Data in EHRs

The comparative effectiveness piece in the Jan MLA News is worth a read.  In particular, one part caught my eye:

As electronic health record systems begin to provide rich data sources for conducting CER [comparative effectiveness research] and the body of effectiveness research evidence grows, it is likely that evidence derived from CER will substantially supplement or even replace traditional RCTs as the main source of evidence for EBM guidelines and clinical decision support.

EHRs are (or will be) great sources of data and it seems reasonable to expect that data to become the centrepiece of new evidence.  

Health Science Librarianship Quiz

From Trend Spotting - Whither Health Science Librarianship?:

Quiz – Key dates in medical librarianship relating to automation 

1. When was the 1st edition of the Medical Subject Headings (MeSH) released for use in both indexing and cataloguing?

2. In what decade did the demand for mediated online searches in the health sciences begin? 1950s, 1960s, 1970s, 1980s?

3. Modern machine methods were first applied to the production of index Medicus in the middle of which decade?

4. In what year did the Medical Literature Analysis and Retrieval System (MEDLARS) become operational?

5. When was the 1st International MEDLARS Centre (to implement batch bibliographic retrieval services using NLM data) established?

6. When did the NLM initiate experiments in real time, interactive online access to the MEDLARS bibliographic database?

7. In what year did MEDLINE become operational?

8. When did widespread searching of online commercial databases by academic reference librarians begin?

9. When did services oriented to end users of online databases begin to appear?

10. What was the real breakthrough in end-user searching in the mid-1980s?

11. In what year did NLM develop the software package Grateful Med? (A personal computer-based search interface for health professionals who wanted to do their own searches)?

12. When did MEDLINE on CD-ROM first appear?

13. What was the major benefit of CD-ROM technology compared to online commercial databases?

14. When did the NLM release Internet Grateful Med?

15. When was access to MEDLINE over the Web made free of charge?

Answers:

1. 1960
2. 1960s
3. Mid-1960s
4. 1964
5. 1966
6. 1970–1971
7. 1971
8. late 1970s
9. early 1980s
10. the introduction of CD-ROM technology
11. 1986
12. early 1987
13. cost-effective, fixed annual cost rather than variable cost of online connect charges
14. in 1996
15. 26 June 1997

<aside> I need to brush up on the history of my profession.  And, I'm glad I missed the MEDLINE on CD-ROM generation. </aside>

Clinical Queries Are Effective

The use of the clinical queries filters is strongly recommended by proponents of evidence-based medicine and is often taught in courses for physicians about literature searching. Our results support the use of this PubMed filter.

The authors also point out that the filters were infrequently used by the sample.  Unless you know they're there, they're difficult to stumble upon.  Perhaps they can be integrated into the main search in some way.  

 The abstract in PubMed.

iPads for Residents

A perfect example of how iPads can enhance the clinical workflow. 

My role in the project was minimal.  I discussed the E-Book market and specific title availability with the department's administration.  We - the library - purchased MD Consult's anesthesiology collection.  The department handled the rest. 

Rethinking the Textbook

The inspiration for this came from Dr. Theodore Sanford, professor and associate chair, Department of Anesthesiology, who noticed that residents were using textbooks less and less.

“We used to provide residents a $3,000 allowance to select and buy textbooks, and discovered that not everyone spent the money,” says Sanford. “Then we moved to a model where we distributed a ‘box of books,’ costing $1,500 each, but some were never opened.”

With more textbooks becoming available electronically, Sanford started thinking about other options. Instead of spending thousands on the usual textbook reorder, “why not use an iPad?” he thought.

Full story.

Kidney Transplantation Filter

Here's the McMaster group's attempt to develop sensitive and specific Medline and Embase search filters for kidney transplantation. Rigorous methodology.