Psychiatry clerkship
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Keck School of Medicine Year 3 Psychiatry Clerkship CRRE Fall 2014
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Psychiatry clerkship
- 1. RESOURCES FOR CLINICAL REASONING EXERCISE KSOM Psychiatry Clerkship, 2014-2015 Lynn Kysh, MLIS Information Services Librarian
- 2. LEARNING OBJECTIVES Formulate a clinical research question from clerkship experience Identify databases relevant to psychiatry and conduct an effective search Apply basic criteria to appraise evidence Retrieve available resources for more information on citation styles, search strategies, etc.
- 3. MEDICAL STUDENTS YEARS 3-4 PORTAL Available on the Norris Medical Library Homepage usc.edu/nml norris.usc.libguides. com/medyrs3-4
- 4. REFRESHER: QUESTION TYPES What is the disorder? What causes it? How does it present? How can it be prevented? What are treatment options? Background Questions Foreground Questions Clinical research question Information for an actual patient PICO based Experience with condition
- 5. FORMULATE A CLINICAL RESEARCH QUESTION Scenario: Patient diagnosed with schizophrenia is being treated with an anti-psychotic drug (olanzapine). This drug is causing patient to gain weight. You wonder if nutrition therapy would be effective for weight loss.
- 6. FORMULATE A CLINICAL RESEARCH QUESTION: THERAPY Problem/Patient/Popul ation Intervention/Indicator Comparison/Control (if any) Outcome Weight gain with anti-psychotic olanzapine Nutrition therapy None Continued treatment with olanzapine while managing healthy weight
- 7. FORMULATE RESEARCH QUESTION How effective is nutrition therapy in reducing weight gain caused by olanzapine?
- 8. TYPES OF CLINICAL QUESTIONS How is the problem treated? What causes the problem? What is the frequency of the problem? Does this person have the problem? Who will get the problem? Therapy Etiology, Risk Factors Frequency Diagnosis Prognosis, Prediction
- 9. AN IDEA FOR AN ETIOLOGY QUESTION Does the recreational use of marijuana increase the incidence of psychosis among adult men?
- 10. FORMULATE A CLINICAL RESEARCH QUESTION: ETIOLOGY Problem/Patient/Popul ation Intervention/Indicator Comparison/Control (if any) Outcome Adult men Recreational use of marijuana No recreational use of marijuana Increased incidence of psychosis
- 11. COMMON MISTAKE IN FORMULATING A RESEARCH QUESTION What is the most effective treatment of schizophrenia? ďWho is the patient? ďAge, gender, comorbidities, etc. ďWhat treatments are known to be effective? ďPrimary research does not answer general questions ďConsider background information tools (UpToDate, AccessMedicine, etc.)
- 12. Biomedical information database Search with automatic term mapping or Medical Subject Headings (MeSH)
- 13. Psychiatry-specific database Search with synonyms and narrower terms Quotes to search as phrase; * to truncate
- 14. Journal articles, meeting abstracts, dissertations, book chapters Search with synonyms and narrower terms Quotes to search phrase; * for truncation
- 15. SELECT 5 BEST ARTICLES 1. Does this article address my research question (PICO)? 2. Is this the best article for my research question? 3. Does this article rely on sound research methodologies?
- 16. 1.DOES THIS ARTICLE ADDRESS MY RESEARCH QUESTION (PICO)? Remember⌠Problem/Patient Intervention Comparison Outcome Source: Flahery, RJ. âA simple method for evaluating the clinical literature.â Family Practice Management. May 2004.
- 17. Patient Problem Interventio n Compariso n (if any) Outcome Schizophrenia or schizoaffective disorder (DSM IV) Men and women; 19-64 y/o Olanzapine for 12 weeks 7% or more weight gain Associated weight gain with olanzapine Diet management: food diary, dietician consultation Exercise management: exercise diary, exercise manager None Physical exam (BMI measurement) Pulse rate Blood pressure
- 18. 2. IS THIS THE BEST ARTICLE FOR MY RESEARCH QUESTION? Remember⌠Problem/Patient Intervention Comparison Outcome Add⌠Date of Publication Times cited (Web of Knowledge, PSYCinfo, Google Scholar) Publication Type Source: Flahery, RJ. âA simple method for evaluating the clinical literature.â Family Practice Management. May 2004.
- 19. TIMES CITED
- 20. PYRAMID OF PUBLICATION TYPES Guidelines Systematic Reviews Randomized Controlled Trials Cohort Studies Case Series, Case Reports Higher Quality of Information Fewer Articles Lower Quality of Information More Articles
- 21. Date Times Cited Publication Type April 2006 69 (Web of Science) 71 (PsycINFO) 101 (Google Scholar) Randomized Control Trial (RCT)
- 22. 3. DOES THIS ARTICLE RELY ON SOUND RESEARCH METHODOLOGIES? Critical Appraisal Charts for... ⢠Systematic Reviews ⢠Therapy Studies ⢠Diagnosis Studies ⢠Prognosis Studies ⢠Harm/Etiology
- 23. Randomization Allocation Concealment Similar Baseline Characteristics Blinding To what extent? Follow up Intention to Treat Yes (maybe); methods not described Not described Yes No Not described Yes
- 24. SELECT 5 BEST ARTICLES 1. Does this article address my research question (PICO)? YES 2. Is this the best type of article for my research question? YES 3. Does this article rely on sound research methodologies? MOSTLY
- 25. WHAT I AM LOOKING FOR ON THE ASSIGNMENT 1 Point â Reference 5 Articles 1 .75 .5 .25 0 List four or five articles that relate to the research question and relevant PICO elements. List three articles that relate to the research question and relevant PICO elements. List two articles that relate to the research question and relevant PICO elements. List one article that relates to the research question and relevant PICO elements. List no articles that relate to the research question and relevant PICO elements.
- 26. WHAT I AM LOOKING FOR ON THE ASSIGNMENT 1 Point â Provide One Article that Meets Assessment Criteria 1 .5 0 At least one article listed meets assessment criteria of high quality evidence (combination of publication type, currency, statistics, times cited, aApt pleraaissta ol)n. e article listed meets some assessment criteria ranking it as medium quality evidence (combination of publication type, cNuor raernticcyle, ss tlaisttisetdic ms,e teimt aensy c aitsesde,s aspmpernatis carli)t.eria ranking all articles as low quality evidence.
- 27. RESOURCES Citation Style LibGuide ď Sample paper, cheat sheet, useful websites, examples, etc. http://norris.usc.libguides.com/citation Psychiatry LibGuide (Clerkship Resources) ď Download PowerPoint, download âSimple Method for Evaluating Clinical Literatureâ article, access databases mentioned http://norris.usc.libguides.com/psychiatry
- 28. CONTACT Lynn Kysh, MLIS Information Services Librarian (323) 442-1124 kysh@usc.edu
- 29. LEARNING OBJECTIVES Formulate a clinical research question from clerkship experience Identify databases relevant to psychiatry and conduct an effective search Apply basic criteria to appraise evidence Retrieve available resources for more information on citation styles, search strategies, etc.
- 30. QUESTIONS?
- 31. THANK YOU!