Information Resources – NSUOCO New Residents Orientation Sandra A. Martin, M.L.I.S. Health Sciences Resource Coordinator Optometry Subject Librarian John Vaughan Library Room 305B –

Learning Objectives To provide a mechanism for residents to access the most current vision science and medically related information To familiarize residents with specific information resources and library services to support research for projects and clinical applications To familiarize residents with evidence-based practice and life-long learning techniques 2

John Vaughan Library (JVL) Short walk from the Optometry building Comprehensive print and online collections Friendly, welcoming staff Open until 12:00 a.m. Sunday-Thursday during Fall and Spring semesters Hours posted at Checkout Laptops, iPads, & cameras at Reserve Desk Wi Fi hot spots throughout the building Comfortable seating and study environments 3

Services and Collections 1 st Floor – Reserves, Audiovisuals, Circulation, Interlibrary Loan, Computers, Scanners & Printers 2d Floor – Journals, Newspapers, Special Collections, Computers, Scanners & Printers 3d Floor – Books, Government Documents, Optometry Librarian (305B) Books & Journals shelved by Library of Congress call numbers. Most Vision Science titles found in R, RE, and Q areas 4

Sandra Martin Provides…. Instruction Research Assistance Small Group Consulting Database Searches Collection Development (Selection of print and online books, audiovisuals, journals and databases) Assistance with any health-related information need Office Hours: Tuesday 10 am to 4 pm

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Helpful Tools Optometry Web Page  Optometry Databases, e-journals, e-books, and other tools available 24/7  Supports specific research, teaching, and patient care needs of NSUOCO faculty, students, and residents  Start Here to find resources for all optometry and medical topics  Important Link: Instructions for Locating Full Text Journal Articles shows you how to find full text of articles available in “all” library databases

Instructions for Locating Full Text Journal Articles

Link From the NSU Libraries Home Page 11

Remote Access Enter NT-NSU user id and password to access the library’s electronic resources Contact Tom Tinnell if you have problems with your user id or password Contact Sandra to report other technical problems or for search assistance 12

Interlibrary Loan/Document Delivery Services  Scan and pdf of articles from journals in the library’s print collection – you do not have to pull print journals from the shelf and scan or photocopy  Deliver books, audiovisuals, and journal articles not owned by the library  Journal articles delivered electronically if possible ILL Requests  Click on Interlibrary Loan link from Optometry Web Page  Create the online Iliad Profile  Complete online request form for articles and books Contact for 13

Getting Started: Match Resource to Information Need What is the question? How will information be used? 14

Background vs. Foreground Questions Asking questions about your proposed topic helps to clarify your knowledge gap Clarifying type of question helps to determine which sources are most likely to have the answers you need 15

Part I. Information Retrieval for Research Projects Comprehensive in scope and time  All levels of resources  Current and retrospective  Background and foreground Information Use/Application of results  Presentations  Publications  Sharing with colleagues 16

Background Questions Generally ask who, what, why, where or how about a single concept Require general knowledge of disease and therapeutic processes 17

Proposed Research Projects Evaluate the accuracy of the Humphrey Visual Field Analyzer compared to the MP-1 in patients with glaucoma Assess efficacy of anti-fatigue lenses in relieving eye strain and computer vision syndrome Assess effectiveness of vitamin supplements and oral antioxidants to improve dry eye symptoms 18

Begin with Background Questions What are methods of visual field testing in glaucoma? How is the Humphrey Visual Field Analyzer used? What are the ocular causes and potential treatments of visual fatigue and computer vision syndrome? What oral antioxidant combinations and topical vitamin eye drops have been used to treat dry eyes in adult patients? 19

Answers to Background Questions Information Resources:  Clinical Key  e-Book and e-Journal Collections  Print Books  Ovid MEDLINE – Basic Search  Visionet – vision therapy related topics 20

Clinical Key Full text access to 1,000 books and 500 journals in every medical and surgical specialty Ophthalmology – Over 60 full text books Includes 12 Content Types Access to information at all levels from topic overview to evidence-based data in one search Smart search engine matches first few letters of search word/words to relevant clinical content No complicated search strategies or Boolean connectors Easier than Google – but with reliable, evidence-based results

Ovid MEDLINE- Basic Search U. S. National Library of Medicine’s premier database. Contains over 20 million citations to journal articles in medicine, nursing, allied health, and basic sciences as they relate to health care OvidSP software provides useful tools to filter search results and target information for precise needs Begin with “Basic Search” Contains links to full text of major vision science journals in NSU libraries subscriptions and open access sources NOTE: PubMed (free MEDLINE) contains links to “open access” (free) full text but NOT to NSU subscriptions 22

Visionet – produced by SCO Citations to articles in Optometry journals not found in MEDLINE Especially useful for articles on vision therapy, visual training, vision screening, low vision, practice management, etc. Contact Sandra for help 23

Major e-Book Publishers Elsevier and Subsidiaries: Clinical Key, Science Direct Lippincott, Williams & Wilkins: Slack and Springer Science: R2 Digital Library McGraw Hill: Access Medicine Search e-Books from the Optometry web page 24

Drug Monographs Full-text monographs for all FDA approved drugs: Clinical Key, Access Medicine, UpToDate Include information for the health care professional and the patient Search by generic or brand name Include sections on indications, contraindications, handy tools, calculators, and tables 25

Print Book Collection John Vaughan Library, 3 rd Floor Comprehensive collection  Meets Association of Vision Science Libraries standards for core collection  Largest Optometry/Ophthalmology book collection in the region Search NSU libraries “Catalog: Books & More” link from Optometry web page Interlibrary loan staff will mail books from NSU collections at no cost to you except return postage 26

Additional Background Resources Frequently used e-Journals  Optometry and Vision Science  JAMA Ophthalmology  JAMA  New England Journal of Medicine  Investigative Ophthalmology & Visual Science Web Portals  ARVO Journals  Healio Optometry  Open Access Ophthalmology Journals Link to these titles directly from Optometry web page 27

Part II. Information Retrieval for Evidence Based Patient Care Using research findings versus conducting research Retrieving and evaluating information that has direct application to specific patient care problems Selecting resources that are current, valid and available at point-of-care Developing search strategies that are feasible within time constraints of clinical practice

Answers to Clinical (Foreground) Questions Require:  precise information about complex issues  trustworthy clinical research data with direct application to patient problems Fill gaps in clinical knowledge pertinent to:  Therapy/prevention  Diagnosis  Prognosis  Etiology 29

Background v Foreground Knowledge Both types of knowledge needed Varies over time Depends on experience with condition Point A: Student – limited experience Point B: Resident – growing clinical experience Point C: Attending – extensive experience Note: Diagonal line shows “we’re never too green to learn foreground knowledge, nor too experienced to outlive the need for background knowledge” Source: Evidence-based medicine: how to practice and teach it. 4 th edition. By Straus, et. al. Churchill Livingstone Elsevier

Therapy Question Example In patients with primary open angle glaucoma, [Patient/Population], do topical medications to reduce intraocular pressure [Intervention] versus no treatment [Comparison Intervention], delay visual field defect progression [Outcome]?

Answers to Foreground Questions Resources – Evidence based textbooks  Provide rapid access to concise information to clinicians at the point of care  Not a database of articles from books, journals, or guidelines  Original, current, summaries written by experts  Formal systems used to grade strength of recommendations and quality of evidence Available from Optometry web page  UpToDate  First Consult

Clinical Question Therapy/Prevention  In patients with primary open angle glaucoma or ocular hypertension [Patient/Population], do topical medications to reduce intraocular pressure [Intervention] versus no treatment [Comparison Intervention], delay visual field defect progression [Outcome]?

Summaries UpToDate –Evidence based summaries of over 9,500 topics in over 22 specialties –8,500 Treatment Recommendations –GRADE System used to score recommendations and strength of evidence –Practice changing updates; Updated continuously –Drug database; Patient education materials –The Gold Standard of summaries

Simple UTD Search Answers Clinical Question in Seconds

Summaries FirstConsult –Search online in Clinical Key –App available through NSU subscription to Clinical Key for iPhone or iPad only –Create a personal account in Clinical Key –Download the app from the Apple app store –Login with your CK username and password –Concise summaries; sections on differential diagnosis; quality of evidence graded –Not updated as rapidly as UTD

Next Steps Explore online resources from the Optometry web page Review slides and exercises posted at Residency Program class page Attend “Clinical Applications of Evidence Based Practice” Workshop – Sept. 2