Abstract:
BACKGROUND:To practice Evidence-Based Medicine (EBM), physicians must quickly retrieve evidence to inform medical decisions. Internal Medicine (IM) residents receive little formal education in electronic database searching, and have identified poor searching skills as a barrier to practicing EBM. OBJECTIVE:To design and implement a database searching tutorial for IM residents on inpatient rotations and to evaluate its impact on residents' skill and comfort searching MEDLINE and filtered EBM resources. DESIGN:Randomized controlled trial. Residents randomized to the searching tutorial met for up to 6 1-hour small group sessions to search for answers to questions about current hospitalized patients. PARTICIPANTS:Second- and 3rd-year IM residents. MEASUREMENTS:Residents in both groups completed an Objective Structured Searching Evaluation (OSSE), searching for primary evidence to answer 5 clinical questions. OSSE outcomes were the number of successful searches, search times, and techniques utilized. Participants also completed self-assessment surveys measuring frequency and comfort using EBM databases. RESULTS:During the OSSE, residents who participated in the intervention utilized more searching techniques overall (p < .01) and used PubMed's Clinical Queries more often (p < .001) than control residents. Searching "success" and time per completed search did not differ between groups. Compared with controls, intervention residents reported greater comfort using MEDLINE (p < .05) and the Cochrane Library (p < .05) on post-intervention surveys. The groups did not differ in comfort using ACP Journal Club, or in self-reported frequency of use of any databases. CONCLUSIONS:An inpatient EBM searching tutorial improved searching techniques of IM residents and resulted in increased comfort with MEDLINE and the Cochrane Library, but did not impact overall searching success.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Stark R,Helenius IM,Schimming LM,Takahara N,Kronish I,Korenstein Ddoi
10.1007/s11606-007-0387-xsubject
Has Abstractpub_date
2007-12-01 00:00:00pages
1656-60issue
12eissn
0884-8734issn
1525-1497journal_volume
22pub_type
杂志文章,随机对照试验abstract::Nicotine meets all critical criteria for an addictive drug. Furthermore, there is no evidence that there would be widespread compulsive use of tobacco without nicotine. These findings have led to consideration of the cigarette as a contaminated vehicle for an addictive drug (nicotine). Nevertheless, nicotine itself ma...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/BF02600847
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abstract:BACKGROUND:Perception of body size is a key factor driving health behavior. Mothers directly influence children's nutritional and exercise behaviors. Mothers of ethnic minority groups and lower socioeconomic status are less likely to correctly identify young children as overweight or obese. Little evaluation has been d...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-3002-y
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abstract::Comprehensiveness of primary care (the extent to which the clinician, as part of the primary care team, recognizes and meets the majority of each patient's physical and mental health care needs) is an important element of primary care, but seems to be declining in the U.S. This is concerning, because more comprehensiv...
journal_title:Journal of general internal medicine
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doi:10.1007/s11606-015-3300-z
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abstract:BACKGROUND:Rapid antigen detection tests (RADT) are commonly used to guide appropriate antibiotic treatment of group A beta-hemolytic streptococcal (GABHS) pharyngitis. In adults, there is controversy about the need for routine backup testing of negative RADT. OBJECTIVE:Estimate the costs and benefits in adults of rou...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-012-2245-8
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:As children with diabetes transition to adulthood, they may be especially vulnerable to diabetic ketoacidosis (DKA). Cross-national comparisons may inform efforts to avoid this complication. OBJECTIVE:To compare DKA hospitalization rates in the USA and Manitoba, Canada, during the vulnerable years known as ...
journal_title:Journal of general internal medicine
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doi:10.1007/s11606-019-05006-6
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:To determine patient characteristics associated with patient and proxy perceptions of physicians' recommendations for life-prolonging care versus comfort care, and with acceptance of such recommendations. DESIGN:Cross-sectional. SETTING:Five teaching hospitals in Denver, Colo. PATIENTS:We studied 239 hospi...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1525-1497.2000.07004.x
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:African-American and low-income women have lower rates of cancer screening and higher rates of late-stage disease than do their counterparts. OBJECTIVE:To examine the effects of primary care, health insurance, and HMO participation on adherence to regular breast, cervical, and colorectal cancer screening. ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.2002.10431.x
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:Deficiencies in care for cancer survivors may result from unclear roles for primary care providers (PCPs) and oncology specialists in follow-up. OBJECTIVES:To compare cancer survivors' care to non-cancer controls. DESIGN:Retrospective, longitudinal, controlled study starting 366 days post-diagnosis. SUBJE...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s11606-009-0903-2
更新日期:2009-04-01 00:00:00
abstract::I have discussed the pharmacokinetics, efficacies, and side effects of the various nonnarcotic drugs available for the treatment of patients who have headache. Sumatriptan, the newest one, is expensive but may be cost-effective for those who have failed traditional migraine treatment, who visit the ER frequently, who ...
journal_title:Journal of general internal medicine
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doi:10.1007/BF02599185
更新日期:1994-06-01 00:00:00
abstract:INTRODUCTION:Most residents have limited education or exposure to health policy during residency. AIMS:We developed a course to (1) educate residents on health policy topics applicable to daily physician practice; (2) expose residents to health policy careers through visits with policy makers and analysts; (3) promote...
journal_title:Journal of general internal medicine
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doi:10.1007/s11606-009-1143-1
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:The use of coronary computed tomographic angiography (CCTA) for evaluation of patients with suspected coronary artery disease (CAD) is growing rapidly, yet questions remain regarding its diagnostic accuracy and its impact on clinical decision-making and patient outcomes. METHODS:A systematic literature revi...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-010-1556-x
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:To compare the analgesic efficacy of valdecoxib with placebo and naproxen sodium for relieving menstrual cramping and pain due to primary dysmenorrhea. DESIGN:Single-center, double-blind study with a 4-period, 4-sequence crossover design. Patients assessed pain intensity and pain relief at regular intervals ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1525-1497.2004.30052.x
更新日期:2005-01-01 00:00:00
abstract::Polypharmacy occurs when a medical regimen includes at least one unnecessary medication. Factors that contribute to this problem include: patient characteristics of increasing age, multiple medical problems, therapy expectations, and decisions to self-treat; physician factors such as excessive prescribing; and system ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/BF02600099
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Heart disease is the leading cause of death for women in the United States, accounting for 24.5 % of all deaths among women. Earlier research has demonstrated racial/ethnic differences in prevalence of cardiovascular (CVD) risk factors. OBJECTIVE:To empirically examine the prevalence of CVD risk factors amo...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-012-2309-9
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Individualized selection of antiretroviral (ARV) therapy is complex, considering drug resistance, comorbidities, drug-drug interactions, and other factors. HIV-ASSIST (www.hivassist.com) is a free, online tool that provides ARV decision support. HIV-ASSIST synthesizes patient and virus-specific attributes to...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05531-4
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:To address concerns that the Hospital Readmissions Reduction Program (HRRP) unfairly penalized safety net hospitals treating patients with high social and functional risks, Medicare recently modified HRRP to compare hospitals with similar proportions of high-risk, dual-eligible patients ("peer group hospital...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06222-1
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is a growing public health concern that overwhelmingly affects older adults. National guidelines have called for earlier referral of CKD patients, but it is unclear how these should apply to older adults. OBJECTIVE:This scholarly review aims to explore the current literature abo...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-007-0492-x
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE:To identify differences between patients viewed as frustrating by their physicians and those considered typical and satisfying. DESIGN:This cross-sectional observational study focused on psychologically distressed high users of medical services. Frustrating patients were compared with typical and satisfying ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02598969
更新日期:1991-05-01 00:00:00
abstract:INTRODUCTION:How can residency programs help trainees address conflicting emotions about their professional roles and cultivate a curiosity about their patients' lives beyond their diseases? We drew on the medical humanities to address these challenges by creating an intensive writing workshop for internal medicine res...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2006.00550.x
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abstract:BACKGROUND:Lower socioeconomic status is associated with excess disease burden from diabetes. Diabetes self-management support interventions are needed that are effective in engaging lower income patients, addressing competing life priorities and barriers to self-care, and facilitating behavior change. OBJECTIVE:To pi...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-011-1689-6
更新日期:2011-09-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:1997-06-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1998.00164.x
更新日期:1998-08-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF02600185
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVE:To examine in-depth the lives of women whose partners attempted to kill them, and to identify patterns that may aid in the clinician's ability to predict, prevent, or counsel about femicide or attempted femicide. DESIGN:Qualitative analysis of 30 in-depth interviews. SETTING:Six U.S. cities. PARTICIPANTS:T...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.2003.21202.x
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:To compare the prevalence of major medical problems in homeless and nonhomeless patients. PATIENTS:All 475 persons seeking care at an ambulatory clinic serving the medically indigent for one calendar year. INTERVENTION:None. MEASUREMENTS AND MAIN RESULTS:Demographic and clinical data were collected by stru...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02598086
更新日期:1992-05-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.2002.20218.x
更新日期:2002-10-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-05914-y
更新日期:2020-12-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1525-1497.2005.40244.x
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Little information exists regarding the impact of Medicare Part D on generic drug use. OBJECTIVE:To examine changes in the use of generic prescriptions attributable to Part D among a sample of Medicare beneficiaries. DESIGN, PARTICIPANTS, AND MEASUREMENTS:Difference-in-difference analysis of pharmacy claim...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-008-0742-6
更新日期:2008-10-01 00:00:00
abstract::In rare cases, pancytopenia results from hormonal deficiencies that arise in the setting of panhypopituitarism. Here we describe the unusual case of a 60-year-old man who presented with progressive fatigue and polyuria, and whose laboratory workup revealed a deficiency of the five hormones associated with the action o...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-014-3161-x
更新日期:2015-05-01 00:00:00