Go Mobile!

If you have a Blackberry, iPod Touch, iPhone, or wireless PDA, you can now access a mobile version of the Library's Website. Search PubMed, use a medical calculator, read an article, or look up a quick clinical question in Dynamed. It will all be at your fingertips!

Bookmark us! http://www.mclibrary.duke.edu/m

The Data You Need May Be Closer Than You Think

The Triangle Census Research Data Center (TCRDC) can provide access to restricted National Center for Health Statistics and Agency for Healthcare Research and Quality (AHRQ) data to members of the Duke community. Use of restricted data must still undergo the NCHS or AHRQ approval process; however, the data can now be accessed in a secure computing environment on Duke's campus (which is a lot closer and easier than traveling to Bethesda!) Data that may be available includes:

1. Variables removed from public-use data files: Most surveys collected by NCHS and AHRQ contain sensitive information which is suppressed or masked to protect the confidentiality of respondents. Such information, which can include geographic and demographic detail, study design information, expenditure information, detailed business information, and information on childhood disease and behavior, is only available to users through NCHS, AHRQ, and Census Research Data Centers (RDCs).
2. Linked files or matching data: Many widely used surveys, such as the National Health and Nutrition Examination Survey (NHANES), have been linked to national mortality records, Medicare and Medicaid records, and Social Security Administration Records. Many of these linked files are only available through RDCs.
3. Restricted data files: Some files, such as the Insurer Component of the Medical Expenditure Panel Survey or the National Employer Health Insurance Survey, have no public use versions. All forms of these files are only available for access through RDCs.

For further information about the approval process and the data available, visit the NCHS RDC Website, the AHRQ Website, or the TCRDC Website. A brief summary of potentially available restricted data can be found online at the New York Census Research Data Center. More detailed information on what information is restricted can be found on websites for the individual surveys.

July 4th Holiday Hours

The Library will be CLOSED on Friday, July 3rd and Saturday July 4th. The Library will resume regular hours on July 5, 2009.

Cost Conundrum - What a Texas town can teach us about health care

The Cost Conundrum by Atul Gawande from The New Yorker, Annals of Medicine, June 1 , 2009. "The primary cause of McAllen's extreme costs was, very simply, the across-the-board overuse of medicine. This is a disturbing and perhaps surprising diagnosis. Americans like to believe that, with most things, more is better. But research suggests that where medicine is concerned it may actually be worse.

A few doctors took profit growth to be a legitimate ethic in the practice of medicine. Not all the doctors accepted this. But they failed to discourage those who did. So here, along the banks of the Rio Grande, in the Square Dance Capital of the World, a medical community came to treat patients the way subprime-mortgage lenders treated home buyers: as profit centers."

Some of the studies cited by Gawande appeared in Health Affairs.

Library to Close on Saturdays

Saturday hours will be eliminated effective July 1st. Read about this and other economic impacts on the Library in this month's newsletter.

Create your own filter in PubMed

Ever wanted to filter your results to those that contain a certain term, are written by a specific author, or maybe appear in a specific journal or group of journals? Well... now you can!

A new feature in My NCBI (the place in PubMed where you can save searches, create collections of citations, etc.) allows you to customize your filters for any of the Entrez databases. To create your own filter, simply log in to your My NCBI account (or create one... it only takes a moment) and click on the My NCBI link and then "Search Filters." On the PubMed filters screen, click on the "Custom Filters" tab and follow the link to "create a new one." You'll be asked to enter your own search strategy for your filter. This can be one term or multiple terms and should NOT include History search statement numbers.

For a filter to be effective, the search strategy should include field tags. For example, a filter for articles in BMJ, JAMA and NEJM would have the search strategy: "BMJ (Clinical research ed.)"[Jour] OR "JAMA : the journal of the American Medical Association"[Jour] OR "The New England journal of medicine"[Jour]. The best way to get the field tags is to run your search in PubMed, then copy the strategy off the Details screen and then paste it back into the Custom Filters area mentioned above.

Once you've created your custom filter, you'll need to place a checkmark next to it to add it to your list. Note that you can only have a total of 5 filters, whether they are standard or custom does not matter.

Full instructions appear online. If you need assistance creating your search strategy for your filter, please call, email or IM the reference librarians.

Happy filtering!

Resident Duty Hours Report - Now Online

Resident Duty Hours:
Enhancing Sleep, Supervision, and Safety
Cheryl Ulmer, Dianne Miller Wolman, Michael M.E. Johns, Editors, Committee on Optimizing Graduate Medical Trainee (Resident) Hours and Work Schedule to Improve Patient Safety, National Research Council

Note: click on the link above, then scroll down to read the report online for free.

Description from the National Academies Press:
Medical residents in hospitals are often required to be on duty for long hours. In 2003 the organization overseeing graduate medical education adopted common program requirements to restrict resident workweeks, including limits to an average of 80 hours over 4 weeks and the longest consecutive period of work to 30 hours in order to protect patients and residents from unsafe conditions resulting from excessive fatigue.

Resident Duty Hours provides a timely examination of how those requirements were implemented and their impact on safety, education, and the training institutions. An in-depth review of the evidence on sleep and human performance indicated a need to increase opportunities for sleep during residency training to prevent acute and chronic sleep deprivation and minimize the risk of fatigue-related errors. In addition to recommending opportunities for on-duty sleep during long duty periods and breaks for sleep of appropriate lengths between work periods, the committee also recommends enhancements of supervision, appropriate workload, and changes in the work environment to improve conditions for safety and learning.

All residents, medical educators, those involved with academic training institutions, specialty societies, professional groups, and consumer/patient safety organizations will find this book useful to advocate for an improved culture of safety.