 Hi, this is Julie Nanavadi, clinical informationist at the Welch Medical Library. Today I'm going to talk about evidence-based clinical tools and resources available to you to support your clinical decision making. We'll start by discussing clinical tools used for finding disease summaries and drug information. These tools are designed to be easy to use so that you can quickly access high-quality evidence-based information on a topic. Then we'll discuss resources available to you for instances when you need to dig a little bit deeper. Perhaps the overview does not provide enough information or does not apply to your specific case. For these situations you can turn to high-quality literature or practice guidelines. I'll show you the resources to use to find these. We'll also talk briefly about when using Google, Google Scholar, and Wikipedia are most valuable and when they should be avoided. Next we'll talk about some resources that you can use to find patient education handouts. Let's get started. You can access most of the clinical tools and resources that we'll talk about from the Welch Medical Library's website. When you're at the hospital, you can access them from the workstations. Now let's move on to the clinical tools for finding disease summaries. I'm sure you've used up-to-date before, but tools like Dynamed and Clinical Key are also valuable resources to add to your toolkit. Dynamed provides evidence-based disease summaries. The literature used for each summary is linked throughout so you can easily access the referenced primary studies. The best part about Dynamed is the information is current with entries being updated daily. There's also a free app available for Dynamed that you can download for your phone. You might notice from the screenshot that Dynamed and Micrometics are now combined into one seamless database. We'll talk about Micrometics shortly. Clinical Key is produced by Elsevier, one of the largest publishers of biomedical books and journals. You can use it to find disease summaries similar to those in Dynamed and up-to-date. You might also find it a valuable source for journal articles, e-books, medical images, and procedure videos. Because Clinical Key has so many resources, it can be a bit overwhelming to search this database. If you're just looking for disease summaries, pull down the arrow next to the search box and limit to clinical overviews. Up-to-date is the largest of the disease summary tools providing access to summaries on over 11,800 clinical topics. It is often referred to as an evidence-based resource, but this is a bit of a misnomer. While the topic summaries that you find in up-to-date are based on the literature and incorporate findings into the information provided, the authors do not perform systematic reviews of the literature on a topic. Rather, they combine a synthesis of selected literature and their own expert knowledge to form patient care recommendations. That being said, medical students and residents tend to appreciate this resource for its reliable information, ease of use, readable format, and access to quick answers to clinical questions. I'm guessing you're wishing we'd just tell you one clinical tool to use for finding disease summaries. That would certainly be easier, but the reason you have access to three separate tools is that it's important to not rely too heavily on one resource of information, even if it's of high quality. If you do, you could miss out on important information that can make a difference in your patient's care. Because each of these tools references different pieces of evidence, Dynamed might bring up an important point that isn't mentioned in the up-to-date summary, or vice versa. For this reason, it's vital to reference more than one of these tools when answering a clinical question. Let's move on to drug information clinical tools. Remember what I said about referencing more than one disease summary tool? The same goes for drug information tools. For this reason, there are two drug information tools I'll recommend for you, Micromedics and Lexicomp. In both databases, you can find overview information about a drug and lookup interactions. In addition, Micromedics has a mobile app that's freely available. You can access Micromedics two ways. If you use the Dynamed plus Micromedics database, you get seamless access to both databases. In it, you can access drug monographs, check interactions, and access medication calculators. You can also use the standalone version of Micromedics to get a little bit more information regarding drugs. In this tool, you can also get patient handouts and compare drugs side by side. To access Lexicomp from the library's website, you need to search for it in the database search box on the right-hand side of the screen. Lexicomp is used as the hospital formulary, so when you look up the formulary from the hospital workstation, Lexicomp is running behind the scenes. What this means for you is that you can quickly search for additional drug information from Lexicomp whenever you have the formulary open. As mentioned earlier, while clinical tools are great for understanding the basics about a condition or medicine, you may need to dig deeper on a topic. Tools like the TRIP database, Cochrane library, and PubMed clinical queries will enable you to find these resources. The TRIP database is a clinical search engine a little bit like Google, but designed for evidence that will inform your clinical practice. You can access it by going to www.trippdatabase.com. In TRIP, when you enter your search terms and see your search results, you'll be able to filter by systematic reviews, evidence-based summaries, guidelines, trials, and more. The Cochrane library is accessed on the Welch library website and includes a collection of Cochrane databases. One of which you'll find highly valuable for answering clinical questions is the Cochrane database of systematic reviews, which contains over 7,500 Cochrane reviews. Cochrane systematic reviews are considered the gold standard for systematic reviews because of their rigorous methodology and transparency. If you find yourself needing more in-depth information than what you can find from disease summaries, see if you can access a high quality systematic review such as one published by Cochrane. You can feel comfortable that the review analyzed findings from high quality trials to make its recommendations, alleviating the need for you to do the same on your own. In addition to systematic reviews, the library also contains a collection of controlled trials. These are taken from bibliographic databases, mainly PubMed and MBase, but records are also derived from other published and unpublished sources, including CINNL, clinicaltrials.gov, and the HOOS International Clinical Trials Registry Platform. The last Cochrane resource that I'll mention is the Cochrane Clinical Answers, which is also found in the library. It provides a readable, digestible, clinically focused entry point to rigorous research from Cochrane reviews. I'm sure you're familiar with PubMed, but did you know that there's a clinical tool you can use in PubMed to quickly find primary studies related to your clinical question? This tool is called PubMed Clinical Queries. You can access it from the PubMed homepage underneath the find heading. In it, you can search for high-quality primary research related to therapy, diagnosis, prognosis, etiology, medical genetics, and COVID-19. Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances. These guidelines are available in the TRIP database, in Dynamed and Micrometics, Clinical Key, and also from major societies like AAP or ACC. Let's briefly talk about Google, Wikipedia, and other internet resources. With so much out there, it's important to know what to use and when. Google or Wikipedia both have their place. For example, they are both useful when you are just getting started learning about a topic and you need general background or overview information. Google can even be helpful in finding medical images, procedure videos, or epinence. When using Google or Wikipedia, it's important to evaluate the information that you find and make sure that it's credible. It's important to keep in mind that not all information found in Google or even Wikipedia is reliable or based on the most current evidence. And most information that you find by Googling or in Wikipedia is not geared for clinicians. For this reason, you won't find dosing information on the Wikipedia page for a medication. What about Google Scholar? Google Scholar can be a very handy tool for a couple of purposes, but proceed with caution. Know that searches conducted in Google Scholar are based on your past Google search history and are not reproducible. Google Scholar scans the internet for scholarly and gray literature and may be helpful for a particularly difficult topic. You'll often be able to locate hard-to-find PDFs through Google Scholar. Also, you can use Google Scholar to find seminal works on a topic. If you want to read more about this, here are a couple articles that might interest you. And the last thing I'll mention is that it's good to know what's out there on the internet, because chances are this is where your patients are looking before they come to see you. You can help your patients by providing them with information from more authoritative and evidence-based sources. Which leads us to the last set of resources I'll talk about, consumer health resources like MedlinePlus and patient handouts. MedlinePlus is the National Institute of Health and the National Library of Medicine's Consumer Health Information Resource. It provides easy-to-understand information about diseases, drugs, and laboratory tests in a wide range of languages. In addition, clinical key, up-to-date, and micromedics all have patient education handouts that you can print out and give to your patients. These are written to a fourth- to fifth-grade reading level, include links to additional credible resources, and are available in many languages. So in conclusion, there are a wide variety of resources available to you for answering clinical questions and providing information for your patients. Most resources are available through the Welch Medical Library website and hospital workstations. Others are freely available online.