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PBL Information Resources and Tools for the First Year: Case #8: Cardiovascular Block - George Roberts - Up in Smoke

This guide provides resources and strategies for finding background, clinical and drug information, including evidence-based medicine strategies and specific information for problem-based learning exercises.

Textbooks

The following are textbooks of possible interest and are available either in print or online.  To find more books of interest, use the search box below

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Ask Karen - you can reach me at 858-534-1199 or at kheskett@ucsd.edu

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George Roberts - Up in Smoke

Resources for this case include:

Textbook Suggestions (look left)

Resource Highlight -- Procedure Videos

Resources for Understanding Lab Tests

National or State Organizations

Drug Resources

PubMed Search Tips

Life-long Resources -- Smoking Cessation

Clinical, Point of Care Resources - some of your familiar favorites (Clinical Tab)

Procedure Video Sources

Procedures Video Sources

With the growth of Youtube, you might think that is the only place to look for a video of the stent procedure, but there are other sources  you could use.  

Lab Tests Info

Looking up information about the results of lab tests are mostly background questions.  The following resources are easy to use tools to find very reliable information about the normal values, reference ranges, and more.

National & State Organizations

National organizations have funded a great deal of research and the results not only become journal articles, guidelines, and recommendations, but might include risk calculators based on the results of the research.  

Drug Resources

One of the questions you have this week might be about some of the drugs used in this case.  What if you didn't already know what the problem is when giving nitroglycerin to a patient with a history of taking sildenafil - where would you look?  You can aso run a drug interaction report to see the info with taking these 2 drugs.  We have several drug resources you might think to check.  The following two are the resources used by UCSD Medical Center.

Clinical Pharmacology Drug Information Database

Clinical Pharmacology :  In this case, look for the "Reports" tab at the top to run report for drug interactions between these two drugs.

 

 

 

Micromedex Drug Information Database

Micromedex : Look for the tab at the top to run the report for drug interactions. You can even search for try smoking cessation and look for the option Drugs that treat smoking cessation for a list of options by effective or evidence favors efficacy. 

 

PubMed Searching - A Different Look

Searching PubMed

Which procedure gives a better outcome, stents or bypass?  What's the evidence say on this topic?  This clinical question lines up very well for the PICO way of searching (part of evidence-based practice).

PICO stands for:

P = Patient & problem

I = Interventions

C = Comparison

O = Outcome

     

Note:  this is just an example and you could easily change it to ETT vs. with a completely different outcome.

 

 

 

 

 P:
 I:

 C:

 

O:

Search terms are easy to highlight with this model and you can also identify filters to help refine the results -- such as, patient's age and possibly, gender.  An English Language filter might be helpful to apply as well

59 year old male, chest pain - possible CAD

You want to treat with stents

What you might also use is the bypass procedure

What you want to see is an improvement in survival, but you might also use the term mortality.

What you want to see is an improvement in: survival, - that's the patient focus.  If you thought of the term mortality that is not as patient focused.

Understanding what the highest level of research type you can expect for the question you ask is another way to narrow your results to very pertinent results.  Because one of the highest level of evidence in this case is a randomized trial, I would look for those from the start. 

Life-long Resources -- Smoking Cessation

Smoking Cessation Counseling Techniques and Patient Resources

The following resources are available to everyone without a subscription and for the most part have been developed with government funding.  These tools will be available to you even when you graduate and move on from UCSD.