LibGuides: Problem-based Learning & Finding the Evidence: Case 5: Alma Carlsson -- Oh no, not again!

Books

Helicobacter Pylori in the 21st Century by Philip Sutton, et al
Helicobacter pylori is a globally significant pathogen that infects half of the population of the world. This book explores a range of topics including virulence factors, vaccine development and obstacles, epidemiology, antibiotic resistance and the role of Nod receptors.
Evidence-based gastroenterology and hepatology by John W.D. McDonald, et al
Stomach or liver ailments -- find the evidence on diagnosis, screening, and treatment. It grades both the evidence and the treatment recommentations.

Not Finding What You Need? Just Ask:

Not finding what you need? Having trouble using one of our resources? Please let us know.

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

Ask a Librarian - check out all the ways to reach one of us at the Biomed Library

Ask a UC Librarian - for those late-night questions, chat with a Librarian 24/7

Alma Carlsson -- Oh no, not again!

Dealing with abbreviations - search with them or spell it out? For example, h pylori or helicobacter pylori; MALT or mucosa-associated lymphoid tissue? Abbreviations like these two, because they are so well known, will give you pretty good results, but often, searches will be better with the full phrases than the abbreviations. Be prepared to search again with a the full term whenever you search with abbreviations and the results seem limited.

Textbooks (look left)

ACCESSSS - an EBM federated search tool

Links to Point of Care Tools

PubMed Search Tip -- Finding Articles with Title Searches

DDX & Symptom Checkers (reminder)

National Organizations

MedlinePlus -- Fruit & Veggie Resources

ACCESSSS

ACCESSSS - Search Across Multiple Clinical Resources

Ever wish there was something like Access Medicine for some of those clinical tools? Well, we have partnered with the people at McMaster to use their search tool called ACCESSSS. Give it a shot this week and see if it helps. You will need to create an account to fully use this tool.

Need an example? Try dyspepsia and see what you get.

ACCESSSSS screenshot of results

ACCESSSS Federated Search

Links to Point of Care Tools

Point of Care Tools - just so they are easy to get to

Differential Diagnosis Resources

DDX Resources

Perhaps your questions this week deal with understanding the different symptoms the patient mentioned. What do they indicate? Without some good hunches it is hard to move forward. There are a number of differential diagnositc tools to help with the process. You may also find mnemonics helpful as well as the following website.

VINDICATE from FirstAidTeam.com
Introduction to Exercises in Clinical Reasoning
Try out their cases and get a little extra practice.
Digital DDX
UCSD designed

DDX & Symptom Checker Resources

Symptoms & DDX Resources

Symptoms and differential diagnositic information is often buried in a number of our resources. However, a few tools (both online and for your smart phone/PDA) have special tools to help with this process.

Dr. Gates has found a very helpful text within Access Medicine - Symptoms to Diagnosis: An Evidence Based Guide. Presented through a series of cases of patients complaining of a specific issue, then walks you through buiding the DDX and prioritizing it, and making the diagnosis. Unlike the interactive tools that give you list, this text helps explain the thinking process. Topics include a variety of non-specific complaints from low back pain to weight loss to GI bleeding, to abdominal pain. Check out Chapter 1 as an overview of the diagnostic process.

The books we have include one that helps explain the thinking process (Symptom to Diagnosis) with topics that include a variety of non-specific complaints from low back pain to weight loss to GI bleeding, to abdominal pain. One book has a list of mnemonics (Collins' book) as well as the symptom info. Another book (Syed & Rasul's book) is organized by body areas and the last one (DDX of Common Complaints) focuses on the most common symptions and presents the way a doctor might pursue to diagnosis (images & tests).

Isabel - the last one in the list - is an up and coming tool that is starting to be integrated into the EMR environment. This free version should be very helpful for many look ups.

Also listed below are some of the interactive DDX tools and their advantages.

Symptom to Diagnosis by Scott D. C. Stern; et al.
An engaging case-based approach to learning the diagnostic process in internal medicine. Each chapter is built around a common patient complaint that illustrates essential concepts and provides insight into the process by which the differential diagnosis is identified. The author points out the findings that help you "rule in" or "rule out" the various diseases. Filled with algorithms, summary tables, and questions that direct evaluation. Check out Chapter 1 as an overview of the diagnostic process.
Differential Diagnosis in Internal Medicine by Walter Siegenthaler
ISBN: 1588905519
Publication Date: 2007
This book encompasses differential diagnosis across the spectrum of internal medicine, covering dermatology, neurology, and rheumatology,and provides the very latest knowledge including pathophysiological aspects. This book traces the path from symptom to diagnosis, just as the physician encounters the situation in the hospital and in the office.

Find information by some common complaints (e.g., fever), by areas of the body (e.g., head & neck), or by clinical criteria (e.g., water, electrolyte & acid-base disorders). Find infomation on the clinical exam & findings as well as diagnostic studies.
The Patient History by Mark Henderson et al
Publication Date: 2012
Highlighting a book you will find in Access Medicine that defines best practices for the patient interview, explaining how to effectively elicit information from the patient in order to generate an accurate differential diagnosis. It also has lots of diagnostic algorithms. For your learning pleasure, they have self-assessment multiple choice Q&A at the end of the chapter. Don't forget you can use a filter to focus on the results from this book.
Differential Diagnosis in Primary Care by R. Douglas Collins
Call Number: WB 141.5 C712d 2012
Print only, but a tremendous resource for understanding the patient's signs & symptoms. Also see suggested procedures and tests. Presented in case-based topics. Check out the TOC to see your options. Also, if you have ever wonder where to find medical mnemonics this book makes them easier to find.
Differential Diagnosis in Primary Care by Mehmood Syed (Editor); Nairah Rasul (Editor)
Call Number: WB 39 R231d 2009
Yep - two books with the same name, different authors. This book presents information organized by areas of the body.
Differential Diagnosis of Common Complaints by Robert H. Seller; Andrew B. Symons
This book looks at the 36 most common symptoms reported by patients in order to quickly and efficiently diagnose a condition. Each chapter mirrors the problem-solving process most physicians use to make a diagnosis. Determine which imaging modalities and laboratory tests offer the greatest efficiencies and accuracy for a given set of symptoms.

Online Look-up Tools

Medscape
They have an nice DDX tab. (You may need to create and account - free - to access this resource - and they don't spam.)

Search or browse for a topic of interest and DDX will be one of the sections of available information.
Diagnosaurus
Use the links to navigate through either symptoms or diseases to find a short list of etiology and when appropriate, those rare causes of a problem. Use the items in this list to know what else to explore in other resources.
Isabel Health - Free Symptom Checker
A small section of a well-regarded clinical tool but this symptom checker is free to use - no subscription required. Once you register, enter symptoms and it will help you use some standardized terms.

More DDX Checker Tools

Check out our home grown tool or use one of the mnemonics.

Digital DDx
An online education tool. You can browse by specific symptoms - perhaps chest pain or fatigue, or browse by organ system. How do you know if you can trust this site? Be sure to check out the About page.
Practical way of creating differential diagnoses through an expanded VITAMINSABCDEK mnemonoic
An article from Adv Med Educ Pract along with an associated video.

National Organizations

NCCN Guidelines
Recommended by Dr. Gupta. Create your free account to see the full text. Lots of great resources for clinicians.
American Cancer Society
From details about lymphoma to gastric cancer, a nice patient friendly site with some great updated information.
National Cancer Institute
Check out the classification and staging details from the NCI's PDQ (physician's data query) -- they have both patient & health professional information.
National Institute of Diabetes and Digestive and Kidney Diseases
This patient friendly resource describes the "alarm symptoms" of peptic ulcers and the h-pylori infection and a variety of other conditions.

PubMed Search Tip

PubMed -- Quick Search with Terms in Title

You have seen this tip before, but depending upon your look up topic, a title search in PubMed can help you target the article that are highly relevant. Caveat, as you get more focused like this, you might miss something, so know what you primary objective is - a handful of very relevant resources or you want to find everything on your topic.

You have 2 ways to run a search where terms are in the title.

Use the Advanced Search form. You will find the link to it under the search box.

Once on the Advanced Search form, enter the term you want in the title and change the search option to Title.

When ready - click search and see what you might find.
If you want, you can skip the form and just add in the code PubMed uses to specify searching the title field [title] or even shorter [ti].

MedlinePlus: Information Tool for Patients

MedlinePlus is a great place to find consumer-friendly materials along with directories, a dictionary & encyclopedia, and more. These week, if you have a look up for fruits & vegetables, the consumer info might be very helpful. Take a look and see what you find - try fruits vegetables.