Presented By: Andy Chuang

Elsevier Taiwan LLC

Date: Aug 21, 2007

FIRSTConsult

FIRSTConsult OverviewDifferential DiagnosisMedical TopicsProceduresPatient EducationFull Text Search FeatureWork with MD ConsultFIRSTConsult HandheldBenefits of FIRSTConsult

Systematically Review

SUMSearch (http://sumsearch.uthscsa.edu/)

TRIP (www.tripdatabase.com)

Entrez PubMed (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi)

Cochrane Database of Systematic reviews

National Guidelines Clearinghouse (www.guidelines.gov)

FIRSTConsult:editorial workflowfor Medical Topics

10. Content Editors and Drugs Editors (PharmD’s) undertake final check prior to publication to live site

1. Medical Topic – including drug doses, risks & benefits - written by professional medical writer

3. Topic Editor (Attending Physician in US) edits Medical Topic to ensure clinical relevance and accuracy, and answers queries

4. Content Editors & Drugs Editors (PharmD’s) check Topic Ed work

2A. Content Editors check style, consistency, omissions

2B Drugs Editors (PharmD’s) check doses provided by med writer and write all other drugs info by customizing data in FC drugs dbase

9. Evidence-Based Medicine Editors (MD’s) insert evidence references and links to guidelines

8. Generalist Editor (e.g. internist or family physician) review Medical Topic to ensure relevance to target audience

6. Specialty Editor (e.g. cardiologist or hematologist) reviews Medical Topic for clinical accuracy & currency, and writes Clinical Pearls etc.

5. CAM Editor (complementary/alternative medicine) review (optional)

7. Content Editors & Drugs Editors (PharmD’s) check Specialty Editor’s work

Pink box = medical writer (work for hire)

Blue box = in-house check

Green box = external review by Ed Board member

Evidence-Based Medicine

Evidence-based medicine (EBM) has been defined as 'the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients' (Sackett DL, Rosenberg WMC, Gray JAM, et al. BMJ 1996;312:71-2).

Look for the icon in the text Evidence is summarized by our team of experts, principally from three critically evaluated, very highly regarded sources:

Cochrane Systematic Reviews Clinical Evidence The National Guideline Clearinghouse™

Within the Medical Topics, the best available evidence and guidelines are integrated into the content. You can find evidence and guidelines in the following sections:

Diagnosis - for diagnostic guidelines

Treatment - for guidelines relating to management; and summaries of evidence from primary research articles and systematic reviews relevant to your treatment plan

Prevention - for evidence and guidelines relating to prevention

Level of Evidence

Resource from: http://www.mdconsult.com/php/about/82479328-4/pm_FC_EBM.html

What is FIRSTConsult?

FIRSTConsult is a revolutionary web and PDA-based clinical information system that provides continuously-updated, evidence-based guidance on the latest in patient evaluation, diagnosis, and management — all written and designed for rapid access at the point of care!

FIRSTConsult offers:Covering Specialty: 23Medical Topic: 684Patient Education: 360Procedure: 70DDX: 320Diagnosis: 1800

Synthesized

…are synthesized under the supervision of expert

faculty…Cochrane Database

National Guidelines

Clearinghouse

Clinical Evidence (ACP/BMJ)

MD Consult

Consensus Statements

ReferenceTexts and

Peer-ReviewedArticles

Editorial Advisory BoardLeaders and well-known authors in IM, FP, Peds Ob-gyn, emergency and specialty medicine.

Clinical ReviewersPracticing clinicians and regional experts.

Medical WritersAssist in categorizing information and creating a consistency of style from diverse sources

Sources of Evidence… …delivered via web/PDA

Evidence-Based Medicine

Look for the icon in the text

Evidence is summarized by our team of experts, principally from three critically evaluated, very highly regarded sources:

Cochrane Systematic Reviews Clinical Evidence The National Guideline Clearinghouse™

Once summarized, Evidence is only then included if clinically actionable

All evidence is based on a rating system published by the AAFP

Evidence and guidelines are regularly updated

Evidence Glossary

Includes definitions for:

Case-control study Clinical cohort studyCross-sectional study Meta-analysisRandomized controlled trial Retrospective study Systematic review Uncontrolled study

Differential Diagnosis

Based on the patient’s chief complaint

Start by choosing from over 320 signs & symptoms

Search options include:Enter chief complaint in search boxScroll the list to find the complaintClick on A-Z to jump to the chief complaint

Differential Diagnosis

Work from the chief complaint to the diagnostic tables

Over 1,800 possible diagnoses available

Sorted by age and prevalence

Emergency conditions are marked in red *

Differential Diagnosis

Clinical Benchmarks provided for each diagnosis

Click on diagnosis to view

Differential Diagnosis

To compare multiple disorders, select the check boxes and click ‘Compare’

Differential Diagnosis

Show all of the characteristics for this diagnose.

Medical Topics

684 medical topics

Browse by alphabetical on A-Z or search in the up blank field

Medical Topics

Use left site navigation to access in-depth information

3-9 subcategories in each menu

Content is updated weekly

Medical Topics

Background Menu includes:Cardinal features Causes Epidemiology Codes

Diagnosis Menu includes:Clinical presentation Differential diagnosis Clinical pearlsConsider consultWorkup

Diagnostic decisionQuestions to askExaminationTests

Treatment Menu includes:Immediate actionTherapeutic optionsSummary of therapiesMedications and other therapies [EBM]Summary of evidence Clinical pearlsFollow-up

Outcomes Menu includes:PrognosisClinical complicationsConsider consult

Prevention Menu includes:Primary preventionModifiable risk factorsSecondary preventionScreeningGuidelines

Resources Menu includes:ReferencesGuidelinesAssociationsPatient and caregiver informationRelated topicsContributors

Procedures

Systematic guidance on surgical and diagnostic procedures commonly performed

70 available

Video clips or animations included with each file

Full Text Search Feature

Full Text Search function will take your keywords and present ranked, targeted results, from all of the FIRSTConsult content.

Enter search term(s) in the Full Text Search box on the left-hand panel Search terms can contain Boolean terms, such as AND, OR, NOT.

Header describes the details of the current search

Results include an ordered list of search hits, the most relevant appearing first and also provide Recommended Results

Work with MD Consult

An automatic MD Consult search will be generated using the term you have linked from when you click this icon

Totally integrated to MD Consult

Thank You!