UpToDate® Confident, clinical decision-making Virginia Chiu 邱嘉慧 Sales Account Manager

The Story of UpToDate … https://youtu.be/k4nQWM6U298 Dr Bud Rose – The Founder of UpToDate

什麼是UpToDate? 醫生在臨床時遇到的2/3問題無法解答 解答臨床問題每天可能改變5~8名患者的臨床治療策略 為醫生(和其他臨床工作者)在治療患者時解答問題的線上電子產品 他為自己編寫的教科書總是很快過時而感到苦惱 由一位著名的撰寫教科書的腎臟學家於1992年創建 教科書主要是講述某種疾病的參考工具 UpToDate主要是告訴醫生怎樣治療患有這種疾病的病人 並不是取代教科書，而主要用於解決教科書所不能解決的問題

填補空白 每周有10,000 項研究新增到Medline中 1965年僅有39項隨機試驗發表，而2008年有26,000 項隨機試驗發表 沒有醫生能夠吸收、記憶海量的醫學文獻並且判斷這些新發表的研究成果對診治患者有什麼影響 審讀文獻，來回答臨床問題 綜合相關文獻，推薦診療方案 持續更新内容 借鑒本領域專家意見 UpToDate 做到這些 自1992 來，UpToDate已成為臨床工作者的專業“工具” 因此，臨床工作人員可以在診療過程中獲取建議， 解決問題

What is UpToDate ? UpToDate is an electronic evidence-based clinical decision support tool written by physicians to help clinicians 為醫師作者們執筆所撰寫提供實時臨床醫療訊息，被設計於與醫師們所遇 之臨床問題能快速回覆，以協助醫師們進行診療上的判斷和決策 Answer your clinical questions 解答臨床遇到的問題 Increase your clinical knowledge 新增臨床的知識 Improve patient care 有助於其為患者提供更好的醫療

The trusted way to practice medicine Rigorous three-tier peer-review process Practice Changing UpDates 診療方式更新快訊 32,000+ 10,500+ Graphics 圖表 170+ Clinical Topics 臨床的專題內容 Medical Calculators 臨床計算器 5,800 440,000+ Drug Monographs 藥物訊息與交互作用查詢功能 References 包含引用文獻 1,500 26 Patient leaflets 患者教育内容 Specialties 專科

Our Editorial Board 1. Authors 2. Editors 3. Peer Reviewers - Clinically active - World-renown physician topic experts - Have an academic affiliation 2. Editors - Clinically active - Specialty experts - Trained to use EBM 3. Peer Reviewers - Clinically active - Specialists in their field - Anonymous to the author

Evidence Grading 實證等级 In 2001, we began a collaboration with Gordon Guyatt, a world leader in EBM, and his colleagues in the international GRADE collaborative to implement a grading system for recommendations UpToDate grades specific treatment and screening recommendations 7

Evidence Grading 實證等级 RECOMMENDATION GRADES 醫囑的強度 (診療建議的強度) Grade 1 1 級推薦 Strong Recommendation 強推薦 Benefits clearly outweigh the risks and burdens (or vice versa) for most, if not all, patients “We recommend…” Grade 2 2 級推薦 Weaker Recommendation 弱推薦 Benefits and risks closely balanced and/or uncertain “We suggest…” EVIDENCE GRADES 證據的品質(證據的強度) Grade A A 級證據 High Quality Evidence 高品質證據 Consistent evidence from randomized trials, or overwhelming evidence of some other form Grade B B 級證據 Moderate Quality Evidence 中等品質證據 Evidence from randomized trials with important limitations, or very strong evidence of some other form Grade C C 級證據 Low Quality Evidence 低品質證據 Evidence from observational studies, unsystematic clinical observations, or from randomized trials with serious flaws 8

UpToDate 目前涵蓋主題 Adult and Pediatric Emergency Medicine Gastroenterology and Hepatology Obstetrics, Gynecology and Women’s Health General Surgery Adult and Primary Care Medicine Oncology Geriatrics Palliative Care Allergy and Immunology Hematology Pediatrics Hospital Medicine Anesthesiology* Psychiatry Infectious Diseases Cardiovascular Medicine Pulmonary, Critical Care and Sleep Medicine Nephrology and Hypertension Dermatology Neurology Rheumatology Endocrinology and Diabetes Sports Medicine Family Medicine

Citing UpToDate – 引用UpToDate文獻 Michael D Jibson, MD. - 作者名 Second-generation antipsychotic medications: pharmacology, administration, and side effects. -主題名 UpToDate. Waltham, MA - 公司名 UpToDate Inc. http://www.uptodate.com (Accessed on January 02, 2017.) – 註明引用日期  

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For More Information Virginia Chiu Sales Account Manager www.twitter.com/UpToDate www.linkedin.com/company/uptodate?trk=hb_tab_compy_id_21924 www.facebook.com/UpToDateEBM Virginia Chiu Sales Account Manager virginia.chiu@wolterskluwer.com www.youtube.com/uptodateebm

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