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Problem-based Learning & Finding the Evidence: Case 1: Danni Crane: Lost to Follow Up

Books

Week 1: Danni Crane - Lost to follow up

Resources for this Case

 

Textbooks  (look left)

Featured Resource : DynaMed

ACOG : Cervical Cancer Guidelines

National Organizations

E-Books Refresher

Clinical Tools Refresher

Patient Information Resources

Featured Resources: DynaMed

DynaMed

Try out our newest resource for point of care information, DynaMed Plus.  You will find some very relevant resources for this week's case from HPV vaccine information (and all the different organization recommendations) to diagnosing and treating Cervical Cancer.  A unique feature that DynaMed has over Up to Date is specifying the level of evidence when they recommend something.  So, as you move ever closer to clinical reasoning, DynaMed will help you know more about the evidence behind what you might suggest to your patient.

ACOG Practice Guidelines

Cervical Cancer Screening Recommendations

One of the confusing factors about guidelines for cervical cancer screening is not only the number of organizations making recommendations but also the varience between their statements.  For example, some of the organizations that have practice guidelines includes:

  • American College of Obstetricians and Gynecologists
  • American Society for Colposcopy and Cervical Pathology
  • Centers for Disease Control and Prevention
  • US Preventive Services Task Force  (USPSTF)

If you are at a large health-care organization, then the guidelines to follow may be spelled out for you.  But what about the doctors in private practice?  You need to discern the most appropriate for your practice - this is where your analytical skills from epidemiology come into play as well as your background with evidence-based medicine.   Which one will you choose?  

A few quesions to consider are:

  • How recent is it?  
  • Does the organization have any specific bias that might impact their conclusions?  
  • How thorough and systematic was the research that helped to make these conclusions?  
  • Many other questions might come to mind -- what else do you need to consider? 

For this case, I like how the American College of Obstetricians & Gynecologists presents the very newest information on recommendations. The USPSTF has just updated the guidelines - August 21, 2018. I would usually point you to a resource like the Trip Database but because the guidelines are so new, let me point you to a Google search.

This organization puts out Practice Advisory notices for their recommendations. Try a search like:
acog practice advisory cervical cancer screening

National Organizations

National organizations, both government and private organizations, often have very useful information for patients as well as physicians. 

Guidelines and concensus statements, while not a systematic review, review the existing literature and are considered a high level of evidence.

E-Books Refresher

Don't forget you can search across multiple texts for the information you seek.  You have a couple of options from which to choose.

 

     

Search for online books with keywords in the search box above.
 

Clinical Tools Refresher

Some of your topics may be ones for which the clinical tools might be helpful.  Just remember, we have several of these tools, not just Up to Date. 

MedlinePlus: Information Tool for Patients

MedlinePlus is a great place to find consumer-friendly materials along with directories, a dictionary & encyclopedia, and more.  Take a look and see what you find - try HPV.

Search MedlinePlus: