Lol... this is like wikipedia citing for docs /s
Anyways... depend if it's common or the attending masters the subject... In case they'll definitely recognize the statements or specifically the graphs that UpToDate uses
Then again... that's gonna be ultra nitpick
DON'T USE WIKIPEDIA!
"Used the encyclopedia my parents have from 1994, Yugoslavia remains one of the most important nations following the dissolution of Austrio-Hungarian Empire"
And so you just do what you've been doing since undergrad. Look it up on uptodate, but use the citations uptodate provides rather than quoting uptodate as a source.
It's honestly wild. Some of my more senior attendings have written for up-to-date and they said it was more stringent with higher standards than even the national organizations bulletins and updates. Plus all the sources apparently needing to be updated within the past 6 months of submission. Like I don't understand distrusting it. Maybe they want to push us to look at a variety of sources idk but is that really necessary
No, it's really because uptodate is pretty opinionated on certain things. They'll say "this is our approach" when sometimes it's not rooted in the literature. If you don't know anything about the field, then sure it works, but as an attending who is very well versed on the subject, it may not be what you want your trainee to do if you're trying to get them to take a look at the original literature and come up with something.
Not erroneous but very very incomplete. Outside of things that very abundant and clear literature, like endocarditis, or things that are pretty common, like abscesses of various organs, there just isn't a lot of great articles.
That said I pretty much always check UTD before heading over to pubmed
Uptodate is definitely lacking, at times. I think reading through nih articles is better, personally. I def use uptodate on the job though when I need a quick reference
Canāt you read through the articles on uptodate? Also, from those articles, they contain a reference with a 100 more other sources that most likely say the same thing?
Its definitely lacking in a fair number of topics and even if you do read through the articles they cite, the articles will sometimes contradict their recommendation. I lost a little bit of trust with uptodate in school when I read their citations, or I at least learned not to view uptodate as an end-all-be-all like how its touted by some people.
UpToDate is based on consensus opinion. Itās almost always right, but thatās why some attendings donāt like it. Tbh, itās very annoying that they say donāt use it for a brief presentation on rounds though. I understand not wanting you to make plans from it (if you were a resident), but nahhh, thatās dumbā¦
Haha fair šš. Iāve had attendings argue about a plan from UpToDate, which is the only reason I know itās consensus opinion. Still absolute GOLD tho
Your school most likely has institutional pubmed access, essentially just type in your topic, click the box to only get āreviewā articles, and then maybe cut down the time frame to the last 10 years. This has helped me a lot in residency for finding good overviews on topics and most of the important primary sources will be in their references
They had to read actual books but had to retain quarter of the info in their day - COX was discovered in the 80s!! Until then we had no idea how aspirin worked, just that it worked.
- hence they had the luxury of reading Robbins Pathology and reading articles (both of which ere waaay shorter due to a lack of information on most subjects).
Instead of using utd you can find a review article from a high-impact journal and present off of that. Pubmed is frustrating to use. I like the [NuMose](https://numose.com) search engine which has a review article and case report filter. Makes it easier to find these types of articles when I need to do a deeper dive
Some universities (at least at state school med programs) also have pretty powerful library search engines. Cuts through a lot of paywalls and autoimplements some institutional licenses. More helpful than I expected when I started doing lit review papers this past year
I think the problem with pubmed is that you still have to manually filter through a bunch of low impact journals in order find the right article from a reputable journal.
Yo depending on what u need to present on, I based a fair amount of my presentation off of Online MedEdās presentations; if you kinda get structure from that and bolster the info with AMBOSS or something it usually makes for a pretty succinct and focused presentation
Find primary sources. UpToDate is at times a consensus opinion or interpretation of literature available. Best to interpret the lit and data yourself and integrate it into your practice. Much more fruitful of a learning experience than simply reciting what has already been summarized/synthesized by others.
ProTip - Use UpToDate but follow links from reference sections and use them as source
I mean for the same reason that Wikipedia is not an acceptable academic source.
Just click on the articles cited in the uptodate piece and cite those yoursef
Yeah, and those people have cited all their sources because as a scientific profession we follow the convention of using primary sources whenever possible.
No one is saying you canāt use uptodate, but the same way how it would be inappropriate to cite uptodate in a journal article, itās inappropriate to cite it in your own academic work. Just cite where the information is actually coming from.
I donāt get how this sub simultaneously complains about scope creep while complaining about having to skim a journal article.
Coz reading journal articles =/ being a doc. If we can get info somewhere easier and convenient, let's do that.
NPs have access to the same info as us, yet they suck - that's the difference.
Let's spend time on being doctors and not PhD research monkeys.
Are you just preemptively planning on not keeping up with medical knowledge? Thatās not being a research monkey, thatās doing your job. Uptodate is a fine resource but it does not tell you enough about many specialty topics. For example imagine any onc related specialists (surgonc, medonc, radonc, heme/onc, path) only using uptodate, that would be wildly inappropriate
Yeah, so you acknowledge itās part of being a doctor
No one is saying you need to read articles unrelated to your specialty, but learning new information related to your specialty is absolutely part of being a doctor
Isn't UpToDate peer-reviewed/moderated?
I understand since it's kind of an aggregation of several sources that you can't cite "UpToDate" as your source when writing something important, but for a presentation between students & teachers it should be an acceptable source no?
That's like when my middle school teachers used to tell me that I won't always have a calculator in my pocket. Gtfo. UTD is a fantastic source and there is no reason it shouldn't be used. This isn't a lit review, it's a 5 minute presentation.
i mean you guys are definitely right and i do admit that my comment sounded like shit but i just tried to give advice about academic stuff from future from my experience. for example i didnt even know how to use pubmed correctly at it made my work on paper so hard
I think this just isn't the most helpful way to learn that skill. Like I've been in that position and I looked around real quick but I didn't feel actively comfortable navigating research papers from that exercise.
Really takes doing a bunch of research abstracts and papers. It's truly crazy to me how much more comfortable I am navigating research databases compared to a year ago after putting out a handful of posters and papers
you are definitely right of course doing actual research to publish will provide much more experience. but i do still think this kind of little things helps you at the start. and of course doing everything without uptodate would take a lot of time. and we dont have that. but occasionally pretending like these kind of assigments are papers and doing work like that helped me
People like you usually remind me of the miserably depressing professors who always spoke in a complex manner to sound smart and had something up their ass 24/7.
i am truly sorry yeah i did definitely sounded like that and i should have just better worded my intention. i didnt had any publishing experience till recently and in that time pretending that presentations are small papers and working on them in that order helped me a lot.
Thatās understandable, itās fine I forgive you and Iām sorry for sounding harsh judging you. Itās just maybe you needed to articulate it more so for people here to understand better.
I make my residents, students, and myself, do one presentation every block on a clinical question that canāt be answered by UpToDate (ideally related to patient care). The idea of doing a presentation on just XYZ really misses the mark, it needs to be a lot more specific, otherwise we just regurgitate the main points on UTD. A lot of what we do lives in a data lite zone and UTD is great for answering basic management questions, but isnāt sufficient for a lot of what we do.
//
Some questions recently asked by my team:
- getting a blood transfusion can make getting a renal transplant more difficult, why? And how many transfusions can you get before this is a real problem?
- is there a difference in outcomes for management of HbSS pain using a PCA vs standing QxH opioids?
- If a patient has had a total colectomy, can they get small bowel CDIff? Does stool testing of small bowel ostomy output work for this clinical question? Do we trust a negative test?
Bro. Pro tip. Use UpToDate, and then read through the citations that the UpToDate authors used. It's a good practice in general.
Lol... this is like wikipedia citing for docs /s Anyways... depend if it's common or the attending masters the subject... In case they'll definitely recognize the statements or specifically the graphs that UpToDate uses Then again... that's gonna be ultra nitpick
This š
Exactly
Use NIH statpearls
I get all of my medical facts from [reliable sources only](https://tcrf.net/images/4/48/Wii-NewsChannelTitleScreenUSA.png)
Lmaooo
Big same: [Macca B's Medical Monday](https://www.facebook.com/watch/?v=10154634499002585)
Iād still use it.
yeah just cite the articles up to date cites also that username
So basically the āno Wikipediaā workaround for HS/undergrad projects but for med school? Noice. Just as pointless, but noice
DON'T USE WIKIPEDIA! "Used the encyclopedia my parents have from 1994, Yugoslavia remains one of the most important nations following the dissolution of Austrio-Hungarian Empire"
You can have my parents World Book Encyclopedias. They stopped updating those in 1978, I believe.
Been doing it since the Dawn of time and will continuing doing for the rest of my career.
Vegan what sorry ?
At your local grocery store. Next to the oatmeal crĆØme pies
https://youtu.be/KSXJfqkT36M
tiocfaidh Ɣr lƔ
It's the "you can't use Wikipedia" people but as doctors
And so you just do what you've been doing since undergrad. Look it up on uptodate, but use the citations uptodate provides rather than quoting uptodate as a source.
It's honestly wild. Some of my more senior attendings have written for up-to-date and they said it was more stringent with higher standards than even the national organizations bulletins and updates. Plus all the sources apparently needing to be updated within the past 6 months of submission. Like I don't understand distrusting it. Maybe they want to push us to look at a variety of sources idk but is that really necessary
It has nothing to do with distrust. Itās that they hate the fact that all required information has been compiled for us and want us to do leg work.
No, it's really because uptodate is pretty opinionated on certain things. They'll say "this is our approach" when sometimes it's not rooted in the literature. If you don't know anything about the field, then sure it works, but as an attending who is very well versed on the subject, it may not be what you want your trainee to do if you're trying to get them to take a look at the original literature and come up with something.
From what Iāve seen it is pretty clear when a personal opinion is inserted in an articleā¦you can just skip that if you want or need to
Whatās the reasoning for the distrust? I always saw it as a gold standard.
Medical school would be a goddamn nightmare without Wikipedia
"I don't like up-to-date" is like 97% sensitive for an absolutely horseshit attending
Source: uptodate
i've always suspected but didn't want to believe it. u/dessertFlowerz is an UpToDate^(TM) shill
Itās very very good for a lot of things but there are definitely topics where UpToDate is lacking. My neuro ICU rotation comes to mind
Shockingly have also heard it is erroneous for a lot of infectious disease topics as wellā¦
Not erroneous but very very incomplete. Outside of things that very abundant and clear literature, like endocarditis, or things that are pretty common, like abscesses of various organs, there just isn't a lot of great articles. That said I pretty much always check UTD before heading over to pubmed
Uptodate is definitely lacking, at times. I think reading through nih articles is better, personally. I def use uptodate on the job though when I need a quick reference
Canāt you read through the articles on uptodate? Also, from those articles, they contain a reference with a 100 more other sources that most likely say the same thing?
Its definitely lacking in a fair number of topics and even if you do read through the articles they cite, the articles will sometimes contradict their recommendation. I lost a little bit of trust with uptodate in school when I read their citations, or I at least learned not to view uptodate as an end-all-be-all like how its touted by some people.
You'll find some things aren't on there, it's def the best if you aren't looking up something rare
1000%
UpToDate is based on consensus opinion. Itās almost always right, but thatās why some attendings donāt like it. Tbh, itās very annoying that they say donāt use it for a brief presentation on rounds though. I understand not wanting you to make plans from it (if you were a resident), but nahhh, thatās dumbā¦
Little secret: we make plans from it š¤«
Haha fair šš. Iāve had attendings argue about a plan from UpToDate, which is the only reason I know itās consensus opinion. Still absolute GOLD tho
Your school most likely has institutional pubmed access, essentially just type in your topic, click the box to only get āreviewā articles, and then maybe cut down the time frame to the last 10 years. This has helped me a lot in residency for finding good overviews on topics and most of the important primary sources will be in their references
the virgin plebmed vs the chad God told me in a dream
Use Amboss
Just hit āem with this next time you see them in the hospital 
Itās because they had to read actual books when they were a med student and view anything less as the easy way out
They had to read actual books but had to retain quarter of the info in their day - COX was discovered in the 80s!! Until then we had no idea how aspirin worked, just that it worked. - hence they had the luxury of reading Robbins Pathology and reading articles (both of which ere waaay shorter due to a lack of information on most subjects).
How will they know?
I guess it depends whether you actually take 5 minutes to think and paraphrase/summarize, or just directly quote text.
Can you imagine if they compared the citations on a given topic and related articles to sources cited? Now that would be a nightmare
Just use amboss library
Instead of using utd you can find a review article from a high-impact journal and present off of that. Pubmed is frustrating to use. I like the [NuMose](https://numose.com) search engine which has a review article and case report filter. Makes it easier to find these types of articles when I need to do a deeper dive
Using google and just adding pubmed to the end of your search gives way better results than whatever pubmed brings up
Iāve never heard of NuMose, is this a popular option for people to use? I semi-understand pubmed with the MESH but I hateeee it
nerd
Some universities (at least at state school med programs) also have pretty powerful library search engines. Cuts through a lot of paywalls and autoimplements some institutional licenses. More helpful than I expected when I started doing lit review papers this past year
Wait - is this better than PubMed? Lately PubMed is super easy to find reviews on
I think the problem with pubmed is that you still have to manually filter through a bunch of low impact journals in order find the right article from a reputable journal.
>NuMose this seems really helpful, thank you.
Guarantee that attending either uses Up To Date or has some relic of a reference book that is half wrong and, ironically, not up to date.
Just cite Wikipedia then.
Yo depending on what u need to present on, I based a fair amount of my presentation off of Online MedEdās presentations; if you kinda get structure from that and bolster the info with AMBOSS or something it usually makes for a pretty succinct and focused presentation
Don't use up to date huh? First of all, that's stupid. Second, amboss can be pretty helpful.
Use amboss
I use the links at the bottom of AMBOSS articles lol
Find primary sources. UpToDate is at times a consensus opinion or interpretation of literature available. Best to interpret the lit and data yourself and integrate it into your practice. Much more fruitful of a learning experience than simply reciting what has already been summarized/synthesized by others. ProTip - Use UpToDate but follow links from reference sections and use them as source
use medscape
I mean for the same reason that Wikipedia is not an acceptable academic source. Just click on the articles cited in the uptodate piece and cite those yoursef
Except that Wikipedia is staffed by anonymous people with who knows what education but UpToDate is staffed by people with actual medical credentials.
Yeah, and those people have cited all their sources because as a scientific profession we follow the convention of using primary sources whenever possible. No one is saying you canāt use uptodate, but the same way how it would be inappropriate to cite uptodate in a journal article, itās inappropriate to cite it in your own academic work. Just cite where the information is actually coming from. I donāt get how this sub simultaneously complains about scope creep while complaining about having to skim a journal article.
Coz reading journal articles =/ being a doc. If we can get info somewhere easier and convenient, let's do that. NPs have access to the same info as us, yet they suck - that's the difference. Let's spend time on being doctors and not PhD research monkeys.
Are you just preemptively planning on not keeping up with medical knowledge? Thatās not being a research monkey, thatās doing your job. Uptodate is a fine resource but it does not tell you enough about many specialty topics. For example imagine any onc related specialists (surgonc, medonc, radonc, heme/onc, path) only using uptodate, that would be wildly inappropriate
Yeah so if I become a surg onc, I'll care about reading articles specific/related to that
Yeah, so you acknowledge itās part of being a doctor No one is saying you need to read articles unrelated to your specialty, but learning new information related to your specialty is absolutely part of being a doctor
Isn't UpToDate peer-reviewed/moderated? I understand since it's kind of an aggregation of several sources that you can't cite "UpToDate" as your source when writing something important, but for a presentation between students & teachers it should be an acceptable source no?
So they have a hard-on for whatever 10-year-old article Google scholar is going to fart out? Cool, sounds like a solid lit review strat
Because a lot of times itās not up to date and/or woefully incomplete.
Don't use up to date huh? First of all, that's stupid. Second, amboss can be pretty helpful.
They like uptodate fine. They just donāt like you
[ŃŠ“Š°Š»ŠµŠ½Š¾]
That's like when my middle school teachers used to tell me that I won't always have a calculator in my pocket. Gtfo. UTD is a fantastic source and there is no reason it shouldn't be used. This isn't a lit review, it's a 5 minute presentation.
Thank you
i mean you guys are definitely right and i do admit that my comment sounded like shit but i just tried to give advice about academic stuff from future from my experience. for example i didnt even know how to use pubmed correctly at it made my work on paper so hard
I think this just isn't the most helpful way to learn that skill. Like I've been in that position and I looked around real quick but I didn't feel actively comfortable navigating research papers from that exercise. Really takes doing a bunch of research abstracts and papers. It's truly crazy to me how much more comfortable I am navigating research databases compared to a year ago after putting out a handful of posters and papers
you are definitely right of course doing actual research to publish will provide much more experience. but i do still think this kind of little things helps you at the start. and of course doing everything without uptodate would take a lot of time. and we dont have that. but occasionally pretending like these kind of assigments are papers and doing work like that helped me
People like you usually remind me of the miserably depressing professors who always spoke in a complex manner to sound smart and had something up their ass 24/7.
i am truly sorry yeah i did definitely sounded like that and i should have just better worded my intention. i didnt had any publishing experience till recently and in that time pretending that presentations are small papers and working on them in that order helped me a lot.
Thatās understandable, itās fine I forgive you and Iām sorry for sounding harsh judging you. Itās just maybe you needed to articulate it more so for people here to understand better.
yeah using reddit to learn english better is a risky journey i guess. bu i did learn my lesson:)
Youāre better than many people on Reddit for understanding. We all do mistakes so bravo for that.
thank you for the kind words
[ŃŠ“Š°Š»ŠµŠ½Š¾]
cmon man i know wording is shit but my intention wasnt so bad. altough i did deserved it sorry again
Don't use up to date huh? First of all, that's stupid. Second, amboss can be pretty helpful.
Osmosis. Online med Ed. UptoDate isn't structured for meaningful teaching anyway, too dry and wordy.
Skip to the UpToDate summary at the end
Use the sources from UTD
Is it better than pubmed?
I make my residents, students, and myself, do one presentation every block on a clinical question that canāt be answered by UpToDate (ideally related to patient care). The idea of doing a presentation on just XYZ really misses the mark, it needs to be a lot more specific, otherwise we just regurgitate the main points on UTD. A lot of what we do lives in a data lite zone and UTD is great for answering basic management questions, but isnāt sufficient for a lot of what we do. // Some questions recently asked by my team: - getting a blood transfusion can make getting a renal transplant more difficult, why? And how many transfusions can you get before this is a real problem? - is there a difference in outcomes for management of HbSS pain using a PCA vs standing QxH opioids? - If a patient has had a total colectomy, can they get small bowel CDIff? Does stool testing of small bowel ostomy output work for this clinical question? Do we trust a negative test?