Choosing Tertiary Resources for Drug Information

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Questions and Answers

What is a key consideration when selecting a resource for drug information?

Not all resources are created equal, requiring careful selection. (correct)

Only the most accessible resource is needed.

All resources provide the same level of detail.

The chosen resource should be the most convenient one available.

When faced with conflicting information from different resources, what should you do?

Always trust the first source you consulted.

Reference at least 2-3 resources to validate the information. (correct)

Choose the most recent resource without comparing others.

Select the resource that you find easiest to understand.

Which of the following best defines evidence-based practice in the context of drug information?

Utilizing the best available evidence and resources for decision-making. (correct)

Relying exclusively on primary research studies.

Using the most popular resources available.

Choosing resources solely based on convenience.

What should be your first step when working on a drug information question?

Analyze the question thoroughly. Signup and view all the answers

In comparing a package insert to a general tertiary database, which is typically considered better?

Package inserts are often more detailed and specific. Signup and view all the answers

Which of the following principles should guide your use of tertiary resources?

Referencing multiple resources is encouraged. Signup and view all the answers

What does the term 'scope of coverage' refer to in drug information resources?

The range and diversity of topics the resource addresses. Signup and view all the answers

How should one approach utilizing online tertiary databases effectively?

Identifying the specific resources or tools within each database. Signup and view all the answers

What is a primary purpose of using online tertiary databases in drug information?

To offer a comprehensive review of specific medications and disease states. Signup and view all the answers

Which of the following features would most likely NOT be found in an online tertiary resource?

Extensive anecdotal patient reviews Signup and view all the answers

When comparing and contrasting two online tertiary resources, which factor is critical in evaluating their effectiveness?

The ease of locating the evidence. Signup and view all the answers

Which question category would best help in assessing the depth of evidence provided by a tertiary resource?

Quality and number of clinical studies cited. Signup and view all the answers

What practice is advisable when conducting sample searches in online tertiary databases?

Utilize diverse topics to explore the database's breadth. Signup and view all the answers

Which statement best describes tertiary literature?

It simplifies primary literature for easier understanding. Signup and view all the answers

What is a common disadvantage of using tertiary resources?

They may not contain complete information. Signup and view all the answers

When categorizing tertiary resources, which of the following does not represent a typical scope of coverage?

Clinical trial results Signup and view all the answers

What is an essential factor in determining the reliability of a tertiary resource?

Author credentials and editorial board reputation Signup and view all the answers

Which of the following is the best practice for efficiently retrieving drug information?

Consulting multiple resources for a comprehensive understanding Signup and view all the answers

Which is not a common characteristic of tertiary resources?

Complete and comprehensive information Signup and view all the answers

In evaluating tertiary resources, what is indicated by the lag time of information?

Information may not be timely and may lag behind current research. Signup and view all the answers

What should be the primary focus when comparing resources within the same category?

Similarities and differences according to evaluation guidelines Signup and view all the answers

Which of the following best exemplifies a tertiary resource in pharmacy practice?

A drug compendium Signup and view all the answers

What role do expert reviews play in tertiary resources?

They help ensure the quality and accuracy of summarized information. Signup and view all the answers

What is a primary resource in the context of biomedical literature?

An original research study or clinical trial Signup and view all the answers

Which of the following is NOT a disadvantage of using primary resources?

Current and up-to-date information Signup and view all the answers

Which of the following statements about MEDLINE is true?

MEDLINE allows quick access to primary literature. Signup and view all the answers

In the context of drug information requests, what best practices should be followed?

Include evidence and important considerations in the response. Signup and view all the answers

What is a common advantage associated with using primary resources?

They are the foundation upon which other types of information are based. Signup and view all the answers

Which factor is a disadvantage when utilizing primary resources?

Requires advanced skills for evaluation. Signup and view all the answers

Which of the following represents a misconception about primary resources?

All primary resources are easily accessible. Signup and view all the answers

What is one potential challenge users may encounter with MEDLINE?

It covers an overwhelming number of journals. Signup and view all the answers

Which practice is essential when formulating a well-rounded response to a query?

Acknowledging alternative views and perspectives. Signup and view all the answers

What must a user be skilled in to effectively use primary literature?

Evaluating the literature critically. Signup and view all the answers

What is a primary function of tertiary literature in drug information?

Collating and interpreting primary literature for easier access Signup and view all the answers

Which factor should be considered when using tertiary literature?

The possibility of bias in interpreting the literature Signup and view all the answers

Which of the following best describes secondary resources in drug information searches?

Bibliographic services that aid in retrieving journal articles Signup and view all the answers

What is a disadvantage of using tertiary literature?

It is often biased due to editorial choices Signup and view all the answers

How should the scope of coverage for drug information be categorized according to the tiered literature structure?

Resources should be used based on their depth and detail Signup and view all the answers

Which step follows the initial search for data in the step-wise approach?

Developing a strategy and conducting a systematic search of the literature Signup and view all the answers

What is typically the first step in the tiered search strategy for drug information?

Reviewing tertiary resources Signup and view all the answers

Which of the following is an advantage of tertiary resources?

They summarize multiple sources into concise formats Signup and view all the answers

Which of the following practices is essential when conducting effective drug information searches?

Use a variety of resource types for a comprehensive view Signup and view all the answers

What is a key consideration in evaluating the sources utilized in drug information requests?

The reliability and quality of the resources Signup and view all the answers

What is a defining characteristic of a descriptive study?

It collects data without manipulation of variables. Signup and view all the answers

Which of the following best describes cohort studies?

They categorize subjects into groups based on exposure to a risk factor. Signup and view all the answers

What is the primary aim of explanatory studies in research?

To explain the relationship between variables. Signup and view all the answers

Which methodology uses observational techniques to analyze outcomes without imposing treatment?

Observational Study Methodology Signup and view all the answers

In case-control studies, how are subjects typically categorized?

Based on the presence or absence of a specific outcome. Signup and view all the answers

Which of the following best describes the primary goal of cohort studies?

To identify risk factors and their impact on disease development Signup and view all the answers

What is a key characteristic of descriptive studies?

They provide a snapshot of a defined population at one point in time Signup and view all the answers

In what way do explanatory studies primarily differ from descriptive studies?

They examine etiologies and treatment efficacies through comparisons Signup and view all the answers

Which type of study is characterized by measuring exposure and disease at one specific point in time?

Cross-sectional study Signup and view all the answers

What is a limitation often associated with cohort studies?

They require extensive and long-term follow-up of participants Signup and view all the answers

Which observational study methodology focuses on participants with a specific disease and compares them to those without the disease?

Case-control study Signup and view all the answers

What is a significant advantage of conducting descriptive studies?

They are often quicker and easier to execute Signup and view all the answers

Which of the following best represents the primary focus of observational studies?

Monitoring participants without intervention to observe outcomes Signup and view all the answers

Which characteristic is NOT a key tenet of descriptive studies in epidemiology?

Efficacy through controlled experimentation Signup and view all the answers

What is the primary focus of explanatory studies in epidemiology?

Examining relationships between variables and determining causal inference Signup and view all the answers

Which of the following best describes the nature of an observational study methodology?

Examining outcomes without active intervention by researchers Signup and view all the answers

In descriptive studies, what does the term 'place' refer to?

The geographical location where health conditions occur Signup and view all the answers

What distinguishes cohort studies from case-control studies in epidemiological research?

Cohort studies focus on outcomes while case-control studies focus on exposures Signup and view all the answers

What is a common limitation of descriptive studies in epidemiology?

They do not establish causation between variables Signup and view all the answers

Which method primarily utilizes comparisons to investigate disease causation?

Explanatory study design Signup and view all the answers

What is the primary characteristic that distinguishes a case series from a case report?

It includes detailed observations of multiple patients. Signup and view all the answers

In what way does time play a role in descriptive studies?

It identifies seasonal trends or patterns in disease occurrences Signup and view all the answers

In what circumstance might a case report be particularly significant?

When recognizing early drug toxicities or rare conditions. Signup and view all the answers

Which study design is suitable for examining health outcomes over time for a specific cohort?

Cohort study Signup and view all the answers

Which statement accurately reflects a limitation of descriptive studies, such as case reports or case series?

They indicate possible relationships that require further investigation. Signup and view all the answers

What is a key purpose of conducting descriptive studies like case reports?

To communicate significant findings to the medical community. Signup and view all the answers

What type of research design primarily documents experiences and begins the search for explanations?

Descriptive design. Signup and view all the answers

Which of the following best describes an explanatory study?

It seeks to determine causality through comparison. Signup and view all the answers

Which of the following scenarios would best warrant a case series study?

Documenting the outcomes of a new treatment across several patients. Signup and view all the answers

Which of the following is NOT a typical scope of descriptive studies?

Assisting in the formulation of strong hypotheses. Signup and view all the answers

What aspect of case reports provides initial insight into potential medical issues?

They describe clinical courses of unique individual instances. Signup and view all the answers

What can often be concluded from the data presented in case series?

The findings require further investigation for validation. Signup and view all the answers

What is the primary purpose of a case-control study design?

To compare individuals with a disease to those without for past exposure Signup and view all the answers

Which characteristic distinguishes a cohort study from a case-control study?

Cohort studies assess outcomes over time in a defined population. Signup and view all the answers

What is the main aim of descriptive studies in research design?

To observe and document experiences without hypothesis testing Signup and view all the answers

In a cohort study, how are subjects initially selected?

From a population free of the outcome being studied Signup and view all the answers

What type of study design typically begins in the present and looks backwards at exposure?

Case-control study Signup and view all the answers

Which of the following best describes explanatory studies?

Studies designed to explore and explain causative relationships Signup and view all the answers

During which phase does a follow-up (cohort) study take place?

It takes place in the present and follows groups into the future. Signup and view all the answers

Which of the following best describes the nature of observational studies?

They observe and measure outcomes without altering variables. Signup and view all the answers

What differentiates prospective studies from retrospective studies?

Prospective studies follow participants looking into the future. Signup and view all the answers

What is the critical factor defining the case-control study design?

The basis of categorizing participants by current health status Signup and view all the answers

Which element is NOT typically included in a proper citation for a study found in MEDLINE?

Database access date Signup and view all the answers

What is a primary advantage of using secondary resources in drug information searches?

They summarize information from primary literature. Signup and view all the answers

When searching in MEDLINE, which Boolean operator is used to retrieve results that include either term in the search?

OR Signup and view all the answers

What is the primary advantage of using MEDLINE compared to other databases?

It includes a controlled vocabulary for consistent search results. Signup and view all the answers

Which feature is characteristic of the EMBASE database compared to MEDLINE?

It includes more conference proceedings and drug studies. Signup and view all the answers

What is the main purpose of utilizing controlled vocabulary like MeSH in MEDLINE searches?

To create a standardized retrieval system across different terminologies. Signup and view all the answers

Which best describes a feature unique to EMBASE that distinguishes it from MEDLINE?

It includes a substantial number of conference proceedings and scientific book reviews. Signup and view all the answers

Which statement about the citation structure in MEDLINE is accurate?

It corresponds directly to printed indexes such as Index Medicus. Signup and view all the answers

Which of the following terms would be best to search for randomized controlled trials related to heart failure and diuretics in MEDLINE?

Loop diuretics Signup and view all the answers

How might the improper use of MeSH headings and subheadings affect a MEDLINE search?

It may yield results that are overly broad or completely irrelevant. Signup and view all the answers

What is the purpose of using controlled vocabularies like EMTREE in databases?

To ensure that search queries are interpreted consistently across different articles. Signup and view all the answers

Which statement accurately reflects the benefits of using filters during MEDLINE searches?

They help limit results to specific study designs or populations. Signup and view all the answers

What is a significant drawback of relying solely on secondary resources like EMBASE?

They often lack comprehensive coverage of primary research articles. Signup and view all the answers

What components are typically included in a citation for a journal article?

Article title, authors, publication year, volume, journal name, issue number, pages Signup and view all the answers

Which of the following is considered an advantage of using secondary resources?

Efficient access to a curated selection of relevant literature Signup and view all the answers

What is a characteristic feature of the MEDLINE database?

Utilizes a controlled vocabulary for indexing articles Signup and view all the answers

Which feature is unique to the EMBASE database compared to other databases?

Extensive indexing of European biomedical literature Signup and view all the answers

When employing a controlled vocabulary, what benefit does it provide in literature searching?

Enhances the precision of searches by standardizing terms Signup and view all the answers

What is a common disadvantage faced when using secondary resources for drug information?

Potential for outdated or lagging information due to publishing delays Signup and view all the answers

In the context of secondary resources, why is the scope of coverage an important consideration?

It determines the range of topics and types of publications available. Signup and view all the answers

What is typically NOT included in a citation for a journal article?

Date of submission Signup and view all the answers

Which of the following statements about the availability of controlled vocabulary in data retrieval is true?

It enhances the ability to conduct deeper and more focused searches. Signup and view all the answers

What aspect of secondary resources can limit their utility?

The complexity of their indexing and categorization systems Signup and view all the answers

What is a significant disadvantage of using text words in MEDLINE/PubMed searches?

It often results in irrelevant articles being included. Signup and view all the answers

Which of the following best characterizes the indexing process of the International Pharmaceutical Abstracts (IPA)?

Conducted by pharmacists who specialize in pharmacy literature. Signup and view all the answers

What is a unique feature of the abstracts provided in clinical studies indexed by the IPA?

Inclusion of study design, patient numbers, route of administration, and dosage. Signup and view all the answers

In what way does the access route affect the lag time for information in databases like IPA?

Lag time can vary considerably based on the medium used for access. Signup and view all the answers

What aspect of MEDLINE or PubMed results in the omission of potentially relevant articles?

Articles without relevant MeSH terms may not be included. Signup and view all the answers

Which statement accurately describes a common feature of electronic databases?

They can provide access to a wider range of international literature. Signup and view all the answers

What is a known limitation of using secondary resources in drug information?

They often lack comprehensive coverage of new studies. Signup and view all the answers

What role does controlled vocabulary play in databases like MEDLINE?

It allows for precise and specific retrieval of information. Signup and view all the answers

Which characteristic best describes the geographic coverage of the International Pharmaceutical Abstracts (IPA)?

Includes international journals along with U.S. publications. Signup and view all the answers

What is one of the primary advantages of using electronic databases for research in pharmacy?

They allow for easy updates of outdated materials. Signup and view all the answers

What is the correct order for the citation of an article in a pharmacy-related journal?

Author(s), Title, Journal Name, Year Signup and view all the answers

Which of the following is NOT an advantage of using secondary resources in drug information searches?

Providing raw data for analysis Signup and view all the answers

Which feature is exclusive to the MEDLINE database compared to similar resources?

Use of MeSH (Medical Subject Headings) for indexing Signup and view all the answers

Which of the following databases is particularly known for its comprehensive coverage of biomedical literature, but does NOT focus exclusively on pharmacy-related content?

EMBASE Signup and view all the answers

In the context of searching for drug information, which of the following terms would be categorized as a controlled vocabulary term?

Lennox-Gastaut syndrome Signup and view all the answers

Which search strategy is most effective for retrieving articles focused on specific drugs and their clinical trial outcomes?

Using specific drug names combined with terms like 'clinical trial' Signup and view all the answers

When using PubMed for literature searches, which type of filter would be most beneficial for narrowing down to clinical trial articles?

Article type Signup and view all the answers

Which of the following statements best describes the utility of supplementary concepts in medical literature searches?

They help in refining search results with specific terms. Signup and view all the answers

Which aspect of a controlled vocabulary is primarily designed to improve the accuracy and efficiency of data retrieval in databases?

Standardization of terms across articles Signup and view all the answers

In a search for original clinical trial data related to osteoporosis treatment, which of the following should be prioritized as search terms?

Forteo and Prolia Signup and view all the answers

Which of the following is a key advantage of prospective cohort studies?

They allow examination of multiple exposures over time. Signup and view all the answers

What is a significant disadvantage of conducting longitudinal studies?

They are often costly and time-consuming. Signup and view all the answers

In which study design are individuals selected based on the presence or absence of a specific outcome?

Case-control studies Signup and view all the answers

How do cohort studies primarily measure associations between exposure and outcomes?

By observing participants over time after identifying their exposure status. Signup and view all the answers

What is typically a challenge faced by prevalence studies?

They cannot account for temporal changes in disease incidence. Signup and view all the answers

Which type of study is least effective at addressing rare events?

Cohort studies Signup and view all the answers

What method is typically used in cross-sectional studies to measure the prevalence of outcomes?

Simultaneous assessment of exposure and outcome. Signup and view all the answers

What is a defining characteristic of a measure of association in cohort studies?

It evaluates the risk of an outcome in relation to a specific exposure group. Signup and view all the answers

What is a primary disadvantage of case-control studies compared to cohort studies?

They are unable to establish causality. Signup and view all the answers

Which situation is least appropriate for a case-control study design?

Studying an acute and rapidly progressing condition. Signup and view all the answers

What does the term 'prevalence' specifically refer to in the context of observational studies?

The total number of existing cases in a population at a given time. Signup and view all the answers

In cohort studies, participants are grouped based on what characteristic?

Prior exposure to risk factors. Signup and view all the answers

Which statement best describes the measure of association in observational studies?

It quantifies the strength and direction of the relationship between exposure and disease. Signup and view all the answers

What is a defining characteristic of a cohort study?

It samples a defined population and follows them over time. Signup and view all the answers

In case-control studies, how are cases and controls typically selected?

By comparing them based on age, sex, and race. Signup and view all the answers

What does the odds ratio (OR) measure in research?

The association between exposure and outcome in two groups. Signup and view all the answers

Which of the following is a potential disadvantage of case-control studies?

They cannot establish a temporal relationship between exposure and outcome. Signup and view all the answers

What type of study design is primarily concerned with determining prevalence rather than incidence?

Cross-sectional study. Signup and view all the answers

How does the data collection process differ in retrospective case-control studies compared to prospective cohort studies?

Retrospective studies depend on patient recall, whereas prospective studies collect data as events occur. Signup and view all the answers

Which of these factors is essential to consider when comparing prevalence across different populations?

The age and sex distribution of the population sampled. Signup and view all the answers

What is a major limitation of using interviews as a data collection method in case-control studies?

Patient recall may be inaccurate or biased regarding past exposures. Signup and view all the answers

Which study design allows for an efficient comparison of cases and controls from a common source population?

Nested Case-Control Study Signup and view all the answers

In observational studies, why is it important to exclude subjects already suffering from the outcome?

To focus solely on the incidence rather than prevalence. Signup and view all the answers

What measure reflects the strength of the association between exposure and disease in cohort studies?

Relative risk Signup and view all the answers

In observational studies, which design collects data on exposure and disease simultaneously within a defined population?

Cross-Sectional Study Signup and view all the answers

Which advantage is NOT commonly associated with cross-sectional studies?

Ability to infer causality Signup and view all the answers

When assessing the prevalence of a condition, which measure is primarily used?

Existing cases Signup and view all the answers

Berkson's bias primarily concerns which aspect in studies?

Admissions rates differing by study groups Signup and view all the answers

What is a common limitation of cross-sectional studies?

They primarily identify existing cases at a single point in time Signup and view all the answers

In which study design are participants categorized based on their disease status at the beginning of the study?

Case-Control Study Signup and view all the answers

Which type of study is best suited for identifying rare diseases or conditions?

Case-Control Study Signup and view all the answers

What is the main goal of explanatory studies in research?

To examine causal relationships Signup and view all the answers

What distinguishes incidence from prevalence in epidemiological studies?

Prevalence reflects the number of existing cases during a specific assessment. Signup and view all the answers

Which characteristic is essential when selecting controls for a case-control study?

Controls should be from the same population as cases. Signup and view all the answers

In a case-control study, what is the importance of using multiple control groups?

To reduce biases from inappropriate control groups. Signup and view all the answers

What is the primary purpose of matching cases and controls in observational studies?

To control for confounding variables that could mislead results. Signup and view all the answers

Which type of study design is most likely to assess the relationship between exposure and outcomes over time?

Longitudinal cohort study Signup and view all the answers

Which factor is critical in determining the validity of results in prevalence studies?

The representativeness of the sampled population. Signup and view all the answers

What outcome measure is most directly associated with incidence studies?

Cumulative incidence Signup and view all the answers

What is a common misconception regarding case-control studies?

They cannot determine causation. Signup and view all the answers

In assessing measures of association, what is the primary goal?

To quantify the strength of the relationship between exposure and outcome. Signup and view all the answers

Why is it important to consider the type of control groups used in case-control studies?

Inappropriate controls can lead to potential biases in results. Signup and view all the answers

Study Notes

Key Online Tertiary Resources

Tertiary resources provide summarized drug information and include databases like UpToDate, Micromedex, Lexidrug, and ClinicalKey.
Familiarity with the specific tools within each database enhances efficiency in retrieving information.

Choosing Resources

Evaluate the need for concise versus detailed information when selecting resources.
Package inserts may offer more specific data compared to general tertiary databases.

Best Practices for Resource Selection

Select resources selectively as quality varies; conflicting information may arise.
Refer to multiple sources (at least 2-3) to ensure comprehensive and accurate responses.
Utilize evidence-based practice, prioritizing the best available resources over convenience.

Workflow for Answering Questions

Analyze and categorize the question before consulting tertiary resources.
Begin with reliable tertiary databases for information gathering.

Tertiary Resource Objectives

Identify commonly used tertiary resources in pharmacy.
Classify resources based on scope (e.g., drug interactions, therapy).
Compare resources within the same category for their strengths and weaknesses.
Choose the most suitable resource for specific drug information requests.

Tertiary Literature Insights

Tertiary literature compiles and interprets primary data into more accessible formats like textbooks and databases.
Advantages include quick access and expert-reviewed information. Disadvantages feature lag time and potential bias.

Assessing Reliability and Appropriateness

Verify editor credentials and the frequency of publication for resource reliability.
Check for references and consider the scope of coverage when assessing content quality.

Primary Resources Explanation

Primary resources offer original research findings through clinical studies published in biomedical journals.
They serve as the foundation for secondary and tertiary literature but can be challenging to access.

Formulating Responses to Inquiries

Formulate a response that includes recommendations, evidence, and alternative views.
Ensure clarity in communication appropriate for the audience (patient vs. provider).

Systematic Search Strategy

Follow a systematic search order: start from tertiary, then secondary, and finally primary literature depending on the question's complexity.
Evaluate and synthesize gathered data while considering the relevance and context of the inquiry.

Step-Wise Approach to Literature

Tertiary, secondary, and primary resources each serve distinct purposes within pharmaceutical research and query resolution.

Pre-Class Assignments

Review two online tertiary databases, identifying five helpful features and comparing them across five question categories.
Consider ease and depth of finding evidence as part of your analysis and include optional comments and thoughts in your review.

Helpful Hints for Research

Utilize handouts and tutorials provided on Canvas for guidance in resource navigation.
Sample searches with specific medications or disease states are encouraged to familiarize with the databases used.

Cohort Studies

Framingham Heart Study: Began in 1948 to identify cardiovascular disease risk factors; participants were residents of Framingham, MA aged 28-62.
American Cancer Society Cancer Prevention Study 1: Started in 1959 focusing on cigarette smoking and cancer mortality among U.S. men and women aged 30 years and older.
Both studies conducted follow-ups every 2 years using interviews, clinic examinations, or self-administered questionnaires.

Study Design Types

Descriptive Design: Aims to document experiences and initiate the search for explanations.
Explanatory Design: Investigates etiology, cause, and efficacy through comparative strategies.

Observational Study Designs

Cross-Sectional Design:
- Measures and classifies exposure or risk factors at a single point in time (snapshot).
- Helps determine prevalence and what is currently happening in a defined population.
Case-Control Design:
- Compares individuals with a disease (cases) to those without (controls) based on past exposure.
- Exposed and unexposed groups are classified retrospectively.
Follow-Up Design (Cohort Study):
- Prospective approach, observing a healthy group over time to assess future outcomes.
- Samples taken from defined populations, excluding subjects already with the outcome.

General Principles of Study Design

Aim to identify various sections of journal articles: abstract, introduction, methods, results, and conclusions.
Studies are categorized by design, focusing on the timing of study initiation, data collection, and measurement techniques.
Descriptive studies focus on three key characteristics:
- Person: Demographic details (age, sex, etc.)
- Place: Geographic information on issue occurrence.
- Time: Timing aspects such as seasonal trends.

Case Reports and Case Series

Case Report: Detailed observation of a single patient's clinical course; serves to communicate significant findings.
Case Series: Observational reporting of a group of patients; often serves as a preliminary step towards hypothesis formulation.
Important for early recognition of drug toxicities, rare disorders, and unexpected disease presentations.

Structure of a Journal Article

Abstract:
- Summary of the study's objectives, design, results, and conclusions.
- Serves as an overview but should not be solely relied upon for recommendations.
Introduction:
- Provides background, summary of previous research, rationale, and study objectives.
Methods:
- Outlines the study design, subject selection, outcome measures, and analytic techniques.
Results:
- Depicts findings through data presentation and graphics; data from primary and secondary outcomes are described.

Discussion and Conclusion

Discussion elaborates on the meaning and significance of the findings, highlighting strengths and limitations.
Conclusions draw comparisons with previous research and incorporate disclaimers or speculations.

MEDLINE MESH TERMS

Medical Subject Headings (MeSH) is a controlled vocabulary by the National Library of Medicine (NLM) for indexing and cataloging articles and other resources.
MeSH provides consistent retrieval methods across different terminologies for similar concepts.

MEDLINE SUBHEADINGS

Subheadings refine searches by focusing on specific aspects of a MeSH heading, potentially enhancing search relevance.
Caution is needed when using heading/subheading combinations as missing relevant ones can lead to unproductive search results.

BOOLEAN OPERATORS

AND, OR, NOT are Boolean operators used to combine search terms to expand (OR) or limit (AND, NOT) search results.

SEARCH STRATEGY EXAMPLE

Search terms for comparing metolazone and chlorothiazide in heart failure include:
- Chlorothiazide [MeSH]
- Metolazone [MeSH]
- Heart failure [MeSH]
Recommended filters: Randomized controlled trial, English language, Human subjects.

RESULTS

Citation for relevant trial: Cox ZL, Hung R, Lenihan DJ, et al. "Diuretic strategies for loop diuretic resistance in acute heart failure: the 3T trial." JACC Heart Fail. 2020; 8(3):157-68.

SECONDARY RESOURCES

Secondary resources help retrieve journal articles quickly but can have limitations such as limited journal coverage and potential lag time before articles become available.
Sources may require specialized training for effective use.

CITATION DEFINITION

A citation typically includes the article title, authors, journal name, year, volume, issue, and page numbers.

CONSIDERATIONS FOR SECONDARY RESOURCES

Important factors include scope of coverage, lag time, controlled vocabulary availability, geographic focus, and ease of use.
Example resources:
- Biosis Previews: Covers life sciences and is updated weekly, with a focus on biomedicine.
- International Pharmaceutical Abstracts (IPA): Covers pharmaceutical agents and pharmacy practice, indexed by pharmacists.

MEDLINE AND PUBMED

MEDLINE includes over 4000 biomedicine journals, with a significant portion of articles in English and updates that can vary by access route.
PUBMED offers online access to MEDLINE and is updated weekly.

EMBASE

EMBASE covers over 7000 biomedical journals and has extensive drug literature coverage, updated weekly, with a significant overlap with MEDLINE.

BIOSIS/BIOLOGICAL ABSTRACTS

Covers life sciences, focusing on various fields such as agriculture, biochemistry, ecology, genetics, and pharmacology, also updating weekly.

SEARCHING MEDLINE/PUBMED

Text word searches encompass all document fields but may lead to broader results, potentially including irrelevant articles.
Text words should be selected carefully to avoid missing pertinent studies not indexed under the searched terms.

EXAMPLES OF SEARCH STRATEGY

Searching for Epidiolex® in relation to Lennox-Gastaut syndrome requires categorizing terms as MeSH, supplementary concepts, or text words, and applying appropriate filters.
For a study comparing teriparatide and denosumab, developing a search strategy to retrieve the correct citation involves identifying keywords related to the study.

Observational Studies: Overview

Measure incidence of new cases through observational studies, particularly prospective follow-up designs.
Strongest observational study design enables direct risk determination.
Prospective data collection ensures exposure is known at the study's start.

Advantages of Prospective Follow-Up

Allows examination of multiple outcomes and determines outcome occurrence.
Administratively easier and cheaper than clinical trials, though long studies can still be costly.

Disadvantages of Prospective Studies

Challenging to address rare events and results often take a long time to be available.
Time-consuming, expensive, and raises ethical concerns.

Sources of Cohorts

Cohorts can be population-based or exposure-based, such as those potentially exposed in specific locations.

Measures of Association

Calculate incidence rate and relative risk as measures of association in these studies.

Nested Case-Control Study

Conducted within a cohort study; efficient and maintains high comparability of cases and controls from a common population source.

Descriptive vs. Explanatory Studies

Descriptive studies document experiences and provide initial hypotheses.
Explanatory studies investigate etiology, cause, and efficacy using comparative strategies.

Cross-Sectional Study Design

Collects exposure and disease data simultaneously, providing a snapshot of risk factors.
Aims to quantify the problem's magnitude and generates hypotheses for future research.

Purpose and Application of Cross-Sectional Studies

Evaluate new or existing tests and the predictive capability of clinical features.
Identify etiological agents, determine prevalence, and can be beneficial for initial explanatory studies.

Strengths of Cross-Sectional Studies

Quick and inexpensive to conduct, requiring less patient involvement than cohort studies.
Helpful for identifying cases and controls for case-control studies.

Types of Bias in Observational Studies

Berkson’s bias indicates differing admission rates in case-control studies, distorting exposure-disease associations.
Healthy worker bias questions whether healthier habits in working individuals influence study outcomes.

Case-Control Study Design

Subjects are selected based on the presence or absence of an outcome and may recall past exposures.
Data can come from health records or interviews, making validation difficult.
Measure of association calculated through odds ratio (OR).

Selection and Matching of Controls

Controls should ideally match cases in characteristics except for exposure.
Control sources include population-based or institution-based groups, emphasizing relevant demographics.

Purpose and Advantages of Case-Control Studies

Aim to identify potential risk factors retrospectively; not suitable for causal determination.
Effective for studying rare diseases or outcomes occurring long after exposure, relatively inexpensive, and quicker to complete.

Selection of Cases

Cases defined by specific characteristics or outcomes, using broad versus rigorous criteria for diagnosis.
Case representation must accurately reflect the larger population with the disease or outcome to ensure validity.

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Description

This quiz focuses on the selection and utilization of tertiary resources for accurate drug information. It emphasizes the importance of using tools like UpToDate and Micromedex efficiently while considering the need for different levels of detail. Participants will learn how to evaluate resources and best practices for achieving accuracy in their responses.