斷都依據 AAFP 的評量標準 實證和導引 (guidelines) 內容經常更新

Differential Diagnosis 基於病患主訴 (chief complaint) 提供超過 350 個病徵(signs) 和 徵候 (symptoms) 搜尋方式包括： 利關鍵字在整合性搜尋欄位中輸入主訴 捲動列表瀏覽以找尋病患主訴 點擊字首( A-Z ) 以便快速跳至病患主訴

Differential Diagnosis 點選病人主訴 (chief complaint) 以連結診斷表 (diagnostic tables) 提供超過 1,800 可能的診斷 依據年齡和盛行率 (prevalence)排序 急症用 紅色 * 標明

Differential Diagnosis 每一診斷都提供臨床評量基準 (Clinical Benchmarks) 點擊診斷表中的臨床主題即可切換該主題資訊

Differential Diagnosis 要比較不同的臨床主題 之間的差異，只要選取該主題再按下 ‘Compare’ 即可

Differential Diagnosis 頁面左方可快速點選來比較、判別相關特徵 選取切合的診斷 直接連結到臨床主題，以獲取完整的診斷和處置細節

Medical Topics 超過 800 個臨床主題 (medical topics) 可以利用以下方式搜尋： 在整合搜尋欄位中輸入關鍵字 利用瀏覽方式尋找 利用字母排序 (A-Z) 快速跳到該主題

Medical Topics 利用點選左方移動式文件大綱選讀所需細節 共計 7 種選項 每種選項內含 6-12 次分類 內容每週更新

Medical Topics Diagnosis Menu includes: Summary Menu includes*: Clinical presentation Associated disorders Differential diagnosis Workup Clinical pearls Consider Consult Summary Menu includes*: Description Synonyms Immediate Action Urgent Action Key Points Background Menu includes: Cardinal features Causes Epidemiology Codes *

Medical Topics Outcomes Menu includes: Treatment Menu includes: Prognosis Clinical pearls Clinical complications Consider Consult Treatment Menu includes: Goals Immediate action Therapeutic options Clinical pearls Never Management in special circumstances Patient and caregiver issues Follow-up Ask for advice Consider Consult

Medical Topics Prevention Menu includes: Resources Menu includes: Primary prevention Modifiable risk factors Secondary prevention Screening Resources Menu includes: References Associations Related topics Contributors

Procedures 系統性的外科和診斷流程導引 數量超過 50 個 提供影像或是動畫

Procedures

Full Text Search Feature 全文搜尋功能會利用您輸入的關鍵字將搜尋結果排序、列出選單、和 所有 FIRSTConsult 內的相關內容 在左方的整合性搜尋欄位中輸入關鍵字 可利用邏輯運算子 (AND, OR, NOT) 來搜尋合乎需求的資訊 於表頭呈現此次搜尋的詳細內容 搜尋結果包含排序的列表最切合的結果放在最前面

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Benefits of FIRSTConsult 節省保貴的時間 設計用於解決臨床(point of care )問題 臨床決策支援 提供即時取用的專家建議 增進醫病的溝通與信賴

FIRSTConsult also… 透過支援 “best practice” 有效制訂決策 增進時間和資源利用效率，迅速解決問題 提供可行的實證醫學處置計畫改善癒後

POCKET Consult 第一手醫學新聞 20 種醫學指數 藥物新知 個人化期刊摘要 開始和儲存搜尋項目 支援掌上型電腦（Palm及 Pocket PC）平台 費用全免！

POCKET Consult My PDA按鈕坐落在右上角 第一次使用的使用者將必須建立一個新的帳號

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POCKET Consult 提供超過400份期刊的目錄可供下載 提供期刊引文 和/或 摘要

POCKET Consult 將所需資訊傳送至PDA 使用同步傳輸（hot sync）功能同時上載搜尋項目至PC中 所有搜尋項目儲存於 「我的搜尋項目」文件夾內 方便日後使用

Thanks For Your Attentions Online practice continued…