Monthly Archives: October 2011

New Authoritative List of Resources in the Health Sciences

In the early sixties a librarian named Alfred Brandon recognized the growing need for an information tool to help guide medical librarians in their collection development decisions. The “Brandon/Hill Selected List of Print Books and Journals for the Small Medical Library” was first published in 1965. From its beginnings as a core list of clinical titles for hospital libraries, the Brandon/Hill list grew to become an indispensable selection tool for small hospital libraries as well as large academic medical libraries.

With the death of Dorothy R. Hill, co-author of the “Selected List,” the final edition of the “Brandon/Hill” medical list ceased publication in 2003. In 2010, members of the Medical Library Association’s Books Panel realized the need that had arisen for a resource that could be used for collection development purposes just as the Brandon/Hill lists had been used, especially in the area of digital and online publications.

The Medical Library Association’s Master Guide to Authoritative Information Resources in the Health Sciences is that new, indispensable collection development tool for librarians. It includes over 1,600 authoritative book and serial recommendations in print, digital and online formats. The editors of the Master Guide selected 108 contributors for their subject knowledge and expertise to compile the “best titles” across 35 specialties for this unique guide.

Now, Dana Medical Library is thrilled to recognize one of their own as a contributor to The Master Guide. Frances Delwiche, MLIS, MT(ASCP) is the expert contributor of the Clinical Laboratory Science specialty section in this work, that is sure to become an updated option to the iconic Brandon/Hill Selected List.

Top Ten UpToDate Topics Searched at UVM and FAHC

Of all topics searched in UpToDate at UVM and Fletcher Allen, drug information is consistently the most frequent. In descending order, the following topics are most popular:

Infectious Diseases
Gastroenterology & Hepatology
Pediatrics
Hematology
Nephrology & Hypertension
Neurology
OB/GYN & Women’s Health
Endocrinology & Diabetes
Adult Primary Care & Internal Medicine.

Usage tends to be highest in October and December, and one can easily see how topics have seasonal highs and lows. In the summer months, for example, there were over 200 “hits” on Lyme Disease and Tick Bites. Other popular topics are: Dog and Cat Bites, Low Back Pain In Adults, and Differential Diagnosis of Abdominal Pain In Adults.

Most physicians agree that UpToDate is a great tool for finding clinical information, but did you know that its use is widespread amongst pharmacists, nurses, and medical students in addition to physicians? After attending and resident physicians, nurses and medical students are the heaviest users of this popular clinical tool.

The chart below provides a snapshot of usage by UVM and FAHC health care professionals in the last twelve months.


Proposed Systematic Review Guidelines Include Librarians

Transparency, objectivity, and consistency are criteria that should form the foundation for new standards for clinical practice guidelines and systematic reviews, according to two reports recently released by the Institute of Medicine (IOM). The reports were commissioned by Congress following passage of the 2008 Medicare Improvement for Patients and Providers Act. Among other features, the reports argue for the role of medical librarians in overseeing sound literature search strategies when systematic reviews and guidelines are being developed.

With the explosion in medical literature, physicians and other health care providers have come to rely on practice guidelines and systematic reviews for their synthesis of the literature and evidence-based approach to patient care. However, the number of clinical guidelines produced has also risen substantially since the early 1990s. In fact, the National Guideline Clearinghouse and the Guidelines International Network, two premier guidelines databases, now include more than 9,500 guideline standards.

Unfortunately, the methods behind creating all these guidelines and systematic reviews vary so greatly that stakeholders have increasingly questioned their quality and reliability. Each of the two new IOM reports sets out to establish “gold standard” practices at a critical time in the health care reform movement.

A key element of both reports is an emphasis on making clinical practice guidelines more inclusive of and accessible by patients and the public. To achieve this goal, the Institute of Medicine identified eight areas for improvement of guideline development, including process transparency, disclosure of all conflicts of interest, and a rating scale for strength of recommendations among others.

The Guidelines companion report on improving systematic reviews sets a similarly high bar. The report notes that the quality of current systematic reviews varies widely from excellent to poor. To strive for quality and usability across the board, the IOM report recommends 21 standards for producing high-quality systematic reviews.

Standard 3.1 is of particular importance to the systematic review project team. The elements of this standard address conducting a comprehensive, systematic search of the literature for evidence. It specifically recognizes the importance of working with “a librarian or other information specialist trained in performing systematic reviews to plan the search strategy” (Standard 3.1.1) as well as using “an independent librarian or other information specialist to peer review the search strategy” (Standard 3.1.3).

Right now, it’s unclear how organizations that develop clinical practice guidelines and systematic reviews will handle the challenges of these new recommendations. The key goal for the Institute of Medicine continues to be restoring trust in the process of assessing medical evidence and applying that evidence to the development of quality clinical guidelines and systematic reviews.

Both Institute of Medicine reports : Clinical Practice Guidelines We Can Trust (W 84.4 AA1 I59c 2011 ) and Finding What Works in Health Care: Standards for Systematic Reviews (W 84.3 I59c 2011 ) are available at the Dana Medical Library.

Evolutionary Medicine

While the national exhibit celebrating Darwin’s 200th birthday has left Vermont for Iowa, Dana’s own exhibit on evolutionary medicine remains. Stop by the Library to explore the history of how evolutionary theory has been applied to medicine. Scholars and major works in the field of evolutionary medicine are also investigated.

Breast Cancer Conference Focused on Wellness

By Jennifer Nachbur

The Vermont Cancer Center at the University of Vermont (UVM) and Fletcher Allen Health Care presented the 14th annual Breast Cancer Conference on October 7, 2011 at the Sheraton Burlington Hotel and Conference Center in South Burlington, Vt. Themed “Being Well throughout the Cancer Journey,” the conference focused on staying active to promote physical and emotional wellness. UVM/Fletcher Allen oncologist Kim Dittus, M.D., Ph.D., associate professor of medicine, and Patricia O’Brien, M.D., associate professor of medicine, served as co-chairs of the event, which attracted more than 600 participants. The conference, which was sponsored by the New Hampshire/Vermont affiliate of Susan G. Komen for the Cure, was free and open to the public.

The Breast Cancer Conference provides education and support to breast cancer survivors, care providers, researchers, advocates, and activists. Dittus delivered a keynote presentation, titled “Exercise Beyond and During Breast Cancer Therapy”, at the reservation-only Plated Luncheon. Workshop highlights included: “Survivorship NOW! Help Us Create a Network on Wellness” featuring presenters Dittus, UVM/Fletcher Allen radiation oncologist Ruth Heimann, M.D., Ph.D., UVM/Fletcher Allen surgical oncologist Mary Stanley, M.D., and Dragonheart Vermont founder and director Linda Dyer, which focused on Dragonheart Vermont’s Survivorship NOW initiative to bridge the gap between treatment and recovery for cancer survivors by helping to create wellness opportunities; and “Researching the Cure: A Personalized Approach” by world-renowned cancer researcher and UVM/Fletcher Allen surgical oncologist David Krag, M.D., who discussed his latest work involving the development of targeted therapies – a personalized approach to breast cancer treatment that uses the body’s own immune system to fight the disease.

As usual Dana Medical Library was in attendance with a new display highlighting information on wellness and breast cancer, including many examples of books from the library’s Consumer Health Collection.

For more information about the program, visit www.vtbreastcancerconference.org.

About the Vermont Cancer Center
The Vermont Cancer Center (VCC) is a nationally recognized comprehensive clinical and research cancer center committed to innovative cancer research, life-saving prevention and treatment programs, public education, and scientific collaboration. With more than 100 scientists engaged in a full range of basic, translational, clinical, and outcomes research, the institution plays an important role in Vermont and northern New York, influencing standards of cancer prevention and treatment across the region. VCC research is conducted primarily at the University of Vermont, and high-quality patient care is provided through the VCC’s clinical partnership with Vermont’s academic medical center, Fletcher Allen Health Care. To learn more, visit www.VermontCancer.org.